What Determines Actual Cost?

Your final price tag depends on a few key factors:

• Have you met your deductible? If not, expect to pay an extra $1,760 upfront (on average).
• Is your provider in-network? Out-of-network costs could be much higher.
• Did your insurance approve your prior authorization? Without approval, you’ll pay full price.
• Do you qualify for the $8,150 subsidy? This could make a massive difference.

 

Estimated Cost Based on Your Situation

Not sure which scenario applies to you?
Scroll further down this page where I made my calculations.

 

Getting The Most Out of Your Insurance

If possible, time your Spravato treatment after meeting your deductible for the year.

• Starting in January? You’ll pay $1,760 more than if you waited until later in the year.
• Already met your deductible? You could save thousands.

 

Bottom Line

Spravato, the esketamine nasal spray, is a powerful treatment for treatment-resistant depression, but it comes at a staggering cost. Without insurance, the 14-session treatment plan runs $24,000—a price few can afford.

Fortunately, most commercial insurance plans cover Spravato—but only partially. Even with coverage, your out-of-pocket cost will likely fall between $7,691 and $9,451, depending on your deductible, copays, and coverage limits.

If you qualify for Johnson & Johnson’s subsidy, you could save up to $8,150 per year, dropping your costs close to zero. If you’re eligible, this is a no-brainer—apply immediately.

If you don’t qualify for the subsidy, you’ll be paying around $8,000 out of pocket. At that price, IV ketamine is a better investment. It’s $2,000 cheaper, three times more effective, faster-acting, and requires fewer treatments—yet insurance won’t cover it.

Your cost breakdown comes down to four key factors:

• Have you met your deductible? If not, expect to pay an extra $1,760 upfront.
• Is your provider in-network? Out-of-network costs can be significantly higher.
• Did insurance approve your prior authorization? If not, you’ll pay full price.
• Do you qualify for the subsidy? This could cut your costs dramatically.

How I Ended Up With Spravato

 

When I started looking into ketamine treatment, I wanted IV infusions. Not just because they seemed like a better option, but because they are the better option. Studies show IV ketamine is more effective, faster-acting, and precisely dosed. With IV ketamine, you know exactly how much is entering your bloodstream. With Spravato’s nasal spray, only 25–50% of the dose is absorbed, making it a far less efficient delivery method.

But wanting ketamine infusion and being able to afford it are two very different things. At $6,000 out of pocket, it wasn’t an option for me. I didn’t have the money, and insurance wouldn’t cover it. So, I turned to Spravato.

Was I “stuck” with it? Maybe. But it worked. In just six weeks, I was in full remission. I don’t know if IV ketamine would have gotten me there faster or with fewer treatments, but I do know this: Spravato changed my life.

The Financial Lifeline That Made It Possible

The only reason Spravato was affordable for me was Johnson & Johnson’s subsidy program. Between that and my insurance, I paid next to nothing for treatment. The application process was shockingly easy—it took me five minutes online, and once approved, my clinic handled everything. No hoops, no paperwork, no hassle.

Gratitude and What-Ifs

I’m deeply grateful for what Spravato did for me, but my experience also highlights a frustrating reality—ketamine IV therapy, the better treatment, is often financially out of reach. It’s disheartening to know that so many people are forced into a less effective option simply because of insurance policies.

If IV ketamine is completely out of reach for you and you have commercial insurance, I strongly encourage you to explore Johnson & Johnson’s subsidy programs. It made all the difference for me, and it could make the difference for you too.

How I Calculated These Costs

These are the calculations I used to give you the bottom-line numbers we’ve been talking about. I broke down Spravato’s costs into medication and clinic fees, factored in typical insurance coverage, and ran different deductible scenarios so you can get a realistic estimate of what you might pay.

You don’t need to read this section unless you want to understand exactly how I did the math. But if you’re trying to estimate your own costs based on your insurance details, this breakdown will help you see where your numbers might land.

A Cost for the Medication; A Cost For The Clinic

Spravato treatment costs are split into two main parts: the medication itself and the clinic visits where it’s administered. Most insurance companies cover both—but not equally. Typically, commercial insurance plans cover around 50% of the medication cost and 80% of the clinic visit cost.

To help you navigate this maze, I’ve broken down some common scenarios for a standard 14-session treatment plan, so you can estimate your out-of-pocket costs.

Note That Real Costs Will Vary

Before we dive into numbers, keep in mind that these are estimates. Your actual costs could be higher or lower depending on several factors:

• Your Deductible
  Some plans have no deductible at all, while others might require you to cough up $5,000 or more before insurance kicks in.
• Coverage Rates
  Insurance plans vary widely, and the percentages I’ve provided might not match your specific policy.
• In-Network vs. Out-of-Network
  Whether your provider is in-network could make or break your budget.
• Prior Authorizations
  Always have your provider submit a prior authorization to your insurance. This step is critical for understanding exactly what your plan will pay.

