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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
Siloam Springs, AR $68.21 $68.21 – $68.21 40 1
Middleboro, MA $333.94 $333.94 – $333.94 40 1
White Salmon, WA $151.19 $151.19 – $151.19 40 1
Horseshoe Bend, AR $7.40 $7.40 – $7.40 40 1
Piketon, OH $6.49 $6.49 – $6.49 40 1
Mt Pleasant, IA $32.06 $32.06 – $32.06 40 1
Faribanks, AK $0.47 $0.47 – $0.47 40 1
Frisco City, AL $0.00 $0.00 – $0.00 40 1
New Houlka, MS $0.02 $0.02 – $0.02 40 1
Garner, NC $3.02 $3.02 – $3.02 41 1
Cave Junction, OR $1.11 $1.11 – $1.11 41 1
Daingerfield, TX $1.57 $1.57 – $1.57 41 1
Fairport, NY $0.95 $0.61 – $1.09 41 2
Brewster, WA $36.42 $36.42 – $36.42 41 1
Wayne, WV $0.00 $0.00 – $0.00 41 1
Loretto, TN $1.32 $1.32 – $1.32 41 1
Centerton, AR $31.09 $31.09 – $31.09 41 1
Weaverville, CA $10.25 $10.25 – $10.25 41 1
Westminster, SC $0.36 $0.36 – $0.36 41 1
Trotwood, OH $0.61 $0.03 – $1.12 41 3
Woodway, TX $0.14 $0.14 – $0.14 41 1
Middlefield, OH $0.00 $0.00 – $0.00 41 1
Arnaudville, LA $0.39 $0.39 – $0.39 41 1
Playa Vista, CA $0.00 $0.00 – $0.00 41 2
Brusly, LA $0.47 $0.47 – $0.47 41 1
Huntley, IL $79.42 $79.42 – $79.42 42 1
Park Rapids, MN $1.07 $1.07 – $1.07 42 1
Indiana, PA $0.00 $0.00 – $0.00 42 1
Rockland, ME $80.21 $75.00 – $82.55 42 2
Pinckneyville, IL $1.78 $1.78 – $1.78 42 1
Blakely, GA $13.33 $13.33 – $13.33 42 1
Lincoln, CA $15.82 $15.82 – $15.82 42 1
De Witt, NY $13.59 $13.59 – $13.59 42 1
Timpson, TX $0.66 $0.66 – $0.66 42 1
Dobbs Ferry, NY $1.58 $1.58 – $1.58 43 1
Springfield, PA $0.42 $0.42 – $0.42 43 1
Stow, OH $0.36 $0.36 – $0.36 43 1
Weaverville, NC $0.10 $0.10 – $0.10 43 1
Granite City, IL $50.98 $0.59 – $83.93 43 2
Lincoln, IL $65.75 $1.46 – $93.61 43 2
Plainville, CT $7.20 $7.20 – $7.20 43 1
Alpharetta, GA $0.68 $0.68 – $0.68 43 1
Moorhead, MN $48.32 $22.16 – $108.70 43 2
Seaside, OR $5.03 $5.03 – $5.03 43 1
Port St John, FL $0.00 $0.00 – $0.00 43 1
Dunbar, WV $0.45 $0.45 – $0.45 43 1
Kansas, OK $11.02 $11.02 – $11.02 43 1
Hueytown, AL $1.34 $1.34 – $1.34 43 1
Buda, TX $0.83 $0.83 – $0.83 43 1
Aspen, CO $8.07 $0.00 – $22.19 44 2

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.