How Much Does Ketamine Therapy Cost?

What You’ll Pay for IV, Spravato, or Injections

If you’re dealing with depression that hasn’t responded to anything else, ketamine therapy might be your last real option. And for many people, the biggest obstacle isn’t whether it works—it’s whether they can afford it.

One thing that jumps out right away is just how different the number of required sessions is between methods. IV and injection ketamine usually require 11 to 18 treatments. Spravato, on the other hand, requires 21 sessions—no matter what. That’s because the medications aren’t equivalent. IV ketamine delivers 100% bioavailability—your body absorbs the entire dose immediately. It also contains both mirror molecules (R-ketamine and S-ketamine), while Spravato only includes the S form. That makes IV therapy more potent, faster-acting, and generally more efficient, which means you need fewer treatments to reach the same level of relief.

What Are The Real Costs Of Ketamine Therapy?

You’ve heard ketamine might help when nothing else has. Maybe you’ve tried antidepressants, maybe you’ve tried everything. But now you’re stuck on a more immediate question: what is this going to cost—and can I afford it if it works?

The answer depends on a few big factors: whether you’re using Spravato (the nasal spray), IV infusions, or injections—and whether you have commercial insurance that covers any of it. This table gives you a full view of what most people pay for a complete round of treatment.

As you’ll see in the sections ahead, the difference between getting help and getting priced out often comes down to what type of ketamine you’re using—and what kind of support system is (or isn’t) in place. For some people, it’s manageable. For others, it’s completely out of reach.

Keep going. We’ll break down each of these scenarios, starting with the most expensive one: paying for everything out of pocket.

What If I Have To Pay For Treatment Myself, Without Any Insurance?

For a lot of people, this is the default scenario—especially if you’re considering IV or injection ketamine. Insurance doesn’t cover them. Medicare doesn’t either. And even though Spravato is FDA-approved, many plans won’t touch it unless you’ve already failed multiple antidepressants and can prove it in writing.

That means you’re stuck paying the full amount yourself. No reimbursement. No partial coverage. No help.

This table shows what that actually looks like across the three main treatment types. These are real numbers, based on full self-pay prices with no insurance and no manufacturer assistance. It’s not pretty. But it’s what many people are facing.

Spravato is clearly the most expensive option when you’re paying out of pocket—because it requires more sessions (21) and the drug itself is priced as a specialty medication. IV ketamine is usually cheaper, but it still adds up fast. Injection therapy is the lowest-cost method, but fewer clinics offer it and you’ll likely have less medical monitoring built in.

The big thing to keep in mind is this: these aren’t optional costs. If ketamine is working, most people need at least a dozen treatments—sometimes more. And if you’re paying cash, there’s no fallback. If you can’t continue, you stop. That’s the risk people take when cost becomes the barrier between them and relief.

Detailed Breakdown: Spravato Esketamine Nasal Spray Cost Per Session Without Insurance

Understanding the financial commitment of Spravato treatment goes beyond just counting sessions. For patients considering self-pay options or wondering what costs look like before insurance, pricing transparency is essential. The following section provides comprehensive information about what each Spravato session typically costs across different regions, dosages, and clinic types.

How Did You Come Up With These Numbers—And Can I Trust Them?

These numbers weren’t pulled out of thin air. We built them from the ground up using real pricing from 30 ketamine clinics across the country—10 in small markets, 10 in mid-sized cities, and 10 in large urban areas.

For IV ketamine and injection therapy, we collected prices from clinics in rural Florida, small towns in Texas and Georgia, mid-sized cities in Colorado and Massachusetts, and major metros like New York, LA, and Chicago. Prices ranged from as low as $275 per session in small towns to over $1,500 in high-end urban clinics.

Instead of treating each clinic equally, we used a population-weighted model based on U.S. census distribution:

• 20% of the population in small/rural markets
• 30% in mid-sized/suburban areas
• 50% in large cities

That weighting gave us a national cost range of about $400–$1,000 per IV ketamine session. But that’s still too broad to be useful for most patients, so we narrowed it using the interquartile range (IQR)—a statistical method that excludes outliers and focuses on the middle 50% of prices. That gave us a more grounded and realistic range: $425–$750 per session.

To estimate total treatment costs, we applied that IQR range to a session count of 11 to 18 treatments. That’s based on real-world clinical protocols: patients typically start with 6–8 infusions in the first few weeks, then taper down over months 2 to 6. This model reflects not just induction, but stabilization and maintenance through the first 6 months of care.

We did the same for injection ketamine, which tends to be $100–$200 cheaper per session than IV infusions. Fewer clinics offer it, but when they do, the pricing tends to fall between $300–$550. We applied the same 11–18 session model for consistency and comparability.

