Average Medicaid Prescription Medications Payments in Sioux Falls, SD: $14.96
Avg. Paid
$14.96
Range
$0.00 – $646.73
Total Claims
29,217
Providers
22
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.
Prescription drug costs and pharmacy services covered under Medicaid. Includes brand-name and generic medications across all therapeutic categories.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Prescription Medications in Sioux Falls, SD
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Sanford Medical Center
1420 W 22Ndst Ste 104 |
$24.50 | 7,268 | 5,854 |
|
Sanford Medical Center
1305 W 18Th St |
$8.06 | 4,999 | 2,502 |
|
Sanford Medical Center
1321 W 22Nd St |
$0.03 | 4,711 | 396 |
|
Avera Mckennan
4210 W 53Rd St |
$0.03 | 3,650 | 802 |
|
Patrick D Munson
1310 W 22Nd St |
$0.74 | 2,154 | 1,744 |
|
Avera Mckennan
1325 S Cliff Ave |
$27.14 | 2,100 | 1,173 |
|
Mohammad Zeeshan Qamar
1205 S Grange Ave |
$1.03 | 1,861 | 152 |
|
Avera Mckennan
1200 S 7Th Ave |
$37.04 | 991 | 916 |
|
Kurt Eeg
1600 W 22Nd St |
$0.12 | 333 | 298 |
|
Siouxland Oral Surgery
6401 S Minnesota Ave |
$5.12 | 325 | 278 |
|
Lu Y Huber
1315 S Cliff Ave |
$3.38 | 165 | 37 |
|
Avera Mckennan
1301 S. Cliff Ave. |
$646.73 | 129 | 70 |
|
John W Belk
800 E 21St St |
$1.49 | 116 | 106 |
|
Mark Gregory Desautel
1310 W 22Nd St |
$1.31 | 102 | 73 |
|
Bassel Salem
1210 W 18Th St |
$337.97 | 73 | 36 |
|
Jared William Daniel
1210 W 18Th St Ste G01 |
$0.02 | 58 | 55 |
|
Geoffrey F Haft
1305 W 18Th St |
$0.23 | 58 | 48 |
|
Rosanne Linda Bosch
1205 S Grange Ave |
$1.07 | 46 | 43 |
|
Michelle Kutzke
1305 W 18Th St |
$88.73 | 29 | 28 |
|
Orthopaedic Consultants Ltd
2908 E 26Th St |
$2.64 | 19 | 13 |
|
Ophthalmology Ltd
6601 S Minnesota Ave |
$436.96 | 18 | 12 |
|
Sean Johnson
1310 W 22Nd St |
$0.00 | 12 | 12 |
What to Expect: Prescription Medications
Medicaid covers most medically necessary prescription medications. Your copay is typically $0-3 for generic drugs and $0-5 for brand-name drugs. Some medications require prior authorization. Most prescriptions can be filled at any participating pharmacy. Mail-order pharmacy may be available for maintenance medications. 90-day supplies may be available for chronic conditions.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| 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 are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Prescription Medications cost in Sioux Falls, SD?
Based on public Medicaid payment data, the average Medicaid reimbursement for Prescription Medications in Sioux Falls, SD is $14.96 per claim, based on 29,217 claims from 22 providers. Typical payments fall between $0.68 and $14.54. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Prescription Medications in Sioux Falls, SD?
There are 22 Medicaid providers offering Prescription Medications related services in Sioux Falls, SD according to public payment data.
What is the price range for Prescription Medications in Sioux Falls, SD?
Medicaid reimbursement for Prescription Medications in Sioux Falls, SD ranges from $0.00 to $646.73 per claim, with an average of $14.96. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Prescription Medications in Other Cities
Phoenix, AZ
Avg $16.15
844,810 claims · 235 providers
Milwaukee, WI
Avg $9.22
755,550 claims · 88 providers
Washington, DC
Avg $6.48
675,765 claims · 92 providers
Los Angeles, CA
Avg $61.23
617,979 claims · 282 providers
Louisville, KY
Avg $31.67
601,676 claims · 181 providers
New York, NY
Avg $40.26
587,024 claims · 195 providers
San Diego, CA
Avg $27.34
493,429 claims · 162 providers
Tucson, AZ
Avg $24.34
489,015 claims · 169 providers
Other Procedures in Sioux Falls, SD
Office Visit
Avg $50.32
948,639 claims
Blood Work & Lab Tests
Avg $10.61
501,187 claims
Vaccines & Immunizations
Avg $11.07
358,214 claims
Psychiatric Evaluation
Avg $63.31
349,102 claims
X-Ray
Avg $9.88
280,494 claims
Emergency Room Visit
Avg $92.67
213,799 claims
Personal Care Services
Avg $119.40
213,761 claims
Speech Therapy
Avg $21.62
173,302 claims