Based on public Medicaid payment data.
Average Medicaid Prescription Medications Payments
Typical Medicaid Prescription Medications reimbursement across 5,304 cities
Avg. Medicaid Paid
$28.35
Price Range
$0.00 – $2,704
Total Claims
61.1M
Cities
5304
Typical Payment Range
Typical Medicaid Prescription Medications payments fall between $0.68 and $14.54 per claim (median: $2.87). The top 10% of payments exceed $78.92.
Based on per-provider averages across all Medicaid claims in this category.
About This Procedure
Prescription drug costs and pharmacy services covered under Medicaid. Includes brand-name and generic medications across all therapeutic categories.
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 |
|---|---|---|---|---|
| Phoenix, AZ | $16.15 | $0.00 – $2,162 | 844,810 | 235 |
| Milwaukee, WI | $9.22 | $0.00 – $877.54 | 755,550 | 88 |
| Washington, DC | $6.48 | $0.00 – $820.33 | 675,765 | 92 |
| Los Angeles, CA | $61.23 | $0.00 – $2,664 | 617,979 | 282 |
| Louisville, KY | $31.67 | $0.00 – $905.23 | 601,676 | 181 |
| New York, NY | $40.26 | $0.00 – $1,393 | 587,024 | 195 |
| San Diego, CA | $27.34 | $0.00 – $3,660 | 493,429 | 162 |
| Tucson, AZ | $24.34 | $0.00 – $2,118 | 489,015 | 169 |
| Richmond, VA | $24.15 | $0.00 – $1,110 | 476,311 | 71 |
| Columbus, OH | $41.87 | $0.00 – $1,379 | 466,534 | 411 |
| Brooklyn, NY | $29.45 | $0.00 – $497.38 | 442,699 | 193 |
| Jackson, MS | $28.53 | $0.00 – $708.89 | 431,392 | 96 |
| Bronx, NY | $18.05 | $0.00 – $520.89 | 416,877 | 127 |
| Bakersfield, CA | $35.29 | $0.00 – $4,862 | 416,479 | 226 |
| Cleveland, OH | $44.59 | $0.00 – $1,925 | 415,249 | 254 |
| Grand Rapids, MI | $43.58 | $0.00 – $1,492 | 383,934 | 39 |
| Detroit, MI | $18.05 | $0.00 – $624.62 | 361,248 | 88 |
| Seattle, WA | $25.86 | $0.00 – $1,263 | 360,308 | 77 |
| Lexington, KY | $52.93 | $0.00 – $3,273 | 353,008 | 108 |
| Hartford, CT | $21.37 | $0.00 – $824.99 | 352,168 | 57 |
| Albuquerque, NM | $113.98 | $0.00 – $1,807 | 349,747 | 142 |
| Norfolk, VA | $46.71 | $0.01 – $2,019 | 319,510 | 63 |
| Cincinnati, OH | $24.56 | $0.00 – $1,496 | 318,779 | 299 |
| New Haven, CT | $47.96 | $0.00 – $785.82 | 318,265 | 46 |
| Sacramento, CA | $37.82 | $0.00 – $2,631 | 318,080 | 113 |
| Boston, MA | $61.29 | $0.00 – $1,112 | 301,915 | 77 |
| Orange, CA | $31.40 | $0.00 – $2,351 | 284,281 | 46 |
| Tacoma, WA | $28.61 | $0.00 – $1,125 | 261,554 | 46 |
| Spokane, WA | $21.68 | $0.00 – $1,490 | 260,273 | 59 |
| Yuma, AZ | $14.50 | $0.00 – $2,211 | 246,152 | 32 |
| Akron, OH | $19.40 | $0.00 – $2,142 | 236,984 | 144 |
| Fresno, CA | $6.39 | $0.00 – $271.07 | 235,861 | 118 |
| Memphis, TN | $46.55 | $0.00 – $1,041 | 229,975 | 253 |
| Mesa, AZ | $4.78 | $0.00 – $1,088 | 224,870 | 52 |
| San Jose, CA | $22.62 | $0.00 – $1,592 | 219,370 | 62 |
| Charleston, SC | $14.59 | $0.00 – $1,216 | 218,570 | 51 |
| San Bernardino, CA | $4.18 | $0.00 – $1,883 | 217,354 | 38 |
| Dayton, OH | $19.98 | $0.00 – $1,140 | 212,950 | 130 |
| Chicago, IL | $33.89 | $0.00 – $1,268 | 208,714 | 239 |
| Oakland, CA | $34.41 | $0.00 – $1,155 | 205,855 | 49 |
| Greenville, SC | $2.93 | $0.00 – $935.46 | 203,111 | 66 |
| Anaheim, CA | $5.79 | $0.02 – $3,488 | 200,284 | 35 |
| Glendale, AZ | $1.37 | $0.00 – $886.60 | 198,422 | 46 |
| Green Bay, WI | $24.41 | $0.00 – $1,473 | 196,056 | 32 |
| Flint, MI | $3.48 | $0.00 – $771.62 | 189,213 | 47 |
| Riverside, CA | $15.49 | $0.00 – $5,117 | 187,771 | 63 |
| Madison, WI | $6.92 | $0.00 – $513.15 | 185,176 | 27 |
| Bridgeport, CT | $6.62 | $0.00 – $69.60 | 181,403 | 33 |
| Newark, NJ | $16.43 | $0.00 – $56.43 | 178,904 | 22 |
| Honolulu, HI | $28.23 | $0.00 – $1,912 | 177,198 | 38 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| J1100 | Dexamethasone sodium phos | $3.37 | 17,408,335 | 19,920 |
