Breast Reduction Cost & Insurance Coverage

The cost of breast reduction can vary from very little in the way of out of pocket expenses, with insurance covering the majority of the costs, to as high as approximately $10,000 to $15,000 if there are no insurance benefits available.

Generally speaking, there are three costs associated with any surgery.

The first cost is the facility fee. The facility is the actual location where the surgery will be performed.

This may be a hospital, outpatient facility or private operating room.

The costs associated with these locations range from being very expensive at many hospitals to much more reasonable at outpatient facilities and private offices.

I try to give people an idea of what each cost is.

A Surgeon’s Cost For Breast Reduction Surgery May Be Based On His Or Her Experience

Make sure that wherever you have your procedure that you verify that the facility is “accredited”. Some common accrediting organizations are “Medicare Approved”, “JCAHO Approved” or “AAAASF Approved”. There are other legitimate accrediting agencies as well.

Facilities with any of these accreditations are heavily monitored and scrutinized by the state and the Federal government and are generally safe. Please ask this question if you are considering having surgery in a private office or some place where there is no obvious hospital affiliation.

These costs are rigid but should be very transparent based on the amount of time needed for the surgery. The second cost is the anaesthesia fee. Again, these fees vary based on geographic location as well as who is performing the anaesthesia for the procedure.

You should make sure that your anaesthesiologist is Board Certified by the American Board of Anaesthesia. There are now C. R. N. A.’s (Certified Registered Nurse Anesthetists) who are responsible for the anaesthesia being performed at certain facilities.

Breast Reduction And Health Insurance

Use of C. R. N. A.’s is certainly within the scope of practice. Again, C. R. N. A.’s are not M. D.’s.

However, they have undergone appropriate training and have specific certification requirements through the National Board of Certification and Recertification for Nurse Anesthetists that you may ask your surgeon about and verify on-line.

I have worked with many C. R. N. A.’s in the past and have been very impressed with their abilities. That being said, the anaesthesia fee is also very regimented and is based on the amount of time needed to perform the case.

Breast Reduction Costs Can Vary Widely

The third cost is the surgeon fee. You will see these fees range from very low ($1,000 to $2,000) to as high as $10,000 to $15,000. This is a fee which is set by each individual surgeon’s practice and is not always set in stone.

The best advice that I can give regarding this last piece of the cost of surgery is to look at credentials and go with your gut feeling about the provider. If the deal seems to good to be true it probably is.

I have taken care of a number of people who have had unfortunate outcomes just to save a few thousand dollars. Meet with the surgeon and ask questions. Ask about Board Certification.

Make sure that the surgeon is certified by The American Board of Plastic Surgery and that he or she is in good standing with the Board.

Breast Reduction Costs May Include Anesthesia Fees

The process of getting Board Certified by The American Board of Plastic Surgery is long and very difficult. Please do not be fooled by other “Board Certifications”.

There are many Boards that sound very legitimate but can be obtained with little to no training and little knowledge of the field and practice of plastic surgery.

In summary, the cost of breast reduction varies greatly for the reasons described above, If you find a Board Certified plastic surgeon with whom you feel comfortable and have your surgery performed in an accredited facility by a licensed.

Certified anaesthesia provider you are giving yourself the opportunity for the safest and most ideal outcome possible.

The people in my practice who have undergone breast reductions are the happiest people in my practice. To me, talking with them after their surgeries and hearing how their lives have changed for the better is the best part of the process. (Kyle A. Belek, MD, Bay Area Plastic Surgeon)

How Much Does A Breast Reduction Cost

There are two basic costs in breast reduction surgery – the cost of the hospital stay/operating theatre and the cost of the specialists involved in your procedure (the surgeon and the anaesthetist). In Australia, part of the fees charged by your specialists will be covered by medicare.

If you are in a health fund, your fund may cover even more of these fees (the difference between what medicare and your fund will cover and what the surgeon/anaesthetist charges is called the “gap”).

Your fund may also cover your hospital stay/surgery. To get an accurate quote for surgery, you need to find out which item numbers are relevant to your planned procedure (your plastic surgeon will advise you of this following a consultation).

Many Health Insurance Plans Cover Breast Reduction Surgery

Your plastic surgeon will also give you a quote for their “gap” and the anaesthetists “gap”. (Damian Marucci, MBBS, PhD, FRACS, Sydney Plastic Surgeon)

The cost of breast reduction can vary function of a number of reasons, risks, duration and cover by your private health fund. Our surgery charges from 6000 AUD and our fees include all postoperative care, until full healing is achieved, even in a context of delayed healing.

We also include Healite II from Lutronic, routinely in our postoperative care. It is also a reduced fee for uninsured patients with special circumstances, of 10,000 AUD all inclusive. (Carmen Munteanu, MD, FRACS, Melbourne Plastic Surgeon)

Breast reduction surgery is often covered by certain medical insurance companies. Although the size of the breasts is taken into account, as is back pain and neck pain, patients also have to meet criteria according to a Schnur scale.

The Average Cost Is $6,000-plus

This scale evaluates your body surface area and the amount of breast tissue that is planned on being removed. If you do not qualify for insurance coverage, it does not mean that you are not a good candidate or that you would not benefit from the surgery.

Unfortunately, it would mean that it would be an out of pocket expense. The cost of breast reduction surgery ranges from state to state.

