Breast Reduction Q&A
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Average Allowable Amount for Breast Reduction

asked 10 months ago by pp6451 in Galivants Ferry, SC
Latest answer by John Whitt, MD
Question viewed 128 times
Tags: Blue Cross/Blue Shield, costs

I have Blue Cross/Blue Choice of Sc breast reduction surgery is covered if I meet criteria, which I do. I have contacted an in-network Dr. surgeon fee is $4900, the facility fee is $800, anesthesia $580 is not covered. I must pay $250 deductable, $100 co-pay, $580 anesthesia, and 15% of the allowable amount. Neither the Dr. office or my insurance will tell me what the allowable amount is. Is there an average percent reduction off of the original surgeon's fee?

2 answers to Average Allowable Amount for Breast Reduction

+1

Allowable Fees For Breast Reduction

The fees which insurance companies pay plastic surgeons for breast reductions is typically quite low, especially for a procedure which is quite time comsuming. I have never practiced in South Carolina, but I doubt that there is a great difference in the allowable fees between there and Kentucky. Therefore, my guess is that the allowable would be $1,300-2,000. If you look around, you probably can find a hospital and anesthesiologist who participate with BC/BS which would... more
John Whitt, MD

Louisville Plastic Surgeon
+1

Breast Reduction Surgery

Unfortunately, insurance companies are difficult to work with when you are trying to get an exact number that they will pay. They usually do not want to commit to anything prior to surgery. Sorry that I cannot assist you further, we have had similar issues and it’s hard to predict.
Tom J. Pousti, MD

San Diego Plastic Surgeon

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