Can i tell me if i am at high risk for breast cancer but don't have it, would the surgery be completely out of pocket?

Good question: Depends on your insurance and what you consider "high risk". For example, a patient with a brca mutation usually can get preventative mastectomies covered. Your doc could consider sending you to a specialist in risk assessment who will estimate your cancer risk using one of several models. If the risk is high enough, it may justify the surgery.