Esketamine nasal spray, per milligram

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

ESKETAMINE 84 MG (28 MG X 3) NASAL SPRAY

Payers reporting HCPCS J0013

Payer pricing summary

Low

$15

Average

$651

Median

$451

High

$2.9k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +13 other terms	175	$30	$36	$16	45%	—	$15 – $163
2	Blue Cross Blue Shield fee schedule · outpatient · +9 other terms	39	$37	$93	$319	343%	—	$13 – $2.8k
3	Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges	26	$414	$338	$91	27%	—	$95 – $448
4	Superior Healthplan facility · percent of total billed charges · outpatientfrom % of charges	25	$116	$124	$40	32%	—	$62 – $239
5	Cigna facility · fee schedule · outpatient · +10 other terms	24	$21	$26	$7	28%	—	$15 – $33
6	Molina facility · case rate · outpatient · +8 other terms	22	$172	$166	$66	40%	—	$78 – $308
7	MultiPlan facility · percent of total billed charges · bothfrom % of charges · +7 other terms	21	$901	$1.0k	$755	73%	—	$801 – $5.6k
8	Aetna facility · fee schedule · outpatient · +14 other terms	16	$36	$35	$8	23%	—	$11 – $45
9	Ambetter facility · percent of total billed charges · outpatientfrom % of charges · +1 other terms	16	$502	$999	$800	80%	—	$502 – $2.8k
10	Anthem facility · case rate · outpatient · +7 other terms	14	$186	$203	$44	22%	—	$171 – $308
11	Caresource facility · case rate · outpatient · +3 other terms	14	$189	$204	$43	21%	—	$168 – $314
12	Medical Mutual facility · percent of total billed charges · outpatientfrom % of charges · +2 other terms	13	$2.0k	$2.3k	$976	43%	—	$674 – $4.6k
13	Optum facility · case rate · outpatient · +3 other terms	13	$164	$169	$58	34%	—	$74 – $279
14	Oscar facility · percent of total billed charges · inpatientfrom % of charges · +2 other terms	13	$361	$361	—	—	—	$361 – $361
15	Carefirst percent of total billed charges · outpatientfrom % of charges · +2 other terms	7	$16	$15	$6	41%	—	$7 – $29
16	Cigna Healthspring percent of total billed charges · outpatientfrom % of charges	7	$16	$15	$6	41%	—	$7 – $29
17	Magellan percent of total billed charges · outpatientfrom % of charges · +1 other terms	7	$16	$15	$6	41%	—	$7 – $29
18	Medicare facility · percent of total billed charges · outpatientfrom % of charges	7	$30	$30	—	—	—	$30 – $30
19	Phcs percent of total billed charges · outpatientfrom % of charges · +2 other terms	7	$16	$15	$6	41%	—	$7 – $29
20	Tricare percent of total billed charges · outpatientfrom % of charges	7	$16	$15	$6	41%	—	$7 – $29
21	Aetna Better Health facility · case rate · outpatient · +2 other terms	6	$93	$93	—	—	—	$93 – $93
22	Amerihealth Caritas facility · case rate · outpatient · +3 other terms	6	$86	$86	—	—	—	$86 – $86
23	Excellus facility · fee schedule · outpatient	5	$25	$28	$17	60%	—	$16 – $71
24	Humana facility · case rate · outpatient · +9 other terms	5	$78	$81	$4	5%	—	$78 – $86
25	First Health professional · fee schedule · both · +6 other terms	3	$18	$18	—	—	—	$18 – $18

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