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.
Original text from hospital filings
ESKETAMINE 84 MG (28 MG X 3) NASAL SPRAY
Low
$80
Average
$466
Median
$295
High
$1.3k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
43 hospitals; the 90th percentile is 12.0× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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54 hospital rates
iThe hospitals that file a Molina rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $176 | $176 | — | — | — | $176 – $176 |
| 2 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $1.0k | $1.2k | $804 | 67% | — | $261 – $2.5k |
| 3 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 1 | $427 | $502 | $338 | 67% | — | $110 – $1.0k |
| 4 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 5 | Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 6 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $171 | $171 | — | — | — | $171 – $171 |
| 7 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $308 | $308 | — | — | — | $308 – $308 |
| 8 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 9 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $193 | $193 | — | — | — | $193 – $193 |
| 10 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $202 | $202 | — | — | — | $202 – $202 |
| 11 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · inpatientfrom % of charges | 2 | $801 | $801 | $327 | 41% | — | $400 – $1.2k |
| 12 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 2 | $801 | $801 | $327 | 41% | — | $400 – $1.2k |
| 13 | Carle Eureka Hospital Eureka, IL percent of total billed charges · inpatientfrom % of charges | 2 | $801 | $801 | $327 | 41% | — | $400 – $1.2k |
| 14 | Carle Eureka Hospital Eureka, IL percent of total billed charges · outpatientfrom % of charges | 2 | $1.1k | $1.4k | $822 | 60% | — | $400 – $2.9k |
| 15 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 16 | ERIE COUNTY MEDICAL CENTER CORPORATION Buffalo, NY fee schedule · both | 3 | $234 | $332 | $138 | 42% | — | $234 – $527 |
| 17 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 18 | Henry Ford Health System West Bloomfield, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $376 | $376 | — | — | — | $376 – $376 |
| 19 | Henry Ford Health System Plymouth, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $376 | $376 | — | — | — | $376 – $376 |
| 20 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $376 | $376 | — | — | — | $376 – $376 |
| 21 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $376 | $376 | — | — | — | $376 – $376 |
| 22 | Hoopeston Community Memorial Hospital Hoopeston, IL percent of total billed charges · inpatientfrom % of charges | 2 | $1.2k | $1.2k | $490 | 41% | — | $601 – $1.8k |
| 23 | Hoopeston Community Memorial Hospital Hoopeston, IL percent of total billed charges · outpatientfrom % of charges | 2 | $1.0k | $1.0k | $460 | 45% | — | $420 – $1.8k |
| 24 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 2 | $80 | $80 | $2 | 2% | — | $78 – $82 |
| 25 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL professional · case rate · outpatient | 1 | $78 | $78 | — | — | — | $78 – $78 |
← Payers reporting HCPCS J0013 · Snapshot 20261111T120946Z-9134e7f7