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,
Medicare pricing data for 607 providers across 26 states
Prices vary significantly by location — from $37 in Connecticut to $1,388 in California. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
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, (HCPCS code G2083) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,148, but hospitals typically charge $2,230 — a 1.9x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,148, your out-of-pocket cost would be approximately $229.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $912.47 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $1,388 | $2,654 | 93 | 3,997 | +21.0% |
| New Jersey | $1,340 | $3,004 | 33 | 1,966 | +16.8% |
| Massachusetts | $1,274 | $2,418 | 48 | 1,452 | +11.1% |
| Washington | $1,256 | $2,072 | 29 | 638 | +9.5% |
| Maryland | $1,220 | $1,916 | 5 | 50 | +6.3% |
| Colorado | $1,189 | $2,492 | 11 | 422 | +3.6% |
| New York | $1,177 | $2,277 | 42 | 1,378 | +2.6% |
| Virginia | $1,144 | $1,683 | 17 | 441 | -0.3% |
| Pennsylvania | $1,139 | $2,100 | 9 | 152 | -0.7% |
| Michigan | $1,137 | $1,453 | 22 | 1,906 | -0.9% |
| Texas | $1,121 | $1,912 | 30 | 2,012 | -2.3% |
| Georgia | $1,115 | $2,278 | 4 | 243 | -2.8% |
| Oregon | $1,100 | $3,422 | 14 | 837 | -4.1% |
| Illinois | $1,096 | $2,339 | 24 | 819 | -4.5% |
| North Carolina | $1,084 | $2,656 | 19 | 434 | -5.6% |
| Nevada | $1,053 | $2,015 | 8 | 477 | -8.2% |
| Wisconsin | $1,046 | $2,843 | 6 | 282 | -8.9% |
| Montana | $1,044 | $1,842 | 8 | 63 | -9.1% |
| Iowa | $1,028 | $2,629 | 11 | 531 | -10.4% |
| Kansas | $1,014 | $1,772 | 17 | 541 | -11.6% |
| South Dakota | $999 | $2,088 | 5 | 162 | -13.0% |
| Arizona | $991 | $1,619 | 10 | 228 | -13.6% |
| Ohio | $981 | $1,737 | 9 | 167 | -14.5% |
| Florida | $979 | $1,584 | 20 | 668 | -14.7% |
| Indiana | $934 | $1,449 | 8 | 86 | -18.6% |
| Connecticut | $37 | $502 | 8 | 266 | -96.8% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber