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Repair of Tetralogy of Fallot

Massachusetts 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?

$2,884

Typical negotiated rate. In Massachusetts, October 2026.

Insurers have agreed to pay about $2,884 for this service. The price depends on where it is billed: about $2,951 from a physician practice, and about $1,995 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2,951$2,239 to $5,248
FacilityA hospital or hospital-owned outpatient department$1,995$794 to $2,884

How much rates vary

Facilitymedian $1,995 · 10th to 90th $407 to $4,074Professionalmedian $2,951 · 10th to 90th $1,738 to $22,387
$100$500$2K$10Kfacility $1,995professional $2,951

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
$2,691.53
Median
$3,090.30
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$3,235.94
AllWays Health Partners
Setting
Facility
Modifier
None
Typical Low
$346.74
Median
$1,047.13
Typical High
$4,570.88
AllWays Health Partners
Setting
Professional
Modifier
None
Typical Low
$1,905.46
Median
$4,677.35
Typical High
$22,387.21
Cigna
Setting
Facility
Modifier
None
Typical Low
$50.12
Median
$954.99
Typical High
$1,380.38
Cigna
Setting
Professional
Modifier
None
Typical Low
$2,951.21
Median
$2,951.21
Typical High
$5,248.07
Fallon Health
Setting
Facility
Modifier
None
Typical Low
$1,995.26
Median
$2,454.71
Typical High
$3,467.37
Fallon Health
Setting
Professional
Modifier
None
Typical Low
$2,089.30
Median
$2,454.71
Typical High
$2,951.21
Harvard Pilgrim
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$954.99
Typical High
$4,073.80
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$2,187.76
Median
$3,981.07
Typical High
$6,025.60
Mass General Brigham
Setting
Facility
Modifier
None
Typical Low
$346.74
Median
$1,047.13
Typical High
$4,570.88
Mass General Brigham
Setting
Professional
Modifier
None
Typical Low
$1,905.46
Median
$4,677.35
Typical High
$22,387.21
United
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$1,023.29
Typical High
$4,073.80
United
Setting
Professional
Modifier
None
Typical Low
$2,344.23
Median
$3,090.30
Typical High
$8,511.38
Well Sense
Setting
Facility
Modifier
None
Typical Low
$1,380.38
Median
$1,905.46
Typical High
$2,884.03
Well Sense
Setting
Professional
Modifier
None
Typical Low
$1,479.11
Median
$1,479.11
Typical High
$1,778.28
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
$630.96
Median
$630.96
Typical High
$2,884.03
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$251.19
Median
$251.19
Typical High
$1,148.15
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$954.99
Median
$954.99
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$190.55
Median
$190.55
Typical High
$870.96
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$125.89
Median
$125.89
Typical High
$575.44
Aetna
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$891.25
Median
$891.25
Typical High
$4,073.80

Where Massachusetts 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.

Massachusetts· 20th of 51

$2,884

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.