@bustrbrwn22 Check out the clinics in your area and see if they have good reviews. Also check and see what they offer, how they do the treatments, etc. It's unregulated for the most part so some are pretty bad, others really good. I got lucky with the one I went to and I have been doing so much better this last year. I have had depression for 35 years now and it got steadily worse until the doctors were saying MDD as well.
The nasal spray should be covered by insurance but the IV isn't. Still, if the nasal spray doesn't work, that doesn't mean the IV wouldn't since the IV uses both ketamine molecules, not just one. I wish you the best and I hope you feel better soon.