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Anesthesia For Diagnostic Shoulder Scope

Mississippi 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 $58 · 10th to 90th $40 to $339Professionalmedian $52 · 10th to 90th $40 to $257
$50$100$200facility $58professional $52

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
$39.81
Median
$57.54
Typical High
$338.84
Aetna
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$57.54
Typical High
$295.12
Cigna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$269.15
United
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$50.12
Typical High
$57.54
3 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
Ambetter
Setting
Professional
Modifier
QK · Directing 2–4 cases
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Ambetter
Setting
Professional
Modifier
QX · CRNA, directed
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Ambetter
Setting
Professional
Modifier
QZ · CRNA, independent
Typical Low
$346.74
Median
$346.74
Typical High
$346.74