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Tennessee 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
$1,796.41 / $1,796.41 / $1,796.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.03 / $976.84 / $1,261.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.74 / $711.59 / $1,647.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.61 / $46.61 / $46.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,077.57 / $1,077.57 / $1,077.57
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.48 / $177.48 / $177.48
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.74 / $1,551.40 / $10,233.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$940.83 / $1,146.39 / $1,956.66