Ketamine treatments for depression typically cost between $400 and $1,000 per session for IV infusions, with a standard initial course running $2,000 to $4,000 total. The actual price depends heavily on the delivery method you choose, whether you have insurance coverage, and how long you need ongoing treatment.
IV Ketamine Infusion Costs
IV ketamine is the most common clinic-based option. A single 40- to 60-minute infusion starts around $400 and can exceed $1,000, depending on your city and the level of care provided. Most clinics follow an induction protocol of four to six infusions spread over two to three weeks, putting the upfront cost at roughly $2,000 to $4,000.
On top of the infusion itself, expect a few additional charges. Initial consultations that include a psychiatric evaluation and treatment planning typically run $250 to $500. Some clinics also offer psychotherapy integration sessions (processing your experience with a therapist between infusions), which add $100 to $200 per session. Not every clinic requires these, but many recommend them.
The biggest financial catch with IV ketamine: it is considered off-label for depression. The FDA has not approved generic ketamine for this use, which means Medicare considers it investigational and will not cover it. Most private insurers follow the same logic. You should expect to pay entirely out of pocket for IV infusions.
Spravato (Nasal Spray) Costs
Spravato is the brand name for esketamine, a close chemical relative of ketamine delivered as a nasal spray. It is the only FDA-approved ketamine-based treatment for depression, which makes it the only version with a realistic path to insurance coverage.
Without insurance, the medication alone costs approximately $1,059 for the lower dose and about $1,663 for the higher dose, per treatment session. On top of that, every session requires a two-hour observation period at a certified clinic, which adds $150 to $300 per visit. The treatment schedule is intensive at first: twice per week for the first month, once weekly during the second month, then tapering to every one or two weeks after that. Without any coverage, you could easily spend over $10,000 in the first two months.
The good news is that insurance changes the math dramatically. Because Spravato has FDA approval specifically for treatment-resistant depression, many commercial insurers and Medicare Part D plans cover it, though you’ll likely need to show that at least two other antidepressants haven’t worked. The manufacturer also runs a patient assistance program called SPRAVATO withMe that can bring costs down to as little as $10 per treatment for people with commercial or private insurance, plus a separate rebate program that covers the observation fee entirely. Medicare enrollees may qualify for the Part D Low-Income Subsidy, which eliminates or sharply reduces copays. State Medicaid programs may also cover the treatment in states with expanded eligibility.
At-Home Oral Ketamine
A newer and significantly cheaper option involves taking ketamine lozenges (also called troches) at home under remote medical supervision. Several telehealth companies now offer this model. Pricing varies by provider, but sessions can cost around $100 each, with a typical starter package of five sessions totaling $500. Some companies offer monthly subscriptions, and many provide financing plans that break costs into payments as low as $54 per month.
At-home ketamine is compounded by specialty pharmacies rather than manufactured by a major drug company, which keeps the price lower. The trade-off is that you’re taking a lower, sublingual dose without in-person medical monitoring. This route still requires an initial evaluation with a prescribing clinician, but the overall cost is a fraction of IV or Spravato treatment. Like IV infusions, at-home ketamine is off-label and not covered by insurance.
Maintenance Costs Over Time
The initial treatment series is only part of the financial picture. Most people who respond to ketamine need ongoing maintenance sessions to keep symptoms from returning. How often varies widely. Some patients come back once or twice a month, while others find their symptoms stay manageable with much less frequent treatment.
For IV ketamine, a single monthly booster at $400 to $800 adds $4,800 to $9,600 per year. For Spravato, the FDA-labeled schedule tapers to every two weeks or once weekly after the first two months, with the goal of finding the lowest frequency that maintains your improvement. If insurance covers Spravato and you’re enrolled in the manufacturer’s savings program, the ongoing cost can remain minimal. For at-home oral ketamine, monthly maintenance is the most affordable at roughly $100 to $200 per session.
Comparing Your Options Side by Side
- IV ketamine: $400 to $1,000 per session, $2,000 to $4,000 for the initial course, rarely covered by insurance.
- Spravato nasal spray: $1,200 to $1,960 per session without insurance, but often covered with prior authorization. Out-of-pocket costs can drop to $10 per session with manufacturer programs.
- At-home oral ketamine: Around $100 per session, $500 for a typical starter course, not covered by insurance.
How to Reduce What You Pay
If cost is a barrier, Spravato with insurance is almost always the most affordable clinical option, assuming you meet the treatment-resistant depression criteria. Start by asking your prescriber whether you qualify and whether your insurer covers it. The SPRAVATO withMe program handles much of the insurance verification and appeals process for you, including help if your initial claim is denied.
For IV ketamine, some clinics offer package pricing that discounts the per-session rate when you pay for the full induction series upfront. A few accept health savings account (HSA) or flexible spending account (FSA) funds, since ketamine infusions can qualify as a medical expense even without insurance coverage. Ask about financing plans as well, since many clinics partner with third-party lenders.
At-home oral ketamine is the lowest-cost entry point, and most telehealth providers offer split-pay financing. It may be worth trying first if your primary concern is affordability, though the clinical evidence behind IV infusions and Spravato is more robust for severe, treatment-resistant cases.