Doctor's salaries and the fees they charge may be the major reason of elevated health care costs in the United States compared with other developed countries, according to a new study.

Primary care doctors and orthopedic surgeons earned an average of $187,000 and $442,000, respectively, in 2008, about one third more than their counterparts in Australia, Canada, France, Germany and the United Kingdom

Their earnings are reportedly from charging higher fees and not from seeing more patients or using more expensive treatment, the study from Columbia University found.

“With the recession we have right now, there are a lot of questions about whether physician fees can continue to go up at the pace they have,” Miram Laugesen, the study's lead author told MSNBC. “We can’t say what is the right amount to pay. But we can certainly shed some light on what is going on.”

Moreover, the study found that doctors in the U.S. who specialize in a specific field earn far more money than a primary care physician.