Spravato required a different approach. Because it’s FDA-approved, it follows a fixed protocol: two sessions per week for the first month, then weekly or biweekly after that. The full 6-month protocol includes at least 21 sessions, which we used for all cost modeling.

We created three separate scenarios for Spravato:

• Self-pay: no insurance, no discounts. This reflects the true sticker price of $800–$1,300 per session, for a total of $16,800–$27,300.
• Commercial insurance: typical coverage with copays and coinsurance, based on real-world billing ranges of $140–$450 per session.
• Insurance plus manufacturer subsidy: for patients who qualify for Janssen’s assistance program, which can reduce the per-session cost to as low as $0–$62, up to a maximum benefit of $8,150.

We also calculated median costs for each scenario—but we’re careful about how we present them. A median of $6,195 for insured Spravato treatment might sound reassuring, but the top end is still $9,450. That’s why we always show both the range and the median side by side: so you don’t mistake “typical” for “guaranteed.”

Bottom line: this is the most complete national pricing model we know of for ketamine therapy. It’s not perfect—but it’s honest, transparent, and built to help you plan instead of panic.

What If My Insurance Actually Covers Spravato? How Much Would I Pay Then?

If you have commercial insurance and your plan covers Spravato, the costs can drop dramatically—but it’s not always straightforward. Even when it’s “covered,” you’re still on the hook for copays, coinsurance, and sometimes facility fees.

This table shows what most patients pay out of pocket when insurance is covering Spravato, but without manufacturer subsidy. The range reflects real billing patterns across dozens of clinics, using the full 21-session FDA-required protocol.

The median out-of-pocket cost for insured Spravato patients is around $6,195. But depending on your deductible and plan design, it could be as low as $2,940 or as high as $9,450. In other words, even with insurance, some patients still pay more than they would for IV ketamine out of pocket.

Also keep in mind: Spravato requires 21 visits, each lasting about two hours. That’s 21 days off work. 21 rides to and from the clinic. 21 chances to get hit with a facility or monitoring fee that’s billed separately from the drug itself.

Insurance coverage helps—but it doesn’t guarantee affordability. And getting approved can be a process. In the next section, we’ll show you what happens if you qualify for both insurance and the manufacturer subsidy program.

How Much Would I Pay If I Qualified For The Manufacturer’s Subsidy?

If you qualify for Spravato’s assistance program, your out-of-pocket costs can drop dramatically. The manufacturer, Janssen, offers up to $8,150 in savings for eligible patients with commercial insurance. That can bring your per-session cost down to almost nothing—sometimes as low as $0, with a cap of $62 per visit.

Here’s what that looks like across a full course of treatment:

In this best-case scenario, Spravato becomes by far the most affordable option—if you qualify. But that’s a big “if.” To qualify for the subsidy, you must:

• Have commercial (non-government) insurance
• Not be using Medicare, Medicaid, or VA coverage
• Be approved for Spravato through your insurer’s prior authorization process

For patients who need Spravato and have insurance, it’s worth applying. You can find the program details here.

Next we’ll look at why IV and injection ketamine—despite being widely used—are almost never covered by insurance.

Why Won’t My Insurance Cover IV Or Injection Ketamine?

This is one of the most frustrating parts of ketamine therapy: the most widely used forms—IV and injection—aren’t covered by insurance. Not because they don’t work. Not because they’re unsafe. But because they’re not FDA-approved for depression.

The irony? IV ketamine has outperformed nearly every antidepressant ever tested. Decades of studies show it can relieve suicidal depression in hours—not weeks—and work when nothing else does. So why hasn’t the FDA approved it?

Because ketamine is old, cheap, and off-patent. There’s no company with a financial incentive to sponsor it through the FDA’s billion-dollar approval process. And that process doesn’t reward what already exists—it rewards what can be packaged, patented, and sold.

Spravato, the nasal spray version of ketamine, got FDA approval in 2019 not because it works better, but because it’s a new enough “formulation” to qualify for commercial exclusivity. It’s ketamine’s left hand—just one half of the full compound—delivered through a nasal spray instead of an IV. That made it novel enough to patent. And profitable enough to fund clinical trials.

IV ketamine? It’s generic. It’s decades old. And it’s already widely available. No one can own it. Which means no one can make enough money on it to justify spending the hundreds of millions it takes to get FDA approval.

That’s not science. That’s a structural flaw in the approval system.

The FDA doesn’t have a pathway for drugs with overwhelming independent evidence but no commercial sponsor. It can’t accept meta-analyses. It doesn’t recognize the success of hundreds of published trials unless they’re part of a specific, company-funded application. So even though IV ketamine has been tested in more than 80 randomized controlled trials, it still sits outside the system—off-label, unfunded, and uncovered by insurance.

