I’m sure Dr. Samji has had patients pay out of pocket, & I know for a fact he’s seen Medicare patients from other states. Medicare requires surgery to be done in a hospital w/ an overnight stay. There is no insurance that I know of that has a procedure code for a styloidectomy. Dr. Samji bills ES surgery as a craniectomy. Your current Medicare plan may pay for that. I don’t think he gives a cash discount for a video consult, but he/his business ofc does for surgery. Snapple2020 wrote a long explanation about how to negotiate w/ the business office, hospital/surgery center &/or doctors themselves to get a lower price if you’re a cash paying patient. It’s embedded in a recent thread. I’ll try to find it & send you a link.
He won’t accept a cone beam scan for sure so get well soon so you can have your CT scan done.
I’m really sorry you’re sick again. Sending you a hug. 
Found it! Cost for Canadian to travel to US for surgery? - #8 by Snapple2020