Don’t forget that pretty much all software that touches medical data will have to go through various approval and regulatory processes. Which sometimes take up even more time than actually writing the software. Hence high costs in this industry.

It is true for actual patient touching software/hardware but it doesn't stop there. If the licence for a single scanner the lady on the registration uses to scan your referral sheet is 500€, than it's clear that this is a "because we can" price and not something which would have some real life connection.