Illustration: Lazaro Gamio/Axios

Even patients who plan elective surgeries with in-network doctors at in-network facilities have a pretty good chance of receiving a surprise medical bill, according to a new JAMA study.

Why it matters: Surprise bills are a problem for the patients who receive them, but also for the system as a whole, as they drive up overall health care costs.

The study found that 20.5% of elective surgeries — procedures like hysterectomies and knee replacements — performed at in-network facilities and by in-network primary surgeons resulted in an out-of-network bill.

  • These bills came from providers who patients usually have no hand in choosing, like surgical assistants, anesthesiologists and radiologists.

Details: These bills ranged, on average, from less than $100 to several thousand dollars, depending on the specialty and the procedure.

  • The average potential balance bill was $2,011.
  • The largest potential bills tended to be from surgical assistants and anesthesiologists, which also were the most frequent sources of out-of-network bills.
  • The South and Northwest had particularly high rates of these bills.

Go deeper: We all pay for surprise emergency room bills

Go deeper

Updated 30 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 7 p.m. ET: 19,486,171 — Total deaths: 723,599 — Total recoveries — 11,822,887Map.
  2. U.S.: Total confirmed cases as of 7 p.m. ET: 4,989,976 — Total deaths: 162,304 — Total recoveries: 1,643,118 — Total tests: 61,080,587Map.
  3. Politics: Trump signs 4 executive actions on coronavirus aid.
  4. Public health: Fauci says chances are "not great" that COVID-19 vaccine will be 98% effective — 1 in 3 Americans would decline COVID-19 vaccine.
  5. Science: Indoor air is the next coronavirus frontline.
  6. Schools: How back-to-school is playing out in the South as coronavirus rages on — Princeton, Johns Hopkins, Howard to hold fall classes online.

Trump signs 4 executive actions on coronavirus aid

President Trump speaking during a press conference on Aug. 8. Photo: Jim Watson/AFP via Getty Images

President Trump on Saturday signed four executive actions to provide relief from economic damage sustained during the coronavirus pandemic after talks between the White House and Democratic leadership collapsed Friday afternoon.

Why it matters: Because the Constitution gives Congress the power to appropriate federal spending, Trump has limited authority to act unilaterally — and risks a legal challenge if congressional Democrats believe he has overstepped.

6 hours ago - World

What's next for Lebanon after the Beirut explosion

Photo: Houssam Shbaro/Anadolu Agency via Getty Images

Beirut residents are still clearing rubble from streets that appear war-torn, days after a blast that shocked the country and horrified the world.

Why it matters: The explosion is likely to accelerate a painful cycle Lebanon was already living through — discontent, economic distress, and emigration.