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Rhode Island 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
$872.98 / $989.37 / $4,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.78 / $1,033.22 / $1,377.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,790.19 / $2,790.19 / $4,283.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.58 / $176.78 / $1,741.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,077.57 / $1,077.57 / $1,077.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.57 / $1,396.76 / $2,033.01