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Arkansas rates for HCPCS G2083

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 greater than 56 mg esketamine nasal self administration, includes 2 hours post administration observation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.00 / $811.76 / $966.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.79 / $976.84 / $1,302.45
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,321.68 / $1,321.68 / $1,554.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.54 / $1,077.57 / $1,077.57
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,519.93 / $1,519.93 / $1,788.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$907.65 / $1,143.42 / $1,565.00