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New Hampshire 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

Facilitymedian $1,023 · 10th–90th $724–$1,2020%20%10th90th$1,023Professionalmedian $1,000 · 10th–90th $31–$2,0890%10%10th90th$1,000$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,023.29 / $1,202.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $977.24 / $1,348.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $851.14 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $1,122.02 / $3,090.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $1,548.82 / $3,235.94
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $741.31 / $1,096.48