This isn’t just a paperwork issue. It’s a matter of access, cost, and survival. Patients are being forced into the most expensive version of a drug while cheaper, more effective forms are ignored. Doctors are boxed into prescribing what insurance will reimburse, not what research supports. And people who might finally find relief with IV ketamine are left without options unless they can pay out of pocket.

There’s a way forward. The FDA could create a separate approval track for therapies with substantial independent evidence. It could evaluate safety and efficacy using peer-reviewed research instead of waiting for a pharmaceutical company to rewrite the rules. It could finally approve what the science has already confirmed: IV ketamine saves lives.

Until then, patients will keep paying more for less—and wondering why a treatment that could change everything is still stuck behind the wrong set of rules.

What does ketamine therapy cost in Atlanta, Ga?

How Can I Lower The Cost If I’m Paying Out Of Pocket?

If you’re paying out of pocket—either because your treatment isn’t covered or your deductible is too high—you’re not out of options. Many clinics are willing to work with patients who ask the right questions. But you usually have to ask first.

Here are four strategies to help reduce your overall cost:

• Ask About Package Pricing: Most IV and injection clinics offer discounted rates if you commit to a full induction series (usually 6–8 sessions). A clinic charging $350 per session might offer a six-pack for $1,800—dropping the per-session cost to $300. Some even waive intake or monitoring fees if you prepay.
• Inquire About Sliding Scale: It’s rare, but some providers offer income-based pricing—especially smaller practices or those run by clinicians who also offer psychotherapy. It’s almost never advertised. You have to ask directly and be honest about your financial situation.
• Look Into Financing or Payment Plans: Some clinics partner with companies like CareCredit or offer internal payment plans with 0% interest if paid within a few months. Read the terms carefully—especially if a third-party lender is involved. These can work well if you can stick to the timeline.
• Negotiate Based On Your Schedule: High-volume clinics sometimes discount off-peak hours (early mornings, midweek slots) to fill gaps. Others may offer repeat patient discounts for booster sessions down the line. If you’re flexible, it’s worth asking.

The key here is simple but hard: you have to bring it up. Clinics rarely publish their discount structure. And some won’t offer anything unless you initiate the conversation. It’s uncomfortable—but it can save you thousands.

In the next section, we’ll talk about the costs that don’t show up on the website or in your first consultation—but hit you just as hard once treatment begins.

What Other Costs Should I Expect Besides The Treatment Itself?

Even when you think you’ve got the treatment cost figured out, other expenses can sneak up on you. Here are the most common hidden costs you should plan for:

• Consultation and Intake Fees: Many clinics charge $150–$500 for the initial evaluation. This is separate from your first treatment session, and it’s not always applied to future visits.
• Monitoring Fees: Some clinics bill separately for nurse supervision, vital sign tracking, or post-session recovery. These fees can run $25–$100 per visit, especially for Spravato.
• Transportation: For IV, injection, and Spravato, you won’t be allowed to drive home. That means 11–21 rides depending on your protocol. Even at $30 per Uber, that’s hundreds of dollars out of pocket if you don’t have a ride.
• Time Off Work: Each treatment takes 1–2 hours plus recovery time. You may miss an entire workday—especially with Spravato. If you don’t have PTO, that’s lost income every week.
• Childcare: Some patients have to arrange paid childcare during treatment hours. Even a few hours per week adds significant cost across a 6 month protocol.
• Maintenance Treatments: Most people don’t stop at the induction phase. You may need boosters every 2–6 weeks to stay stable. That means the costs keep coming, even after you “finish” treatment.

These logistical realities can derail your treatment plan if you’re not ready for them. But you deserve to know.

Next we’ll talk about how to make the right financial decision for your situation—without gambling on your recovery.

How Do I Make The Smartest Financial Decision For Me?

When you’re dealing with treatment-resistant depression, this isn’t just another expense to weigh against your vacation fund. This is about survival, functionality, and reclaiming your life. Here’s how to make the best financial decision with that reality in mind:

Prioritize Getting Started Over Perfect Planning

Start with what you can access right now. If you can afford 6-8 IV ketamine sessions ($2,550-$6,000), begin there even if you’re unsure about affording the entire protocol. The profound relief that 70%+ of patients experience in those first weeks can transform your ability to problem-solve, work, and advocate for yourself.

Remember: Depression itself is financially devastating. It’s not just about treatment costs – it’s about the cost of losing your job, your relationships, your housing, or worse. When weighing costs, factor in what continued depression is already costing you.

Create Strategic Access Points

Use IV or injection for rapid stabilization. These formats deliver faster, more complete relief than Spravato in the critical first weeks. Once stabilized, you’ll have more mental clarity to navigate insurance battles for longer-term coverage.

