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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
New Caney, TX $10.10 $10.10 – $10.10 183 1
Moorestown, NJ $8.15 $5.90 – $9.83 184 4
Buford, GA $0.40 $0.40 – $0.40 184 1
Florence, OR $52.01 $9.75 – $71.75 184 3
Fairmont, NC $0.51 $0.51 – $0.51 184 1
Montvale, NJ $0.45 $0.45 – $0.45 184 1
Kinnelon, NJ $81.82 $81.82 – $81.82 184 1
Gardendale, AL $1.00 $0.54 – $1.08 184 4
Arab, AL $0.40 $0.26 – $0.99 185 3
Greenup, KY $35.12 $27.53 – $36.90 185 2
Hollywood, MD $44.39 $44.39 – $44.39 185 1
Woodlake, CA $0.47 $0.47 – $0.47 185 1
Sarepta, LA $0.00 $0.00 – $0.00 185 2
Junction City, KS $1.07 $1.07 – $1.07 186 1
Moody Afb, GA $39.86 $36.90 – $82.69 186 2
Kermit, TX $6.47 $6.47 – $6.47 187 1
Safety Harbor, FL $0.99 $0.00 – $1.25 187 3
Seaside, CA $55.42 $5.01 – $73.71 187 3
Richmond Heights, OH $17.59 $0.14 – $99.22 187 5
Chapel Hill, TN $1.90 $1.90 – $1.90 187 1
Danville, PA $2.24 $0.00 – $3.00 188 3
Pickerington, OH $1.48 $1.35 – $1.59 188 2
Willows, CA $4.56 $3.08 – $5.22 189 3
Wartburg, TN $0.59 $0.47 – $0.75 190 5
Thomaston, GA $0.40 $0.08 – $0.48 190 2
Wintersville, OH $2.21 $0.43 – $2.34 190 2
Wauchula, FL $17.96 $0.31 – $25.52 190 2
Canton, NY $86.54 $85.47 – $102.50 191 2
Grinnell, IA $0.54 $0.00 – $7.88 191 3
Sherwood, AR $30.41 $30.41 – $30.41 191 1
Jamestown, KY $13.17 $13.17 – $13.17 191 1
Ronkonkoma, NY $0.28 $0.28 – $0.28 192 1
Dallas, NC $0.49 $0.48 – $0.60 193 2
Clayton, AL $0.51 $0.00 – $0.59 193 2
Palestine, TX $16.97 $0.62 – $67.05 194 4
Kingston, OK $1.84 $1.84 – $1.84 194 1
Snead, AL $1.24 $0.69 – $8.76 194 2
Norton Shores, MI $0.57 $0.11 – $0.81 194 2
Montgomery, WV $6.35 $6.35 – $6.35 195 1
Pikeville, TN $2.39 $0.94 – $2.66 195 3
Palm Springs, FL $4.59 $1.05 – $9.63 196 2
Milaca, MN $0.88 $0.88 – $0.88 196 1
Greenfield, CA $30.33 $30.33 – $30.33 196 1
Clarksburg, WV $30.63 $7.29 – $35.49 197 2
Aguadilla, PR $62.91 $0.00 – $68.44 198 2
Fort Scott, KS $2.47 $0.17 – $20.46 198 3
Mountain Brk, AL $0.99 $0.99 – $0.99 198 1
Neon, KY $20.79 $20.79 – $20.79 198 1
Millinocket, ME $2.39 $2.39 – $2.39 198 1
Barboursville, WV $16.25 $6.83 – $53.86 199 4

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.