We've already walked through what a Spravato appointment is like and what TMS is like. This chapter is the numbers: what things cost according to published price surveys, and what the clinical literature reports about response rates. Every figure below links straight to its source.
What published price surveys report
- Spravato with commercial insurance: published price surveys report that most insured patients pay roughly $10 to $250 per session, and that the manufacturer's savings program can bring the medication portion down to as little as $10. Source: Healing Maps Spravato cost guide (2026).
- Spravato without insurance: published price surveys report retail pricing of roughly $700 to $1,000 per session, or about $4,000 to $8,000 for a first month of eight doses. Source: Bright Horizons Psychiatry Spravato cost guide (2026).
- IV ketamine infusions (off-label for depression): published price surveys report a typical cost of $400 to $700 per session, and note that these infusions are rarely covered by insurance. Source: Lumin Health ketamine cost comparison (2026).
- How broadly Spravato is covered: published surveys report that Spravato, the only FDA-approved ketamine-based medicine for depression, is covered by Medicare and most major insurance plans, commonly listing BCBS, UnitedHealthcare, Aetna, Cigna, and Humana. Source: Mindbloom Spravato coverage guide (2026).
- Typical course length: published clinic protocols commonly run six to ten sessions over three to five weeks for the induction course. Source: Lumin Health treatment-course overview (2026).
What the clinical research reports about response
- A two-site randomized controlled trial found a 64% response rate to ketamine at 24 hours, versus 28% for an active placebo (midazolam). Source: American Journal of Psychiatry (Murrough et al.).
- A broader review reports published response rates generally between 35% and 60% for low-dose ketamine in treatment-resistant depression, with meta-analytic estimates around 50% response and 28% remission. Source: Psychiatry Research five-year public-clinic study (2024).
- An open-label study found a 70.8% response rate after up to six IV infusions given over two weeks. Source: Translational Psychiatry.
- By contrast, research summarizing the STAR*D era found roughly 27% response and 17% remission at six months after two ineffective antidepressant trials, with about 14% remission as a third-line medication. Source: PMC ketamine review.
- Response is not universal: one naturalistic inpatient study found 75% of 40 treatment-resistant patients were classified as non-responders to short-term ketamine, a reminder that outcomes vary by protocol and by population. Source: Pharmacological Reports (2025).
The honest takeaway: what you'd actually pay and how you'd actually respond depend on your insurance, your history, and the specific clinic, none of which a published survey can tell you. A clinician who knows your case, and a clinic that can check your coverage, are the only sources that can answer those two questions for you.
Where to get your own numbers
If you're in St. Charles County, St. Louis County, or anywhere in the greater St. Louis area, Brain Recovery Centers is a doctor-supervised clinic that offers FDA-approved esketamine for treatment-resistant depression, often covered by insurance including MO HealthNet, subject to prior authorization. They can check your specific coverage and give you a real estimate rather than a published average.
See if you qualify → Book a free consultation