Skip to content
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
Heflin, AL $0.14 $0.14 – $0.14 136 1
Stafford, TX $0.26 $0.26 – $0.26 137 1
Misissippi State University, MS $0.17 $0.17 – $0.17 137 1
Burnsville, MS $7.06 $7.06 – $7.06 137 1
Vadnais Heights, MN $0.67 $0.67 – $0.67 138 1
El Dorado Springs, MO $0.00 $0.00 – $0.00 138 1
Fort Sam Houston, TX $0.14 $0.13 – $0.16 138 2
Dickinson, TX $36.77 $29.78 – $64.23 138 2
Hayti, MO $3.56 $3.56 – $3.56 138 1
Lincoln City, OR $5.04 $0.00 – $11.29 139 4
Lake Katrine, NY $33.09 $5.02 – $308.41 139 3
St. Paul, MN $0.06 $0.06 – $0.06 139 1
Waterford, CA $8.93 $8.93 – $8.93 139 1
Bryson City, NC $2.82 $2.82 – $2.82 139 1
Granbury, TX $34.56 $2.46 – $57.42 140 6
Davie, FL $0.25 $0.00 – $0.37 140 2
Redmond, WA $28.92 $28.92 – $28.92 140 1
Jamestown, CA $0.00 $0.00 – $0.00 140 1
Du Bois, PA $2.63 $2.63 – $2.63 141 1
New Ulm, MN $5.58 $4.38 – $10.97 141 3
Nephi, UT $24.90 $24.90 – $24.90 141 1
Jacksonville, TX $0.55 $0.55 – $0.55 142 1
Pampa, TX $14.61 $0.48 – $69.73 142 3
Buena Vista, GA $0.18 $0.18 – $0.18 142 1
Cedar Park, TX $69.36 $0.63 – $521.87 143 5
Syosset, NY $2.78 $2.78 – $2.78 143 1
Wild Rose, WI $0.04 $0.04 – $0.04 143 1
Maple Heights, OH $0.00 $0.00 – $0.00 144 2
North Bellmore, NY $0.67 $0.67 – $0.67 144 1
St Augustine, FL $1.22 $0.58 – $1.31 146 2
Barrington, IL $634.46 $634.46 – $634.46 147 1
Brockport, NY $82.33 $82.33 – $82.33 147 1
Langley Afb, VA $0.10 $0.00 – $0.34 147 2
Kirksville, MO $0.03 $0.00 – $0.33 149 2
Silverton, OR $6.47 $0.00 – $8.35 149 4
South Pasadena, CA $330.18 $17.10 – $362.65 149 2
Mc Lean, VA $2.10 $1.42 – $5.13 149 5
Simmesport, LA $0.05 $0.00 – $0.48 149 2
West Lafayette, IN $5.01 $0.72 – $5.56 150 2
Lancaster, NH $75.72 $75.72 – $75.72 150 1
Solon, IA $0.63 $0.63 – $0.63 150 1
Parrish, FL $1.04 $0.34 – $1.15 151 2
Canyon Country, CA $60.24 $60.24 – $60.24 151 1
Crystal Springs, MS $1.79 $1.79 – $1.79 151 1
Coto Laurel, PR $1.07 $0.00 – $12.81 152 3
Brinkley, AR $0.01 $0.01 – $0.01 152 1
Willoughby Hills, OH $39.03 $39.03 – $39.03 152 1
Owatonna, MN $6.98 $0.00 – $65.00 153 5
San Marino, CA $3.41 $3.34 – $4.17 153 2
Cape Carteret, NC $0.93 $0.93 – $0.93 153 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.