Chhabra KR, et al. - This study was conducted to investigate out-of-network billing across common elective operations performed with in-network primary surgeons and facilities. Between January 1, 2012, and September 30, 2017, Researchers designed a retrospective analysis including claims data from a large US commercial insurer, representing 347,356 individuals who had undergone 1 of 7 common elective operations (arthroscopic meniscal repair [116 749]; laparoscopic cholecystectomy [82 372]; hysterectomy [67 452]; total knee replacement [42 313]; breast lumpectomy [18 018]; colectomy [14 074]; coronary artery bypass graft surgery [6378]) by an in-network primary surgeon at an in-network facility. A substantial proportion of operations were correlated with out-of-network bills in this retrospective analysis of commercially insured individuals who had experienced elective surgery at in-network facilities with in-network primary surgeons.