Ketamine treatment ranges from about $200 per month for at-home lozenges to over $1,000 per session for in-clinic infusions. The total cost depends heavily on which form of ketamine you receive, whether a therapist is involved, and how many sessions you need. Most people should expect to spend $2,400 to $6,000 or more for an initial course of treatment.
IV Infusion Costs
IV ketamine infusions are the most common in-clinic option and the most expensive. A single 40- to 60-minute session typically starts around $400 and can exceed $1,000, depending on the city and the level of care provided. Most clinics recommend an initial series of six infusions over two to three weeks, putting the starting cost for that induction phase at roughly $2,400 to $6,000.
After the initial series, most people need periodic booster sessions to maintain the benefits. Research on maintenance protocols suggests that an infusion roughly every two weeks can sustain symptom relief, though frequency varies from person to person. Some patients eventually stretch to monthly sessions. At $400 to $1,000 per visit, ongoing maintenance adds $400 to $2,000 or more per month to the long-term cost.
Intramuscular Injection Costs
Intramuscular (IM) ketamine injections are a less expensive in-clinic alternative to IV infusions. Each session generally costs $275 to $300 without a therapist present. If a therapist or facilitator guides the session, the price typically rises to $400 or more. The treatment schedule mirrors IV infusions: an initial series of several sessions followed by periodic boosters.
Spravato (Esketamine Nasal Spray)
Spravato is the only FDA-approved form of ketamine for depression and the only version with a realistic path to insurance coverage. It’s a nasal spray administered under supervision at a certified clinic. The drug alone costs roughly $882 for a standard dose and $1,319 for a higher dose, before insurance or manufacturer discounts.
Unlike other forms of ketamine, Spravato is covered by many insurance plans and by Medicare, though coverage typically requires a diagnosis of treatment-resistant depression or major depression with suicidal ideation. Your insurer will also require documentation that you’ve tried and failed other antidepressants first. If you do qualify, copays vary widely by plan, but manufacturer savings programs can reduce out-of-pocket costs significantly for commercially insured patients. The treatment schedule is more intensive upfront, with up to eight sessions in the first month, tapering to roughly once a week or every two weeks after that.
At-Home Oral Ketamine
Telehealth companies now prescribe ketamine lozenges (also called troches) that you take at home. These are the most affordable option. A basic self-directed plan runs about $200 per month, which typically includes the medication, a prescriber appointment, and a brief counseling session. A therapist-assisted plan with weekly counseling costs around $775 per month.
Oral ketamine is prescribed off-label, meaning it’s not FDA-approved for depression or any psychiatric condition. The lower price reflects both the simpler delivery method and the reduced clinical oversight compared to in-clinic treatments. Some providers ship the medication directly to your door, while others use local compounding pharmacies.
Therapy and Integration Add-Ons
Many clinics offer ketamine-assisted psychotherapy, where a therapist is present during dosing sessions and helps you process the experience afterward. Integration sessions, the follow-up therapy appointments where you work through insights from the ketamine experience, typically cost $100 to $400 per session. These are separate from the cost of the ketamine itself and aren’t always included in quoted prices, so it’s worth asking upfront what’s bundled and what’s billed separately.
Adding therapy raises the total cost but may improve outcomes. If you’re comparing clinics, check whether their quoted price includes any therapy or is purely for the medication and monitoring.
What Insurance Covers
Standard IV and IM ketamine treatments are almost never covered by insurance. They’re considered off-label, and most insurers won’t reimburse for them regardless of the diagnosis. The same goes for at-home oral ketamine from telehealth providers. You’ll pay entirely out of pocket for these options.
Spravato is the exception. Because it has FDA approval, it can be billed through insurance using specific billing codes. Medicare and many commercial plans cover it when the prescribing criteria are met, though prior authorization is almost always required. Even with coverage, copays for specialty medications like Spravato can still be substantial. Janssen, the manufacturer, offers a savings program that may reduce costs for eligible patients.
Some clinics offer financing plans or sliding-scale pricing. A few newer companies, like Enthea, have started offering ketamine therapy as an employer-sponsored benefit, though this is still uncommon.
Total Cost Comparison
- At-home oral ketamine: $200 to $775 per month, ongoing
- IM injections: $275 to $400+ per session; roughly $1,650 to $2,400+ for a six-session series
- IV infusions: $400 to $1,000+ per session; roughly $2,400 to $6,000+ for a six-session series
- Spravato (before insurance): $882 to $1,319 per session for the drug alone, with up to eight sessions the first month
- Integration therapy: $100 to $400 per session, if added
The initial treatment phase is only part of the picture. Most people need some form of ongoing maintenance to keep symptoms from returning, whether that’s periodic booster infusions, continued oral ketamine, or regular Spravato sessions. When budgeting for ketamine treatment, plan for at least three to six months of costs rather than just the first series.