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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
Hoffman Estates, IL $4.99 $0.69 – $5.43 347 3
Batavia, IL $2.48 $2.48 – $2.48 347 1
Bedford, MA $1.44 $1.28 – $4.32 347 2
Olivehurst, CA $1.70 $1.64 – $2.37 347 2
Campbell, OH $0.16 $0.15 – $0.38 348 2
Bennington, VT $0.21 $0.15 – $0.74 349 3
Pounding Mill, VA $0.72 $0.72 – $0.72 349 1
Kodak, TN $1.79 $0.92 – $2.01 349 3
Onley, VA $47.11 $41.32 – $49.46 350 3
Glandorf, OH $0.18 $0.18 – $0.18 350 1
Beverly, KY $1.86 $1.86 – $1.86 350 1
Wexford, PA $9.35 $9.35 – $9.35 351 1
New Canton, VA $54.28 $54.28 – $54.28 351 1
Labelle, FL $1.67 $0.89 – $1.78 351 3
Wetumpka, AL $0.80 $0.00 – $1.85 352 4
Independence, MO $0.00 $0.00 – $0.00 353 1
Cuthbert, GA $0.29 $0.29 – $0.29 353 1
Oakdale, LA $0.25 $0.00 – $0.82 353 5
Derby, KS $0.00 $0.00 – $0.00 353 1
Holly Hill, SC $0.57 $0.57 – $0.57 354 1
West Haven, CT $34.88 $0.00 – $53.95 355 3
Nederland, TX $2.93 $1.04 – $3.02 356 2
Casselberry, FL $0.00 $0.00 – $0.00 356 1
Agoura Hills, CA $61.73 $4.89 – $1,270 356 2
West Plains, MO $67.79 $0.00 – $85.52 357 3
Taylorville, IL $816.04 $816.04 – $816.04 357 1
Goshen, IN $11.75 $0.00 – $149.74 357 3
White Plains, MD $44.09 $0.00 – $70.41 358 3
Chesterfield, VA $4.47 $0.76 – $8.87 358 2
Woodbury, TN $0.42 $0.36 – $0.43 359 3
Bland, VA $0.59 $0.45 – $0.59 359 2
Michie, TN $0.48 $0.48 – $0.48 359 1
Allen, TX $248.89 $4.24 – $914.73 361 2
Waxahachie, TX $15.70 $0.04 – $68.12 361 5
Ft Worth, TX $13.67 $0.87 – $18.07 361 4
Worthington, OH $75.38 $0.14 – $84.76 361 2
Fort Valley, GA $1.55 $0.06 – $1.62 361 2
Uniontown, PA $0.03 $0.00 – $0.03 362 2
North Arlington, NJ $5.54 $5.52 – $5.55 363 2
Stratford, CT $0.59 $0.53 – $0.60 364 2
Cave City, KY $2.63 $0.85 – $4.30 364 4
Maurice, LA $0.10 $0.00 – $0.68 364 3
Somerville, MA $8.79 $8.79 – $8.79 365 1
Islip, NY $392.05 $23.90 – $437.37 365 2
Westville, IN $0.66 $0.66 – $0.66 366 1
Mason, OH $8.07 $0.94 – $11.95 367 4
Fort Defiance, AZ $12.37 $0.00 – $78.00 367 4
Brainerd, MN $12.08 $0.65 – $34.87 367 7
Mustang, OK $0.64 $0.64 – $0.64 367 1
Red Bay, AL $0.33 $0.28 – $0.44 367 3

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.