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.
Generation details were not recorded for this description.
Original text from hospital filings
SPRAVATO (84 MG DOSE) 28 MG-DEVICE NA SOPK
Low
$13
Average
$372
Median
$225
High
$1.0k
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4 hospital rates
iThe hospitals that file a Ambetter 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 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 2 | MEMORIAL HEALTH MEADOWS HOSPITAL Vidalia, GA fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 3 | Mary Bridge Children's Hospital Tacoma, WA fee schedule · outpatient | 1 | $400 | $400 | — | — | — | $400 – $400 |
| 4 | UNIVERSITY OF MICHIGAN HEALTH Ann Arbor, MI facility · fee schedule · outpatient | 1 | $1.0k | $1.0k | $205 | 20% | — | $819 – $1.2k |
← Payers reporting HCPCS S0013 · Snapshot 20261111T120946Z-9134e7f7