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Vermont 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
Facility
Modifier
Low / Median / High Price
$575.44 / $645.65 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $691.83 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $758.58 / $1,047.13
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,071.52 / $1,445.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $660.69 / $1,258.93