A common range for this area of the country is about $7800 for the procedure, which includes the surgeon’s fee, the facility fee, anesthesia, and post operative garments and care. (Emese Kalnoki, MD, Rochester Physician)

At our center we charge between $2500 to $3500 Or 150000 to 200000 INR. This is inclusive of surgeon fees, Anaesthetist fees and hospital fees. (Jayanthy Ravindran, MS, DNB, MRCS, India Plastic Surgeon)

Breast Reduction Costs May Include Hospital Or Surgical Facility Costs

Breast reduction is a commonly performed procedure helping women minimize back, neck and shoulder pain due to excessively large breasts. You may be able to have your surgery covered by your insurance company assuming you meet their criteria.

In that case you would only be responsible for your copay and deductible fees as outlined by your insurance plan. If you are not eligible for insurance coverage then you are paying the surgical, facility, and anesthesia fees.

These fees will vary from region to region and will depend on the efficiency of your plastic surgeon.

An efficient surgeon will take less time and thus save you money. Surgeons fees for breast reduction in the Midwest range from $3000 to $5000.

Remember you might be able to use your flex plan or health saving account money for your surgery too. (Brian Kobienia, MD, Edina Plastic Surgeon)

Breast Reduction Costs May Include Medical Tests

Your insurance may cover a breast reduction if you have enough symptoms with back pain and rash and irritation. They often cover anesthesia as well. An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice. (Michael M. Omidi, MD, FACS, Beverly Hills Plastic Surgeon)

Typically for plans that cover breast reduction, it is covered in patients who have documented back and neck pain , large breasts, and patients have typically tried non-surgical options such as supportive bras, NSAIDs, and chiropractic treatment.

However in this day and age some plans exclude breast reduction as a covered procedure. This is unfortunately increasingly common. This being said, if you are going to pay out of pocket for the procedure, cost will vary based on surgeon, hospital performed, and region in which you live.

Getting A Breast Reduction Cost

Make sure you ask if anesthesia and hospital fees are included because you will need to factor all these in the total costs. Anywhere from $6000 to $9000 would be a typical range. (Kailash Narasimhan, MD, Sherman Plastic Surgeon)

At Plastic Surgery Institute of Southeast Texas, the cost for a Breast Reduction starts at $8,400. We offer two different financing options. This cost includes the surgeon, facility, anesthesia (MD), supplies, and all post op visits.

Most of our cosmetic surgeries are done at our private surgical suite. Schedule your next consultation with a Board Certified Plastic Surgeon to give you a more accurate quote. (Leo Lapuerta, MD, Houston Plastic Surgeon)

Miami Breast Reduction

Because Miami is a competitive market, you tend to find lower costs than other parts of the country. Currently you can find breast reduction surgery anywhere between 4500-10000. This depends on whether you are going to a clinic or a private office. (Sergio Alvarez, MD, Doral Plastic Surgeon)

What Does A Breast Reduction Cost

Breast Reduction Cost vs Insurance Coverage

While insurance companies have definitely become much more stringent with approving medical necessity for a breast reduction procedure, you should not count this option out until a board certified plastic surgeon has submitted a case to your insurance company on your behalf and received a denial.

Every insurance company has set forth guidelines and criteria that must be met in order for medical necessity to be considered and this often requires photographs and letters from other physicians across different specialties attesting to failed past conservative management.

Like other cosmetic surgical procedures, the cost for a breast reduction will vary depending upon where you live, the procedure in question, reputation and experience of the operating surgeon and location of the surgery (out patient ambulatory center or hospital setting).

Compare The Cost Of Breast Reduction

One of the most important considerations and something that I would highly stress to you is the importance of seeking out a board certified plastic surgeon who you trust and who specializes in breast reduction procedures.

In New York, for example, the average cost for a breast reduction is between $10,000 to $12,000. Keep in mind that the best deal is not always the best option. (Stephen T. Greenberg, MD, Woodbury Plastic Surgeon)

The cost of breast reduction will need to factor in the cost of anesthesia, facility and surgeon’s fee and the overall time it takes to the procedure. The cost can vary from $6K to 10K depending on what is involved with the procedure. (Young R. Cho, MD, PhD, Houston Plastic Surgeon)

The Breast Reduction prices really range in price. Depending on the location, the surgeons expereicne and how much skin/excess tissue has to be removed. For instance, we include the OR & Anesthesia with the cost of the procedure, however, not every surgeon does this that is why it’s important to have a breast down of all the costs when consultation with a physician. (Leonard Hochstein, MD, Miami Plastic Surgeon)

Breast Reduction Prices in Montreal, Laval, Quebec, Canada

Surgeon’s Fee

In Quebec breast reduction is covered by the Universal health care plan for Quebec residents as long as 250g are removed from each breast.

The key is to choose a board certified plastic surgeon by the royal college of surgeons of Canada when living in Canada and a surgeon with the expert training in such surgery. Having a one year fellowship in Aesthetic surgery goes a long way.

And as importantly, you as a patient must “click” with your surgeon and establish a comfortable rapport. (Hani Sinno, MD, Montreal Plastic Surgeon)

Each individual requires a different surgical plan and each surgeon charges a bit differently. If you dont have insurance or your breasts dont fit the requirements for insurance, then you should consult with a few surgeons in order to compare and contrast styles and prices. (Payman Danielpour, MD, FACS, Beverly Hills Plastic Surgeon)

Generally speaking the prices start with 6500 and up- depending on how much time the operation will take,the experience of a surgeon and all the other people required to deliver a service. (Thomas Trevisani, Sr., MD, Orlando Plastic Surgeon)

2 Comments

  1. Kimm says:

    Where is the best place to get surgical bra?

    • Melany says:

      I was sent home in one. But only had to wear it for a few days. Then I bought a sports bra Fruit of the Loom or Hanes at Walmart that’s hooks in the front. You really don’t need a surgical bra just one with good coverage but not too tight.