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Repair of Tetralogy of Fallot

Indiana rates for HCPCS 33694

Open-heart surgery for a child born with tetralogy of Fallot, a combination of heart differences in which a hole between the lower chambers and a narrowed route to the lungs together mean too little blood reaches the lungs. The hole is closed with a patch and the narrowed outflow is enlarged so blood can flow properly to the lungs.

Rates data updated October 2026.

How much does Repair of Tetralogy of Fallot cost?

$3,020

Typical negotiated rate. In Indiana, October 2026.

Insurers have agreed to pay about $3,020 for this service. The price depends on where it is billed: about $2,630 from a physician practice, and about $7,079 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2,630$2,188 to $3,020
FacilityA hospital or hospital-owned outpatient department$7,079$1,514 to $25,704

How much rates vary

Facilitymedian $7,079 · 10th to 90th $676 to $43,652Professionalmedian $2,630 · 10th to 90th $1,738 to $3,981
$500$1K$2K$5K$10K$20K$50Kfacility $7,079professional $2,630

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$2,187.76
Median
$3,467.37
Typical High
$5,011.87
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,949.84
Median
$2,187.76
Typical High
$2,398.83
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$1,445.44
Median
$21,877.62
Typical High
$45,708.82
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$1,621.81
Median
$3,019.95
Typical High
$4,073.80
Anthem BCBS
Setting
Professional
Modifier
62 · Two surgeons
Typical Low
$1,023.29
Median
$1,905.46
Typical High
$2,570.40
Anthem BCBS
Setting
Professional
Modifier
80 · Assistant surgeon
Typical Low
$263.03
Median
$489.78
Typical High
$724.44
Anthem BCBS
Setting
Professional
Modifier
AS · PA/NP assist
Typical Low
$229.09
Median
$426.58
Typical High
$575.44
CareSource
Setting
Facility
Modifier
None
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$1,949.84
Cigna
Setting
Facility
Modifier
None
Typical Low
$512.86
Median
$851.14
Typical High
$2,691.53
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,905.46
Median
$2,630.27
Typical High
$4,365.16
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$2,454.71
Typical High
$5,011.87
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
None
Typical Low
$2,041.74
Median
$2,398.83
Typical High
$3,162.28
United
Setting
Facility
Modifier
None
Typical Low
$302.00
Median
$2,290.87
Typical High
$10,232.93
United
Setting
Professional
Modifier
None
Typical Low
$1,862.09
Median
$2,630.27
Typical High
$3,715.35
6 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$977.24
Median
$1,071.52
Typical High
$1,202.26
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$389.05
Median
$436.52
Typical High
$478.63
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$1,479.11
Median
$1,621.81
Typical High
$1,819.70
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$295.12
Median
$323.59
Typical High
$363.08
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$194.98
Median
$218.78
Typical High
$239.88
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$1,380.38
Median
$1,513.56
Typical High
$1,698.24

Where Indiana sits

The same service costs 5.8 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Indiana· 15th of 51

$3,020

AK $7,762TX $1,349

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.