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Idaho 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
$31.62 / $31.62 / $1,064.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.02 / $1,018.40 / $1,334.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,077.57 / $1,077.57 / $1,077.57
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.11 / $1,069.32 / $1,708.47
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.51 / $94.19 / $2,342.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $55.00 / $1,863.02
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,209.50 / $3,937.86 / $6,117.75
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.06 / $98.75 / $1,851.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,138.11 / $1,537.98 / $1,968.64