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Montana rates for HCPCS 33694

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

Facilitymedian $3,311 · 10th–90th $3,236–$3,7150%50%10th90th$3,311Professionalmedian $2,754 · 10th–90th $1,905–$5,7540%10%10th90th$2,754$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,511.89 / $6,456.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $3,019.95
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,311.31 / $3,715.35
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,311.31 / $3,715.35
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,388.44 / $3,801.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,862.09 / $3,715.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,388.44 / $7,943.28