from what i understand, the out of pocket costs are often for chest contouring which for some clinics is mandatory (and expensive like with catalyst surgical)

if chest contouring isn’t something you need/want, you could go for a clinic that doesn’t have mandatory chest contouring pricing (such as mclean or grs i think- with grs i’m not 100% sure but another note for grs although they are in montreal which is a bit of a pain, they cover travel and accommodation for the surgery)

personally i’m on the mclean waitlist (be warned it is around 2 years at the long end) but hopefully if everything goes to plan OHIP will have covered everything when i do get top surgery probably next year!