The issue is the number of medicaid / medicare patients (single payer) and the cost transfer of these poor to those who have insurance.   Alaskans are TYPICALLY charged 300-600% of medicare reimbursements.    In lower 48, typical reimbursements are about 150% of medicare. 
The massive cost shift, bloated hospital systems, and lack of innovation (due to such a small population draw) means Alaskans pay 2x the HIGHEST costs in the nation for the same procedures and facility fees..  

The state could do something VERY simple..  Require all networks to post CMS pricing and their pricing on a website....  at that point, it will become VERY apparent of where your cost drivers are..  IN WA there is a law calling for cost transparency; Alaskans should have the same... http://www.ofm.wa.gov/healthcare/pricetransparency/