go back

Utah 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
$792.45 / $898.11 / $1,056.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.78 / $940.29 / $1,231.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,077.57 / $1,077.57 / $1,077.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$816.46 / $1,041.46 / $1,306.34
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.18 / $77.00 / $1,518.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$953.56 / $1,230.40 / $1,856.07