go back

Alaska rates for HCPCS 33694

Complete repair tetralogy of Fallot without pulmonary atresia; with transannular patch

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,605.58 / $10,900.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,934.04 / $10,766.66 / $10,766.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,591.32 / $6,591.32 / $6,591.32
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,356.61 / $10,766.66 / $15,396.32
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,653.05 / $10,069.50 / $15,462.66
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,192.50 / $8,343.29 / $12,646.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,356.61 / $10,766.66 / $15,396.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,885.61 / $8,476.50 / $12,958.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,273.06 / $7,909.59 / $12,179.60