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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
Irondale, AL $6.96 $6.96 – $6.96 153 1
Adelanto, CA $82.51 $82.51 – $82.51 153 1
Ft Hood, TX $1.15 $1.15 – $1.15 153 1
Barberton, OH $0.16 $0.00 – $0.37 154 5
Melissa, TX $0.50 $0.50 – $0.50 154 1
Wartrace, TN $0.64 $0.64 – $0.64 154 1
Camilla, GA $15.83 $0.30 – $18.13 155 2
Leon, IA $0.89 $0.89 – $0.89 155 1
Theodore, AL $0.48 $0.48 – $0.48 155 1
Barlow, KY $11.22 $9.52 – $11.42 155 2
Karnack, TX $11.05 $11.05 – $11.05 155 1
Breese, IL $1.49 $1.02 – $3.83 156 2
Huntington, IN $23.53 $0.49 – $63.51 156 4
Pico Rivera, CA $0.85 $0.00 – $3.03 156 3
El Dorado Hills, CA $7.85 $7.07 – $12.14 156 2
Decatur, MS $14.72 $0.00 – $27.33 156 2
Bigfork, MT $17.58 $17.58 – $17.58 156 1
Smiths Station, AL $6.70 $6.70 – $6.70 156 1
Williamsport, PA $0.30 $0.00 – $3.77 157 3
Romney, WV $14.11 $0.00 – $20.51 157 2
Belvidere, IL $0.00 $0.00 – $0.00 157 1
Tipton, MI $0.92 $0.92 – $0.92 157 1
Melrose, MA $3.61 $3.61 – $3.61 158 1
Sioux Center, IA $7.75 $7.75 – $7.75 158 1
Tucumcari, NM $13.43 $13.43 – $13.43 159 1
Kilgore, TX $2.53 $0.00 – $14.43 160 2
Newberry, MI $32.22 $32.22 – $32.22 160 1
Laurelton, NY $5.20 $5.20 – $5.20 160 1
Satellite Beach, FL $22.72 $22.72 – $22.72 160 1
Pleasanton, TX $0.39 $0.00 – $0.97 161 3
Floyds Knobs, IN $4.42 $2.05 – $11.11 161 2
Robbinsdale, MN $0.57 $0.57 – $0.57 161 1
Spring City, TN $0.75 $0.24 – $1.58 161 4
Glenwood, IA $0.60 $0.60 – $0.60 162 1
Clinton, OK $46.06 $0.49 – $53.98 162 2
Maryville, IL $0.13 $0.13 – $0.13 162 1
Coldspring, TX $1.69 $1.69 – $1.69 162 1
Sequim, WA $1.15 $1.14 – $1.16 163 2
New Berlin, WI $0.00 $0.00 – $0.00 163 1
Fair Oaks Ranch, TX $1.39 $1.39 – $1.39 163 1
Macomb, MI $0.92 $0.92 – $0.92 163 1
Wildomar, CA $0.00 $0.00 – $0.00 164 1
Sandy Hook, KY $1.86 $1.86 – $1.86 164 1
Samson, AL $1.09 $0.00 – $9.51 164 3
Morton Grove, IL $9.08 $4.34 – $10.77 165 4
Maywood, CA $1,032 $1,032 – $1,032 165 1
North Liberty, IA $0.58 $0.58 – $0.62 165 2
Lockport, NY $2.84 $2.84 – $2.84 166 1
Fernandina Beach, FL $3.07 $3.07 – $3.07 167 1
Oakland, MD $3.37 $3.37 – $3.37 167 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.