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 — 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 |
|---|---|---|---|---|
| Lombard, IL | $1,467 | $839.52 – $1,702 | 448 | 3 |
| East Setauket, NY | $231.96 | $0.00 – $949.73 | 449 | 8 |
| Rosedale, MD | $8.32 | $1.46 – $14.35 | 449 | 2 |
| Landover Hills, MD | $4.86 | $4.86 – $4.86 | 449 | 1 |
| Robins Air Force Base, GA | $36.91 | $36.91 – $36.91 | 452 | 1 |
| Derry, NH | $3.51 | $3.51 – $3.51 | 453 | 1 |
| Overland Park, KS | $0.49 | $0.00 – $2.33 | 453 | 8 |
| Browns Mills, NJ | $37.61 | $0.98 – $48.49 | 454 | 2 |
| Willard, OH | $0.02 | $0.02 – $0.02 | 455 | 1 |
| Muldrow, OK | $12.20 | $12.20 – $12.20 | 455 | 1 |
| Adkins, TX | $0.19 | $0.19 – $0.19 | 455 | 1 |
| Helenwood, TN | $9.05 | $9.05 – $9.05 | 455 | 1 |
| South Burlington, VT | $396.11 | $33.13 – $594.76 | 456 | 3 |
| North Haven, CT | $20.98 | $7.69 – $23.19 | 456 | 2 |
| Gunnison, UT | $11.25 | $11.25 – $11.25 | 457 | 1 |
| Hayneville, AL | $0.00 | $0.00 – $0.00 | 457 | 2 |
| Fair Oaks, CA | $9.67 | $0.01 – $16.78 | 458 | 2 |
| Prosper, TX | $2.16 | $0.56 – $3.10 | 458 | 4 |
| Grambling, LA | $0.00 | $0.00 – $0.00 | 458 | 2 |
| Ormond Beach, FL | $15.62 | $0.00 – $67.90 | 462 | 7 |
| East Cleveland, OH | $10.62 | $0.01 – $11.63 | 462 | 2 |
| Somerset, PA | $0.00 | $0.00 – $0.00 | 463 | 2 |
| Kodiak, AK | $2.88 | $2.43 – $19.75 | 463 | 2 |
| Saint Francisville, LA | $0.67 | $0.36 – $1.04 | 463 | 3 |
| Park City, UT | $0.00 | $0.00 – $0.00 | 464 | 1 |
| Waynesville, NC | $1.32 | $1.32 – $1.32 | 465 | 1 |
| Jefferson City, MO | $60.59 | $0.90 – $63.94 | 467 | 3 |
| Jourdanton, TX | $9.75 | $1.14 – $11.37 | 467 | 2 |
| Bushnell, FL | $35.67 | $35.67 – $35.67 | 468 | 1 |
| Palm Harbor, FL | $0.86 | $0.00 – $7.29 | 469 | 5 |
| South Boston, MA | $60.91 | $60.91 – $60.91 | 472 | 1 |
| Mc Crory, AR | $0.00 | $0.00 – $0.00 | 474 | 2 |
| Dungannon, VA | $0.99 | $0.70 – $3.15 | 474 | 2 |
| Marshall, VA | $35.85 | $35.85 – $35.85 | 474 | 1 |
| Amityville, NY | $2.34 | $0.00 – $4.78 | 475 | 2 |
| Tremont, MS | $0.01 | $0.00 – $0.18 | 475 | 3 |
| Hibbing, MN | $0.47 | $0.16 – $1.50 | 477 | 3 |
| Defuniak Springs, FL | $2.70 | $0.00 – $26.60 | 477 | 4 |
| Lancaster, TX | $0.65 | $0.20 – $4.68 | 477 | 2 |
| Davenport, WA | $20.77 | $20.77 – $20.77 | 478 | 1 |
| Wellesley, MA | $168.56 | $0.32 – $807.62 | 480 | 5 |
| Austell, GA | $1.02 | $0.00 – $1.44 | 482 | 4 |
| San Luis Obispo, CA | $92.41 | $0.00 – $2,146 | 483 | 9 |
| Paris, IL | $0.00 | $0.00 – $0.00 | 483 | 2 |
| Mineral Wells, WV | $0.36 | $0.36 – $0.36 | 484 | 1 |
| Waurika, OK | $0.82 | $0.82 – $0.82 | 486 | 1 |
| Ellenville, NY | $0.05 | $0.05 – $0.05 | 486 | 1 |
| Headland, AL | $0.51 | $0.48 – $0.51 | 486 | 2 |
| Atmore, AL | $0.42 | $0.01 – $1.47 | 487 | 4 |
| Miramar, FL | $0.43 | $0.00 – $3.27 | 488 | 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 | — |
| J0120 | Tetracyclin injection | — | — | — |
| J0133 | Acyclovir injection | — | — | — |
| J0202 | Injection, alemtuzumab | — | — | — |
| J0795 | Corticorelin ovine triflutal | — | — | — |
| J1160 | Digoxin injection | — | — | — |
| J1205 | Chlorothiazide sodium inj | — | — | — |
| J1260 | Dolasetron mesylate | — | — | — |
| J1290 | Ecallantide injection | — | — | — |
| J1300 | Eculizumab injection | — | — | — |
| J1301 | Injection, edaravone, 1 mg | — | — | — |
| J1303 | Inj., ravulizumab-cwvz 10 mg | — | — | — |
| J1305 | Inj, evinacumab-dgnb, 5mg | — | — | — |
| J1320 | Amitriptyline injection | — | — | — |
| J1322 | Elosulfase alfa, injection | — | — | — |
| J1327 | Eptifibatide injection | — | — | — |
These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.