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West Virginia 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
$737.12 / $835.40 / $982.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.66 / $843.74 / $1,169.01
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$763.64 / $1,174.09 / $1,888.73