@MrMoose63 - Welcome to our forum! I’m glad you found us. 
If you don’t hear anything back from Dr. Costantino’s office by the end of next week, call again. “It’s the squeaky wheel that gets the grease”. Many of our members have found they have to self advocate to get the care they need & part of that is staying on top of doctors offices where you’d like to have a consult when you don’t hear back w/in a reasonable amount of time.
We have numerous members whose medical insurance only covered doctors w/in their states but who appealed that rule when there were no doctors in their states who did the specific surgery they needed. Dr. Costantino’s & possibly Dr. Liu’s offices are accustomed to working with patients who are dealing w/ that problem though the bulk of the work will be on you to get out of state approval.
Many medical insurance companies have a patient advocate who works for them. You should check into this as that’s the person you would work with to appeal for coverage for an out of state surgery. Some members have gone as far as reaching out to their state’s board of health insurance to get help after receiving continual denials to appeals.
Here’s a link to @lilwider’s journey - Update ....final appeal
and one from @vcp02 -
and finally from @Chrickychricky -
If filing an appeal with your insurance company feels like too big of a project for you at this time, then waiting till next year for better insurance would be your best bet. As @Jules said, this isn’t a surgery you want to have to re-do if it’s not done correctly the first time.