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Indiana 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
$24.89 / $807.70 / $1,076.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.56 / $826.26 / $1,201.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$892.97 / $892.97 / $1,428.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.15 / $1,429.64 / $1,959.40
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.79 / $41.33 / $1,484.41
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,080.68 / $1,184.58 / $1,621.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.61 / $46.61 / $46.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.99 / $1,077.57 / $1,266.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$888.10 / $1,122.78 / $1,512.32