| J1270 | Injection, doxercalciferol | $16.67 | 15,455,545 | 1,785 |
| J0696 | Ceftriaxone sodium injection | $4.52 | 8,442,343 | 9,869 |
| J1170 | Hydromorphone injection | $3.20 | 6,069,586 | 3,002 |
| J1200 | Diphenhydramine hcl injectio | $3.10 | 5,922,771 | 3,790 |
| J0690 | Cefazolin sodium injection | $5.07 | 4,950,109 | 2,942 |
| J1050 | Medroxyprogesterone acetate | $38.04 | 2,722,661 | 5,740 |
| J0131 | Inj, acetaminophen (nos) | $15.79 | 2,017,135 | 1,612 |
| J1030 | Methylprednisolone 40 mg inj | $5.08 | 1,577,497 | 4,461 |
| J0882 | Darbepoetin alfa, esrd use | $63.10 | 1,115,197 | 646 |
| J1040 | Methylprednisolone 80 mg inj | $6.39 | 1,102,119 | 2,895 |
| J0585 | Injection,onabotulinumtoxina | $534.00 | 949,108 | 1,450 |
| J0702 | Betamethasone acet&sod phosp | $9.01 | 907,372 | 2,580 |
| J0780 | Prochlorperazine injection | $4.11 | 869,130 | 1,089 |
| J0178 | Aflibercept injection | $802.42 | 747,781 | 1,182 |
| J0171 | Adrenalin epinephrine inject | $5.61 | 533,091 | 956 |
| J0897 | Denosumab injection | $708.53 | 175,698 | 394 |
| J1071 | Inj testosterone cypionate | $3.01 | 121,666 | 206 |
| J0636 | Inj calcitriol per 0.1 mcg | $2.19 | 94,974 | 28 |
| J0885 | Epoetin alfa, non-esrd | $82.64 | 88,458 | 179 |
| J1020 | Methylprednisolone 20 mg inj | $3.48 | 88,065 | 344 |
| J0881 | Darbepoetin alfa, non-esrd | $149.52 | 63,199 | 108 |
| J0878 | Daptomycin injection | $167.80 | 55,762 | 36 |
| J1245 | Dipyridamole injection | $5.21 | 54,912 | 138 |
| J0592 | Buprenorphine hydrochloride | $15.56 | 48,440 | 32 |
| J0153 | Adenosine inj 1mg | $18.75 | 46,321 | 143 |
| J0670 | Inj mepivacaine hcl/10 ml | $0.91 | 37,668 | 90 |
| J0129 | Abatacept injection | $1,614 | 34,397 | 89 |
| J0735 | Clonidine hydrochloride | $6.85 | 32,191 | 92 |
| J0610 | Calcium glucon (fresenius) | $9.34 | 31,253 | 88 |
| J0135 | Adalimumab injection | $738.85 | 28,382 | 35 |
| J1094 | Inj dexamethasone acetate | $2.39 | 27,586 | 144 |
| J0717 | Certolizumab pegol inj 1mg | $2,072 | 22,279 | 41 |
| J0697 | Sterile cefuroxime injection | $0.94 | 18,132 | 47 |
| J0256 | Alpha 1 proteinase inhibitor | $2,389 | 16,156 | 1 |
| J1250 | Inj dobutamine hcl/250 mg | $6.92 | 14,579 | 60 |
| J0588 | Incobotulinumtoxin a | $295.98 | 10,950 | 18 |
| J1325 | Epoprostenol injection | $636.33 | 9,713 | 5 |
| J1240 | Dimenhydrinate injection | $0.02 | 8,738 | 12 |
| J1000 | Depo-estradiol cypionate inj | $11.84 | 1,738 | 11 |
| J1230 | Methadone injection | $4.00 | 1,439 | 2 |
| J1212 | Dimethyl sulfoxide 50% 50 ml | $175.32 | 1,145 | 5 |
| J1265 | Dopamine injection | $2.67 | 840 | 1 |
| J0132 | Acetylcysteine injection | $0.11 | 814 | 6 |
| J0834 | Inj., cosyntropin, 0.25 mg | $60.82 | 696 | 6 |
| J1120 | Acetazolamid sodium injectio | $8.30 | 446 | 4 |
| J0713 | Inj ceftazidime per 500 mg | $8.01 | 398 | 5 |
| J0698 | Cefotaxime sodium injection | $0.61 | 371 | 9 |
| J0775 | Collagenase, clost hist inj | $9,463 | 323 | 1 |
| J0207 | Amifostine | $23.74 | 42 | — |
| J0120 | Tetracyclin injection | — | — | — |
| J0133 | Acyclovir injection | — | — | — |
| J0202 | Injection, alemtuzumab | — | — | — |
| J0795 | Corticorelin ovine triflutal | — | — | — |
| J1160 | Digoxin injection | — | — | — |
| J1205 | Chlorothiazide sodium inj | — | — | — |
| J1260 | Dolasetron mesylate | — | — | — |
| J1290 | Ecallantide injection | — | — | — |
| J1300 | Eculizumab injection | — | — | — |
| J1301 | Injection, edaravone, 1 mg | — | — | — |
| J1303 | Inj., ravulizumab-cwvz 10 mg | — | — | — |
| J1305 | Inj, evinacumab-dgnb, 5mg | — | — | — |
| J1320 | Amitriptyline injection | — | — | — |
| J1322 | Elosulfase alfa, injection | — | — | — |
| J1327 | Eptifibatide injection | — | — | — |
These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.