Out of pocket question

I know that after my 500 deductible I am responsible for 10% of the remaining reasonable and customary charges for my procedure.  Does anyone know what reasonable and customary according to Aetna in the Dallas area?  Or do you know where to find out?  I have the CPT code but I have not been able to find out so far.

 

Thoughts?

I would suggest calling Aetna, they should be able to tell you, reasonable and customary means the "going or negotiated" rate between Aetna and area DR's - hospitals. LOL Jen

Your post is confusing to me.  Usual and Customary means it's an out of network provider and it does not sound right that your coinsurance would be 10% for an out of network provider.  10% is usually for inn network providers and if so then it would be 10% of the allowable and insurance would pay 90@ of the contracted amount.  I never heard of out of network insurance plan that pays 90% for out of network, are you sure?  If it's in the network then charges are based on a contractual agreement not u&c.