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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
Troy, TN $1.27 $1.27 – $1.27 85 1
Jerseyville, IL $21.48 $0.00 – $48.73 86 3
Mount Pleasant, WI $470.06 $470.06 – $470.06 86 1
Lake Arthur, LA $0.00 $0.00 – $0.00 86 2
Foxworth, MS $0.03 $0.03 – $0.03 86 1
Cottonport, LA $0.00 $0.00 – $0.00 86 2
Murfressboro, TN $2.15 $2.15 – $2.15 86 1
Eagan, MN $387.44 $103.24 – $678.25 87 2
Ridgefield Park, NJ $4.12 $4.12 – $4.12 87 1
Cottage Grove, OR $10.96 $0.00 – $47.67 87 2
Decatur, IN $0.63 $0.00 – $1.11 87 3
Boerne, TX $1.14 $1.14 – $1.14 87 1
Spearfish, SD $55.20 $55.20 – $55.20 87 1
Middle River, MD $5.91 $5.91 – $5.91 87 1
Brooklyn, MS $2.56 $0.00 – $2.97 87 2
Sandusky, MI $7.53 $0.00 – $20.08 88 2
West Nyack, NY $3.57 $0.00 – $5.24 88 2
Worthington, MN $33.16 $1.58 – $97.39 88 2
Murphysboro, IL $0.71 $0.14 – $0.99 88 2
Big Sky, MT $0.25 $0.25 – $0.25 88 1
Firth, ID $7.73 $7.73 – $7.73 88 1
Farmers Branch, TX $0.20 $0.00 – $0.40 89 3
Middleburg Heights, OH $0.09 $0.00 – $0.54 89 3
Loogootee, IN $0.30 $0.30 – $0.30 89 1
Cuyahogo Falls, OH $0.11 $0.11 – $0.11 89 1
Galena, KS $5.23 $5.16 – $5.66 90 2
Stamps, AR $0.18 $0.18 – $0.18 90 1
Asbury Park, NJ $2.30 $0.90 – $4.21 90 2
Middleburg Hts, OH $0.11 $0.11 – $0.11 90 1
Kaplan, LA $1.99 $1.99 – $1.99 91 1
Mount Gilead, OH $0.20 $0.00 – $0.36 91 2
Osceola, IN $14.26 $14.26 – $14.26 91 1
Port Isabel, TX $1.33 $1.33 – $1.33 91 1
Napoleonville, LA $1.22 $0.53 – $4.24 91 2
Rigby, ID $4.13 $0.24 – $5.03 91 2
Dillingham, AK $14.99 $14.99 – $14.99 91 1
Scottsburg, IN $0.92 $0.17 – $1.52 92 2
Liberty Township, OH $98.77 $98.77 – $98.77 92 1
Vardaman, MS $1.54 $0.00 – $11.79 92 2
Essexville, MI $7.90 $0.05 – $10.94 93 2
Diamondhead, MS $12.97 $8.94 – $14.80 93 2
Roslindale, MA $28.01 $28.01 – $28.01 93 1
Mebane, NC $2.39 $1.34 – $2.93 93 2
Fountain, CO $0.85 $0.00 – $1.13 93 2
Arrington, VA $0.54 $0.54 – $0.54 93 1
Hilmar, CA $1.12 $1.12 – $1.12 93 1
Loxahatchee, FL $1.89 $1.15 – $5.01 94 2
Miami Lakes, FL $0.05 $0.05 – $0.05 94 1
Beatrice, NE $38.90 $7.87 – $54.71 94 3
Longwood, FL $1.76 $0.00 – $2.07 94 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.