Leverage the “foot in the door” approach. Some patients start with self-pay IV ketamine, experience significant improvement, then use that documented response to convince insurance to cover Spravato maintenance – showing previous treatment response often strengthens your case.

Make Depression Recovery Your Temporary Financial Priority

Temporarily reallocate funds from retirement or savings. While normally inadvisable, treatment-resistant depression is a legitimate financial emergency. Successful treatment could add decades of productive earning to your life, far outweighing a temporary savings withdrawal.

Consider credit as a lifeline, not a burden. Using a 0% introductory credit card or CareCredit for initial treatments can bridge the gap until treatment enables you to work more effectively. Improved mental health typically leads to improved income potential.

Extract Maximum Value From Every Dollar

Identify clinics that bundle psychotherapy with ketamine. Combined treatment approaches yield substantially higher remission rates (up to 72% vs. 40-50% with ketamine alone). The added cost of therapy pays for itself through fewer required maintenance sessions later.

Seek clinics using precision medicine approaches. Some providers use biomarkers or genetic testing to personalize dosing protocols, potentially reducing the number of sessions needed to achieve remission.

Create a “Treatment First, Perfect Later” Plan

Focus on getting well enough to solve the money problem. Many patients find that after 6-8 sessions, they’ve regained enough function to either return to work, find better employment, or advocate more effectively with insurance companies.

Split your financial planning into emergency and recovery phases. Make separate plans for: (1) getting immediate relief, and (2) maintaining that relief once you’re functioning better. Different financial strategies apply to each phase.

Navigating Spravato and Manufacturer Assistance: When Insurance Is an Option

Leverage Insurance Plus Subsidies for Nearly-Free Treatment

Stack your financial advantages with Spravato. If your insurance covers it, immediately apply for Janssen’s assistance program which provides up to $8,150 in savings. This combination can reduce your 21-session protocol from $9,450 down to just $650-1,300 total – potentially making it your most affordable path to recovery.

Time your treatment start strategically. If you’ve already met part of your deductible from other medical care this year, starting Spravato before your plan year resets could save thousands. Alternatively, if you know you’ll have significant medical expenses in the coming year, starting after your deductible is met makes Spravato dramatically more affordable.

Turn Insurance Barriers into Financial Opportunities

Document everything your insurance requires. Many plans require proof of failed medications – gather these records proactively. Each prior authorization you secure represents thousands in potential savings compared to self-pay options.

Appeal denials with depression’s financial impact documentation. Include not just medical records but evidence of depression’s cost to your productivity, attendance, and performance. Insurers sometimes respond better to financial arguments than medical ones.

Create a “Spravato Bridge” Strategy

Use the manufacturer’s assistance program as your financial lifeline. The $8,150 subsidy can cover most of your costs while you’re still too depressed to work effectively. By the time you exhaust this benefit, many patients have improved enough to increase income or negotiate better with insurers.

Start treatment even if you can only see your way financially through half the protocol. Many patients report significant improvement after 8-10 Spravato sessions. This improvement often leads to better problem-solving ability, more effective work performance, and subsequently, more financial options for continuing care.

Combine Resources Creatively

Maximize HSA/FSA contributions immediately. If your employer offers these tax-advantaged accounts, max them out specifically for Spravato. The tax savings effectively gives you a 22-37% discount depending on your tax bracket.

Consider a one-time 401(k) hardship withdrawal. While typically not advisable, the 10% penalty may be far less costly than continuing to live with treatment-resistant depression that’s destroying your earning capacity and could eventually end your career entirely.

Develop a “Treatment Now, Perfect Later” Approach with Spravato

Start with insurance-covered Spravato even if it’s not ideal. Getting some relief is better than waiting for perfect financial alignment for IV ketamine. Many patients use Spravato to stabilize, then transition to occasional self-pay IV sessions for maintenance once they’re functioning better.

Use the “foot in the door” leverage. Once you’ve established that ketamine helps you through Spravato treatments, some flexible doctors will consider prescribing off-label ketamine troches for at-home maintenance – a fraction of the cost of either IV or Spravato.

When treatment-resistant depression has decimated your life, waiting until you can “comfortably afford” treatment is often the most expensive decision you can make. The mathematics are clear: The longer you remain severely depressed, the more income you lose and the more likely you become to lose your job entirely. A $650-1,300 investment in Spravato with insurance and subsidy support could be what stands between you and tens of thousands in lost wages.

The best financial decision isn’t about minimizing cost – it’s about maximizing your chance of getting your life back. When treatment-resistant depression has stolen your career, relationships, and joy, effective treatment isn’t a luxury – it’s the most important investment you can make in your future earning potential and quality of life.