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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
Heber City, UT $9.99 $0.00 – $11.35 125 2
Wheaton, IL $1,042 $922.03 – $1,113 126 3
Waxhaw, NC $870.36 $870.36 – $870.36 126 1
De Kalb, TX $0.55 $0.55 – $0.55 126 1
Jackson, LA $0.71 $0.71 – $0.71 126 1
Clark, NJ $4.23 $4.23 – $4.23 127 1
Fairhaven, MA $0.93 $0.93 – $0.93 127 1
Jamestown, ND $55.70 $55.70 – $55.70 127 1
Port Matilda, PA $0.00 $0.00 – $0.00 128 1
Pigeon, MI $0.00 $0.00 – $0.00 128 1
Hayden, AL $0.30 $0.30 – $0.30 128 1
Geneva, IL $85.60 $8.99 – $714.95 129 2
Ocean, NJ $1.18 $1.18 – $1.18 129 1
Waukee, IA $0.00 $0.00 – $0.00 129 2
Lowville, NY $0.44 $0.44 – $0.44 129 1
Rutledge, TN $3.14 $3.14 – $3.14 129 1
Sealy, TX $0.42 $0.42 – $0.42 129 1
Davis, OK $2.85 $2.85 – $2.85 129 1
Carmi, IL $0.76 $0.00 – $1.49 129 3
Peachtree Corners, GA $635.92 $635.92 – $635.92 129 1
La Plata, MD $18.20 $18.20 – $18.20 130 1
Vinton, LA $0.90 $0.90 – $0.90 130 1
Blue Island, IL $28.27 $28.27 – $28.27 130 1
Jonesboro, GA $5.12 $5.12 – $5.12 130 1
Shelby, OH $3.89 $3.89 – $3.89 130 1
Fountain Inn, SC $6.55 $6.55 – $6.55 131 1
Iowa, LA $0.17 $0.17 – $0.17 131 1
Winchester, IN $0.00 $0.00 – $0.00 132 1
Lake Oswego, OR $0.17 $0.00 – $0.20 132 2
Highland Village, TX $4.09 $4.09 – $4.09 132 1
Belle Glade, FL $1.69 $1.69 – $1.69 132 1
Bethel, VT $60.51 $60.51 – $60.51 132 1
Nolensville, TN $1.68 $1.68 – $1.68 133 1
Sisseton, SD $2.90 $0.70 – $3.14 133 2
Anadarko, OK $1.03 $1.03 – $1.03 133 1
Salmon, ID $1.96 $0.61 – $7.75 133 2
Fort Gay, WV $0.00 $0.00 – $0.00 133 2
Adairsville, GA $0.51 $0.32 – $1.11 133 2
Enterprise, MS $0.00 $0.00 – $0.00 133 2
Delta, CO $214.91 $0.00 – $958.03 134 4
Prescott Valley, AZ $6.02 $1.00 – $11.17 134 3
Pismo Beach, CA $40.22 $40.22 – $40.22 134 1
Crawfordsville, IN $0.00 $0.00 – $0.00 134 2
Marina, CA $1.72 $1.72 – $1.72 134 1
Colfax, LA $7.05 $0.00 – $8.42 135 2
Fremont, NE $17.72 $1.10 – $25.22 135 2
Huntertown, IN $3.18 $3.18 – $3.18 135 1
Gunnison, MS $0.45 $0.45 – $0.45 135 1
Collinsville, OK $0.16 $0.16 – $0.16 136 1
Coamo, PR $0.00 $0.00 – $0.00 136 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.