@pefishback I was thinking a "second opinion" would only entail Mayo reviewing your case and giving their advice to your primary Dr. to follow their advice. I interpret from your comment, you will actually get your treatment at Mayo if approved by your insurance. Is that correct?
Because my case is so complex and rare, I was thinking my primary may recommend I do A, B, & C. Then I would ask for a second opinion and Mayo would say in their view, it would be better if my primary treated me by doing X, Y, & Z.
I know from experience, that my Dr./insurance has no problem saying that they are using the standard of care and I need to follow their recommendations. I don't think they give the option of going along with outside advice and having me sign a waver.