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Repair of Tetralogy of Fallot

Pennsylvania 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 July 2026.

How much does Repair of Tetralogy of Fallot cost?

$2,291

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $2,291 for this service. The price depends on where it is billed: about $2,188 from a physician practice, and about $5,370 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2,188$2,089 to $2,455
FacilityA hospital or hospital-owned outpatient department$5,370$2,291 to $7,762

How much rates vary

Facilitymedian $5,370 · 10th to 90th $1,047 to $8,511Professionalmedian $2,188 · 10th to 90th $1,905 to $3,802
$500$1K$2K$5K$10K$20Kfacility $5,370professional $2,188

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$5,370.32
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,905.46
Median
$2,187.76
Typical High
$3,801.89
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$20,417.38
Median
$21,379.62
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$2,951.21
Median
$2,951.21
Typical High
$2,951.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,548.82
Median
$2,454.71
Typical High
$3,890.45
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$2,884.03
Median
$2,884.03
Typical High
$3,235.94
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$1,995.26
Median
$2,630.27
Typical High
$4,168.69
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$4,786.30
Typical High
$8,317.64
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1,905.46
Median
$2,187.76
Typical High
$6,165.95
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$2,691.53
Typical High
$2,884.03
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$1,862.09
Typical High
$2,691.53
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$1,905.46
Typical High
$2,691.53
United
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$2,754.23
Typical High
$7,079.46
United
Setting
Professional
Modifier
Global
Typical Low
$1,819.70
Median
$2,398.83
Typical High
$4,168.69

Where Pennsylvania sits

The same service costs 6.2 times more in California than in Mississippi. 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.

Pennsylvania· 49th of 51

$2,291

CA $13,183MS $2,138

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.