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North Dakota 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
$831.89 / $942.81 / $1,109.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.82 / $976.84 / $1,470.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.73 / $97.03 / $3,071.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $1,077.57 / $1,736.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.91 / $1,109.19 / $2,106.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$855.53 / $1,985.62 / $3,607.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$943.60 / $1,964.91 / $2,761.88