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Anesthesia For Diagnostic Shoulder Scope

Idaho rates for HCPCS 01622

Anesthesia care provided while a scope is used to look inside the shoulder joint. The examination is diagnostic rather than a treatment. The charge covers the anesthesia care, not the shoulder procedure.

Rates data updated October 2026.

How much rates vary

Facilitymedian $62 · 10th to 90th $62 to $269Professionalmedian $257 · 10th to 90th $50 to $347
$50$100$200$500facility $62professional $257

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Aetna
Setting
Professional
Modifier
None
Typical Low
$50.12
Median
$50.12
Typical High
$302.00
BCBS Idaho
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$281.84
Typical High
$302.00
Cigna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$229.09
Typical High
$257.04
Moda Health
Setting
Professional
Modifier
None
Typical Low
$50.12
Median
$169.82
Typical High
$302.00
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$52.48
Median
$61.66
Typical High
$61.66
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$53.70
Median
$61.66
Typical High
$112.20
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$269.15
Typical High
$302.00
Select Health
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$346.74
Typical High
$398.11
United
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$54.95
Typical High
$74.13
9 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
BCBS Idaho
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$147.91
Median
$194.98
Typical High
$204.17
BCBS Idaho
Setting
Professional
Modifier
AD · Supervising 5+
Typical Low
$128.82
Median
$128.82
Typical High
$151.36
BCBS Idaho
Setting
Professional
Modifier
QK · Directing 2–4 cases
Typical Low
$128.82
Median
$128.82
Typical High
$151.36
BCBS Idaho
Setting
Professional
Modifier
QX · CRNA, directed
Typical Low
$128.82
Median
$128.82
Typical High
$151.36
BCBS Idaho
Setting
Professional
Modifier
QY · Directing one CRNA
Typical Low
$128.82
Median
$128.82
Typical High
$151.36
Regence BlueShield
Setting
Professional
Modifier
AD · Supervising 5+
Typical Low
$128.82
Median
$134.90
Typical High
$151.36
Regence BlueShield
Setting
Professional
Modifier
QK · Directing 2–4 cases
Typical Low
$128.82
Median
$134.90
Typical High
$151.36
Regence BlueShield
Setting
Professional
Modifier
QX · CRNA, directed
Typical Low
$128.82
Median
$134.90
Typical High
$151.36
Regence BlueShield
Setting
Professional
Modifier
QY · Directing one CRNA
Typical Low
$128.82
Median
$134.90
Typical High
$151.36