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Based on public Medicaid payment data.

Average Medicaid Chemotherapy Payments

Typical Medicaid Chemotherapy reimbursement across 1,568 cities

Avg. Medicaid Paid

$109.50

Price Range

$0.00 – $913.38

Total Claims

8.5M

Cities

1568

Typical Payment Range

Typical Medicaid Chemotherapy payments fall between $46.77 and $118.62 per claim (median: $74.00). The top 10% of payments exceed $195.22.

Based on per-provider averages across all Medicaid claims in this category.

About This Procedure

Chemotherapy uses drugs to destroy cancer cells. Treatment may be given intravenously, orally, or through injection.

Why do these costs look low?

These figures represent Medicaid reimbursement rates β€” the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.

Costs by City

City Avg. Paid Min / Max Claims Providers
Bristol, CT $179.57 $53.50 – $182.99 3,296 2
Port Angeles, WA $100.64 $100.64 – $100.64 3,311 1
Salinas, CA $14.02 $13.17 – $85.00 3,337 3
Cayey, PR $71.17 $59.91 – $93.05 3,337 2
Winston Salem, NC $76.39 $13.11 – $250.57 3,368 13
Lancaster, OH $108.01 $54.15 – $149.28 3,370 4
Roswell, NM $76.05 $60.88 – $87.21 3,381 4
Farmington, NM $82.64 $73.55 – $253.77 3,402 4
Burbank, CA $11.70 $1.78 – $25.79 3,403 4
Thornton, CO $97.62 $65.57 – $243.98 3,422 4
Aguadilla, PR $67.27 $29.41 – $71.87 3,427 3
Princeton, WV $60.39 $60.03 – $84.80 3,433 2
Victorville, CA $53.71 $24.49 – $58.83 3,440 3
Hampton, VA $73.76 $52.15 – $83.38 3,440 5
Ypsilanti, MI $142.86 $142.86 – $142.86 3,452 1
Cape Girardeau, MO $117.45 $25.97 – $175.24 3,454 6
Morristown, TN $82.65 $35.13 – $83.05 3,455 2
Cerritos, CA $4.18 $0.58 – $19.14 3,457 6
Columbus, IN $132.81 $132.81 – $132.81 3,458 1
Powell, TN $38.75 $35.71 – $41.80 3,458 2
Everett, WA $44.91 $37.23 – $94.83 3,459 12
Burlington, MA $321.81 $70.89 – $323.78 3,460 2
Wayne, NJ $72.92 $72.92 – $72.92 3,464 1
Brockton, MA $95.36 $35.72 – $111.56 3,468 5
Stratford, NJ $190.00 $93.44 – $191.81 3,483 2
Oak Park, MI $42.05 $42.05 – $42.05 3,491 1
Amarillo, TX $82.08 $55.84 – $144.40 3,509 5
Oroville, CA $19.66 $19.66 – $19.66 3,516 1
Pinehurst, NC $21.54 $13.20 – $26.52 3,534 5
Marietta, OH $97.24 $68.22 – $115.32 3,536 3
Presque Isle, ME $92.15 $92.15 – $92.15 3,549 1
Henderson, NV $68.40 $49.28 – $111.37 3,553 11
Clifton, NJ $26.24 $26.24 – $26.24 3,582 1
Reed City, MI $168.10 $168.10 – $168.10 3,625 1
Harlingen, TX $55.48 $26.18 – $67.50 3,628 6
Corona, CA $45.32 $14.33 – $106.80 3,634 5
Wheeling, WV $99.58 $0.00 – $101.42 3,711 3
Oak Ridge, TN $88.67 $87.61 – $96.12 3,711 3
Toms River, NJ $325.12 $325.12 – $325.12 3,795 1
Racine, WI $44.04 $44.04 – $44.04 3,821 1
Canfield, OH $56.51 $54.45 – $73.45 3,842 4
Greenwood, SC $30.76 $30.76 – $30.76 3,850 1
Decatur, AL $40.81 $38.80 – $55.38 3,867 3
Northport, AL $21.58 $21.48 – $22.47 3,890 2
Owosso, MI $109.16 $109.16 – $109.16 3,902 1
Anderson, SC $69.28 $2.47 – $90.99 3,917 5
Manchester, NH $81.43 $41.65 – $103.67 3,922 5
Smithfield, NC $59.55 $59.55 – $59.55 3,928 1
Lakewood, WA $126.82 $126.82 – $126.82 3,948 1
Fort Worth, TX $79.77 $40.79 – $201.47 3,957 6

Cost Components

National averages for each billing code in this procedure category. Sorted by claim volume.

Code Description Avg. Paid Claims Providers
96413 Chemo IV infusion 1st hr $117.22 6,271,753 5,360
96415 Chemo IV infusion each addl hr $133.82 1,276,390 1,260
96417 Chemo IV infusion each addl seq $46.31 875,230 905
96401 Chemo admin subcut/IM non-horm $58.63 403,163 556
96411 Chemo IV push addl drug $55.59 286,798 290
96402 Chemo admin subcut/IM hormonal $60.58 262,364 362
96409 Chemo IV push single drug $90.29 199,614 201
96416 Chemo IV infusion initiation $164.00 144,761 171
96450 Chemo into CNS via lumbar $254.61 45,433 149
96422 Chemo intra-arterial infusion $50.81 156 2
96405 Chemo intralesional up to 7 $43.62 127 2
96406 Chemo intralesional >7 lesions β€” β€” β€”
96420 Chemo intra-arterial push β€” β€” β€”
96423 Chemo intra-arterial each addl β€” β€” β€”
96425 Chemo intra-arterial pump β€” β€” β€”
96440 Chemo intracavitary β€” β€” β€”
96446 Chemo intraperitoneal β€” β€” β€”

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.