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 — 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 |
|---|---|---|---|---|
| Flushing, NY | $86.51 | $30.89 – $213.36 | 17,305 | 5 |
| Santa Isabel, PR | $62.24 | $62.24 – $62.24 | 17,307 | 1 |
| San Bernardino, CA | $64.66 | $1.16 – $102.70 | 17,317 | 9 |
| Knoxville, TN | $68.35 | $0.85 – $128.43 | 17,367 | 30 |
| Teaneck, NJ | $202.24 | $202.24 – $202.24 | 17,937 | 1 |
| Peoria, IL | $44.95 | $21.90 – $69.04 | 18,134 | 14 |
| Akron, OH | $149.25 | $80.29 – $292.95 | 18,209 | 12 |
| Lynchburg, VA | $101.66 | $37.88 – $178.77 | 18,321 | 5 |
| Albany, GA | $60.51 | $60.51 – $60.51 | 18,583 | 1 |
| Kalamazoo, MI | $95.37 | $47.56 – $174.62 | 18,693 | 5 |
| Memphis, TN | $73.75 | $27.26 – $174.32 | 18,793 | 30 |
| Philadelphia, PA | $173.35 | $3.32 – $331.34 | 18,808 | 63 |
| Centralia, WA | $102.25 | $102.25 – $102.25 | 19,003 | 1 |
| Renton, WA | $58.98 | $38.02 – $59.95 | 19,032 | 3 |
| Colton, CA | $29.79 | $28.51 – $29.82 | 19,048 | 2 |
| Hattiesburg, MS | $102.61 | $18.93 – $327.32 | 19,064 | 11 |
| Visalia, CA | $50.58 | $0.00 – $137.01 | 19,348 | 7 |
| Edgewood, KY | $181.25 | $180.56 – $201.77 | 19,462 | 2 |
| Redding, CA | $55.50 | $3.21 – $103.44 | 19,474 | 4 |
| Glendale, AZ | $64.86 | $16.80 – $133.79 | 19,513 | 14 |
| Morgantown, WV | $113.19 | $56.54 – $114.41 | 19,638 | 4 |
| Yakima, WA | $71.37 | $71.37 – $71.37 | 19,803 | 1 |
| Spartanburg, SC | $128.71 | $45.57 – $129.22 | 20,194 | 3 |
| Toledo, OH | $109.38 | $43.13 – $139.46 | 20,251 | 11 |
| Saint Louis, MO | $72.46 | $53.92 – $205.45 | 20,374 | 48 |
| Charleston, WV | $134.28 | $43.39 – $140.74 | 20,519 | 4 |
| Ventura, CA | $31.51 | $31.50 – $32.51 | 21,029 | 2 |
| Wenatchee, WA | $74.49 | $74.49 – $74.49 | 21,038 | 1 |
| Little Rock, AR | $185.63 | $5.71 – $259.17 | 21,543 | 25 |
| Buffalo, NY | $219.49 | $42.75 – $263.86 | 21,579 | 10 |
| Moreno Valley, CA | $35.73 | $35.65 – $70.88 | 21,869 | 3 |
| Carmichael, CA | $10.05 | $3.05 – $30.32 | 21,926 | 6 |
| Chula Vista, CA | $51.29 | $19.75 – $127.92 | 22,517 | 8 |
| La Mesa, CA | $86.39 | $19.96 – $171.74 | 22,674 | 5 |
| Portland, ME | $109.42 | $42.74 – $139.04 | 22,718 | 6 |
| Lafayette, LA | $80.38 | $2.99 – $163.33 | 23,166 | 13 |
| San Juan, PR | $86.49 | $0.00 – $121.85 | 23,293 | 26 |
| Augusta, ME | $86.69 | $2.36 – $86.73 | 23,608 | 2 |
| Richland, WA | $87.67 | $53.72 – $87.92 | 23,879 | 2 |
| Jersey City, NJ | $93.71 | $6.34 – $309.09 | 24,108 | 8 |
| Clovis, CA | $5.67 | $4.56 – $26.06 | 24,379 | 3 |
| Honolulu, HI | $35.13 | $13.96 – $282.26 | 24,573 | 12 |
| Farmington, CT | $135.56 | $8.30 – $136.22 | 24,716 | 5 |
| Syracuse, NY | $159.50 | $57.24 – $178.64 | 25,118 | 7 |
| New Orleans, LA | $89.10 | $9.70 – $248.21 | 25,278 | 21 |
| Gulfport, MS | $90.41 | $41.92 – $105.42 | 25,634 | 4 |
| Houston, TX | $58.87 | $1.50 – $350.66 | 25,640 | 36 |
| Dayton, OH | $99.59 | $37.43 – $248.83 | 26,245 | 14 |
| Oakland, CA | $39.79 | $23.35 – $192.14 | 26,268 | 11 |
| Madison, WI | $60.01 | $51.00 – $102.31 | 26,325 | 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 | — | — | — |
| 96420 | Chemo intra-arterial push | — | — | — |
| 96423 | Chemo intra-arterial each addl | — | — | — |
| 96425 | Chemo intra-arterial pump | — | — | — |
| 96440 | Chemo intracavitary | — | — | — |
| 96446 | Chemo intraperitoneal | — | — | — |
These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.