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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 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
Port Royal, SC $6.88 $6.88 – $6.88 26 1
Pierre, SD $50.60 $50.60 – $50.60 26 1
Salem, UT $0.00 $0.00 – $0.00 26 1
Nipomo, CA $2.66 $2.66 – $2.66 26 1
Carriere, MS $5.89 $5.89 – $5.89 26 1
Usaf Academy, CO $0.00 $0.00 – $0.00 26 1
Lexington, NE $30.72 $30.72 – $30.72 26 1
West Jefferson, NC $1.68 $1.68 – $1.68 26 1
Lindsay, OK $0.36 $0.36 – $0.36 26 1
Orr, MN $0.46 $0.46 – $0.46 26 1
Knightstown, IN $1.00 $1.00 – $1.00 26 1
Benton, LA $0.57 $0.57 – $0.57 26 1
Pangburn, AR $0.04 $0.04 – $0.04 26 1
Fort Johnson, LA $1.43 $1.43 – $1.43 26 1
Hays, KS $2.43 $2.35 – $2.51 27 2
Wynnewood, PA $224.00 $224.00 – $224.00 27 1
Monticello, IN $1.35 $1.35 – $1.35 27 1
Salem, IL $0.00 $0.00 – $0.00 27 1
Lewisburg, PA $3.02 $3.02 – $3.02 27 1
Mccamey, TX $1.52 $1.52 – $1.52 27 1
Bradford, AR $6.67 $6.67 – $6.67 27 1
Bloomsburg, PA $0.00 $0.00 – $0.00 27 1
Lake Forest, IL $3.65 $3.10 – $4.34 27 2
Ft Walton Beach, FL $63.69 $63.69 – $63.69 27 1
Jamestown, OH $0.11 $0.11 – $0.11 27 1
Lamont, CA $0.00 $0.00 – $0.00 27 2
Fairfield, TX $0.16 $0.16 – $0.16 27 1
Basalt, CO $22.77 $22.77 – $22.77 27 1
Del Norte, CO $0.00 $0.00 – $0.00 27 1
Cedar Hill, TX $98.46 $98.46 – $98.46 27 1
Newman, CA $8.61 $8.61 – $8.61 27 1
Sterling, MI $0.58 $0.58 – $0.58 27 1
Avondale, PA $1.18 $1.18 – $1.18 27 1
Cashiers, NC $0.47 $0.47 – $0.47 27 1
Brookhaven, GA $6.78 $6.78 – $6.78 27 1
Adamsville, TN $0.31 $0.27 – $0.35 27 2
Aliso Viejo, CA $0.06 $0.06 – $0.06 28 1
Langhorne, PA $0.45 $0.00 – $0.83 28 2
Piqua, OH $70.23 $70.23 – $70.23 28 1
Lutz, FL $305.98 $305.98 – $305.98 28 1
Angier, NC $1.14 $1.14 – $1.14 28 1
Silverthorne, CO $0.00 $0.00 – $0.00 28 1
Pleasant Grove, UT $4.54 $4.54 – $4.54 28 1
Mangonia Park, FL $0.02 $0.00 – $0.05 28 2
San Fernando, CA $10.71 $0.00 – $21.41 28 2
Newport, OR $5.25 $0.00 – $10.50 28 2
Whitehall, OH $0.00 $0.00 – $0.00 28 1
Uncasville, CT $0.00 $0.00 – $0.00 28 1
El Reno, OK $0.60 $0.00 – $1.20 28 2
Lenox, MA $4.91 $4.91 – $4.91 28 1

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 β€”
J0120 Tetracyclin injection β€” β€” β€”
J0133 Acyclovir injection β€” β€” β€”
J0202 Injection, alemtuzumab β€” β€” β€”
J0795 Corticorelin ovine triflutal β€” β€” β€”
J1160 Digoxin injection β€” β€” β€”
J1205 Chlorothiazide sodium inj β€” β€” β€”
J1260 Dolasetron mesylate β€” β€” β€”
J1290 Ecallantide injection β€” β€” β€”
J1300 Eculizumab injection β€” β€” β€”
J1301 Injection, edaravone, 1 mg β€” β€” β€”
J1303 Inj., ravulizumab-cwvz 10 mg β€” β€” β€”
J1305 Inj, evinacumab-dgnb, 5mg β€” β€” β€”
J1320 Amitriptyline injection β€” β€” β€”
J1322 Elosulfase alfa, injection β€” β€” β€”
J1327 Eptifibatide injection β€” β€” β€”

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