Let’s Begin Our Analysis

Key assumptions:

– A full treatment course of 3 months involves 14 sessions

– Medication costs $738 per dose (insurance pays 50%)

– Clinic visit costs $400 per session (insurance pays 80% after deductible)

– Average commercial insurance deductible is $1,760

– Specialist visit copays are $57.50 per session after deductible

– Medication costs use percentage-based coinsurance

Here’s what you might pay in different scenarios:

Scenario 1: Starting Fresh – Deductible Counts Toward Your Share

– You start by paying your $1,760 deductible

– For remaining sessions, you pay:

  – Half of medication cost ($369 per session)

  – 20% of clinic visit ($80 per session)

  – Specialist copay ($57.50 per visit)

Total cost to you: $8,897.50 for all 14 sessions

Scenario 2: Starting Fresh – Deductible is Separate

– First, you must pay your full $1,760 deductible

– Then for all 14 sessions, you pay:

  – Half of medication cost ($369 per session)

  – 20% of clinic visit ($80 per session)

  – Specialist copay ($57.50 per visit)

Total cost to you: $9,451 for all 14 sessions

Scenario 3: Deductible Already Met

– Since you’ve met your deductible, for each session you pay:

  – Half of medication cost ($369 per session)

  – 20% of clinic visit ($80 per session)

  – Specialist copay ($57.50 per visit)

Total cost to you: $7,691 for all 14 sessions

Scenario 4: Half Deductible Met

– First, pay remaining $880 of deductible

– Then for all sessions, you pay:

  – Half of medication cost ($369 per session)

  – 20% of clinic visit ($80 per session)

  – Specialist copay ($57.50 per visit)

Total cost to you: $8,571 for all 14 sessions

Summary

Total Cost Comparison 

Scenario 1: Deductible Counts Toward Your Share: $8,897.50 

Scenario 2: Deductible is Separate: $9,451 

Scenario 3: Deductible Already Met: $7,691 

Scenario 4: Half Deductible Met: $8,571

Important Note About These Estimates

While these calculations give you a general idea of costs, the real insurance world varies dramatically. Here’s what you need to know:

Deductibles can be wildly different

– About 17% of people with employer insurance have no deductible at all

– Nearly 28% face deductibles over $2,000

– Some people with High Deductible Health Plans (HDHPs) have deductibles of $5,000 or more

– Our analysis used the average deductible of $1,760, but yours could be very different

Insurance coverage varies significantly

– Some plans might cover more than 50% of the medication cost

– Others might cover less than 80% of clinic visits

– A small number of plans might not cover Spravato at all

– Some plans have out-of-pocket maximums that could cap your total spending

Other factors that could change your costs

– Your plan’s specific copays might be higher or lower than our $57.50 assumption

– Some plans use different coinsurance rates

– Your location can affect both provider charges and insurance coverage

– Whether your provider is in-network makes a huge difference

– Some plans require you to try other treatments first (step therapy)

Bottom line: Use these estimates as a starting point, but check with your insurance provider for exact coverage details. The best way to know your actual costs is to have your provider submit a prior authorization to your insurance company.

Key Insights from Cost Analysis

1. You’ll pay roughly $506.50 every time you go in for treatment

– $369 for the medication

– $80 for the clinic visit

– $57.50 for seeing the specialist

2. When you start treatment makes a huge difference to your total cost

– Starting in January? Add $1,760 to your bill

– Already met your deductible? Save $1,760

– Pro tip: If you have other medical expenses, try to time your Spravato treatment for after you’ve met your deductible

3. Your total cost will likely be between $7,691 and $9,451

– Best case (if you’ve met your deductible): $7,691

– Worst case (starting fresh in January): $9,451

– The only difference? That $1,760 deductible

4. Most of your money goes to the medication

– 73% of what you pay goes to the medication itself

– The rest covers clinic visits and specialist fees

– Just seeing the specialist will cost you $805 over the full treatment

5. Insurance coverage makes a big difference

– Without insurance (100% self-pay) Spravato would cost roughly $24,000. With Insurance you pay between $7,691 and $9,451

6. Even with insurance coverage Spravato is VERY expensive

– With out-of-pocket costs ranging from $7,691 to $9,451, this treatment is priced beyond reach for most people.

– Your next step is to see if you qualify for Spravato’s subsidy (up to $8,150) 

– If you don’t qualify but you’ve got the money, can get the money, or are willing to borrow the money then you should seriously consider IV infusions instead of Spravato. IV ketamine is more effective, requires fewer treatments, is less restrictive and runs about $6,000.

Your Complete Guide to Getting Insurance Approval for Spravato

Why Insurance Doesn’t Cover IV Infusions or Injections

Ketamine vs. SSRIs: Which One Costs More in the Long Run?

How to Navigate Insurance Hurdles and Get Spravato Approved

How to Make Ketamine Therapy More Affordable Without Insurance

Everything You Need to Know About Ketamine Therapy Costs and Insurance

Creative Ways to Reduce the Price of Out-of-Pocket Ketamine Therapy