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Ohio 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
$2,145.21 / $6,523.95 / $11,627.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,145.21 / $2,210.26 / $5,620.45
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,097.00 / $8,010.00 / $36,529.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.41 / $2,372.96 / $3,986.94
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,868.90 / $1,868.90 / $2,721.37
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,015.49 / $2,015.49 / $2,531.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,734.21 / $2,839.81 / $4,071.94
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,923.88 / $2,840.01 / $3,879.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.16 / $1,660.64 / $2,564.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,480.00 / $3,086.00 / $6,792.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,978.24 / $2,549.28 / $4,000.72