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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
Great Barrington, MA $2.48 $2.48 – $2.48 167 1
Bridgeton, MO $0.00 $0.00 – $0.00 168 2
Vestavia, AL $0.68 $0.34 – $0.74 168 2
Poulsbo, WA $76.95 $76.95 – $76.95 168 1
Andrews, TX $2.94 $1.78 – $5.25 168 2
Capac, MI $1.14 $1.14 – $1.14 168 1
Wakefield, RI $0.65 $0.57 – $0.79 169 3
Pearisburg, VA $0.92 $0.92 – $0.92 169 1
Benton, TN $1.71 $0.48 – $2.20 169 2
Greencastle, IN $8.06 $8.06 – $8.06 171 1
Greenville, IL $38.34 $0.00 – $42.03 171 2
Bear, DE $0.17 $0.17 – $0.17 171 1
Mammoth Spring, AR $0.12 $0.12 – $0.12 171 1
Hazlehurst, GA $1.56 $1.56 – $1.56 172 1
Big Bear Lake, CA $2.22 $2.22 – $2.22 172 1
Blue Mountain, MS $0.00 $0.00 – $0.00 172 1
Penitas, TX $0.17 $0.17 – $0.17 172 1
Belle Chasse, LA $0.52 $0.51 – $0.52 173 2
Covington, GA $0.84 $0.78 – $0.89 173 2
Rives, TN $0.00 $0.00 – $0.00 173 1
Tremonton, UT $2.69 $2.69 – $2.69 174 1
Liberal, KS $3.18 $3.00 – $3.60 175 2
Kendallville, IN $44.07 $44.07 – $44.07 175 1
Dumfries, VA $0.00 $0.00 – $0.00 175 1
Snoqualmie, WA $18.14 $2.07 – $21.87 175 2
Lady Lake, FL $14.27 $14.27 – $14.27 176 1
Fogelsville, PA $1,158 $1,158 – $1,158 176 1
Sumrall, MS $0.52 $0.00 – $0.62 176 3
Potts Camp, MS $3.98 $3.98 – $3.98 176 1
Spring Branch, TX $2.08 $2.08 – $2.08 176 1
Coleman, TX $0.40 $0.40 – $0.40 177 1
Douglas, GA $6.95 $6.95 – $6.95 177 1
Boyce, LA $0.71 $0.71 – $0.71 177 1
Harrisonburg, LA $8.40 $8.40 – $8.40 177 1
Reisterstown, MD $0.00 $0.00 – $0.00 178 1
Greensburg, IN $7.58 $0.00 – $88.07 178 3
Avon Park, FL $570.07 $0.11 – $622.52 178 2
La Jara, CO $0.70 $0.00 – $4.99 178 4
Lorton, VA $0.19 $0.18 – $0.32 178 2
Red Wing, MN $0.01 $0.01 – $0.01 179 1
Scottdale, PA $0.00 $0.00 – $0.00 179 1
Madisonville, TN $0.32 $0.15 – $0.79 179 5
Orange, TX $25.93 $8.75 – $31.18 180 3
Slippery Rock, PA $0.00 $0.00 – $0.00 180 1
Gray, TN $0.25 $0.15 – $0.52 182 2
North Vernon, IN $0.57 $0.16 – $0.64 182 2
Bermuda Run, NC $2.25 $2.25 – $2.25 182 1
Harrisburg, NC $29.02 $26.48 – $59.55 182 2
Jerome, ID $1.23 $1.23 – $1.23 182 1
Roxboro, NC $0.00 $0.00 – $0.00 183 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.