News Center

Originally published in The Tennessean, November 2025

If you or a loved one has ever needed surgery, you know the personal costs can add up quickly, sometimes in unexpected ways. From the operating room to anesthesia, post-operative care, and even time away from work, the expenses can be significant. These costs sometimes even lead people to delay or avoid seeking care.

In my own family, both my son and daughter recently needed emergency appendectomies just weeks apart. It was a reminder to me that these procedures are more common than we think. And they’re increasingly performed in outpatient settings.

Since 2021, we’ve seen a steady shift: inpatient surgical admissions have remained relatively flat, but outpatient procedures for common surgeries like knee and hip replacements, gallbladder removal, and appendectomy, have increased significantly. And advanced techniques and technology can be more expensive. So, the average cost of these procedures continues to rise, too.

For example, outpatient knee replacements increased by over 45% from 2021 to 2024, and the average cost per procedure rose by nearly $800. And as our population continues to age, we’re seeing higher overall utilization add to these trends.

You may be wondering why these trends should matter to you, especially if you don’t have a health issue that could require surgery. And insurance is designed to spread risk and cost across all members who pay those premiums. The bottom line is when health care costs go up, so do insurance premiums.

For employers who offer health coverage to their employees, this means higher costs for both them and their employees (who also pay a portion of the overall cost for the company’s health insurance). For individuals, it can mean higher monthly payments and bigger bills when care is needed.

What can be done?

It’s important to remember that surgery is rarely a one-time expense. Follow-up visits, medications, and recovery time all add to the total cost. At BlueCross BlueShield of Tennessee, our purpose is to help control rising health care costs for our members; while ensuring they have access to quality care. That’s why we work hard to negotiate and build networks that keep costs as low as possible.

We’re committed to helping members navigate these choices. Here’s how those efforts can impact our members and customers in real time.

• Having cost estimates up front: Our price transparency tools let members see estimates of what they’ll pay before surgery, so they can plan ahead and avoid unexpected bills.
• Get the best care at a negotiated price: We work with doctors and hospitals who focus on delivering great results, not just doing more procedures, so members can get high-quality care at a more affordable price.
• One simple bill: For certain surgeries, we worked with Ascension St. Thomas to develop a single, bundled price that covers everything related to necessary procedures. This bundling can mean fewer bills and lower, more predictable costs for our members.
• Lower-cost options: Members can contact us for help finding top-rated providers in our network who offer the same procedures at a lower cost – saving members money without sacrificing quality.
• Protection from unnecessary costs: Our clinical care management team works with members and doctors to ensure surgery is the right choice. Sometimes, less invasive options may be available.

Even if you don’t need surgery today, rising health care costs affect everyone’s premiums. By understanding what drives these costs, and what solutions are available, you can make informed choices about your coverage and care.