It is great that your insurance has approved your panniculectomy! This procedure will definitely help reduce rashes and irritation on the pannus - "apron" crease area. If you would like to have a tummy tuck added the cost, the cost will vary depending on the following things: 1) the additional time required to complete your tummy tuck and panniculectomy surgery 2) the amount of additional surgical work that must be done and whether your surgeon is in or out of network with your insurance carrier. The average cost for a tummy tuck is $8000 but a massive weight loss patient usually requires additional muscle tightening and skin removal horizontally and sometimes vertically. I would also like you to understand that in the massive weight tummy tuck result can be associated with more complications and thus the cost maybe higher.Try to ask your physician to give you multiple surgical tummy tuck options and prices. Lastly, please check the excluded benefits in the contract of your insurance policy. Periodically, the insurance company approves a panniculectomy only to deny the procedure after the surgery because the procedure was an excluded benefit, If the procedure is not in the excluded benefit clause of your insurance contract ask that a copy of your insurance contract be mailed to you so that you can be sure that the insurance company holds up their responsible to pay for your procedure. Success to you on your plastic surgery journey!