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Montana rates for HCPCS G2082

Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self administration, includes 2 hours post administration observation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.42 / $673.51 / $890.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.21 / $801.00 / $1,268.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.21 / $55.21 / $1,348.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.21 / $759.74 / $1,348.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.76 / $724.91 / $1,015.37
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.72 / $844.38 / $1,944.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,031.45 / $1,220.91 / $1,452.46