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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
South Portland, ME $10.29 $3.02 – $48.55 604 3
Oakland Park, FL $0.08 $0.00 – $0.12 605 2
Warsaw, NC $4.12 $1.03 – $59.42 605 2
Warrenville, IL $19.63 $12.10 – $23.49 608 8
Bowie, MD $72.96 $0.00 – $1,450 609 3
Colchester, VT $34.06 $0.96 – $61.82 612 3
Conneaut, OH $0.24 $0.24 – $0.24 614 1
Lake City, FL $26.07 $0.00 – $63.84 615 6
Sheridan, AR $11.70 $3.24 – $14.71 616 2
Richland, MS $0.18 $0.00 – $1.55 618 2
Kerrville, TX $13.07 $11.56 – $13.26 619 2
Thomson, GA $2.90 $0.25 – $4.08 619 4
Bisbee, AZ $7.89 $7.89 – $7.89 619 1
Pine Ridge, SD $260.63 $260.63 – $260.63 620 1
Hewlett, NY $2.73 $1.51 – $11.07 622 3
Maywood, IL $7.43 $1.07 – $19.35 625 4
Hermiston, OR $14.84 $3.75 – $41.15 626 9
Pawtucket, RI $9.47 $9.47 – $9.47 626 1
Lavonia, GA $0.68 $0.68 – $0.68 628 1
Palatka, FL $26.94 $5.67 – $38.36 629 3
Southampton, NY $0.24 $0.24 – $0.24 630 1
Caledonia, MI $9.88 $1.19 – $23.54 630 2
Rockwell, NC $11.81 $11.81 – $11.81 631 1
Decatur, TN $1.20 $1.10 – $1.29 632 4
Salida, CA $4.56 $4.56 – $4.58 632 2
Newport, KY $1.04 $0.22 – $11.98 633 5
Kenton, OH $0.14 $0.00 – $0.73 635 5
Claremont, CA $0.91 $0.00 – $1.01 635 3
Willcox, AZ $0.79 $0.00 – $0.81 635 2
Coalgate, OK $1.16 $1.16 – $1.19 636 2
Lancaster, WI $0.00 $0.00 – $0.00 637 1
Geneva, AL $1.58 $0.00 – $1.91 637 3
South Jordan, UT $0.35 $0.00 – $0.43 638 2
Carver, MA $0.95 $0.95 – $0.95 639 1
Auburn, ME $3.52 $1.59 – $3.61 640 4
Stuart, FL $239.61 $0.00 – $647.36 640 6
Rochester, IN $7.38 $7.38 – $7.38 640 1
Bloomfield Township, MI $58.96 $58.96 – $58.96 640 1
Wynne, AR $0.62 $0.00 – $0.95 643 2
Pekin, IL $5.79 $1.00 – $10.91 644 3
Kingsville, TX $16.18 $0.00 – $74.74 645 8
Mansfield, TX $6.92 $0.00 – $41.43 646 7
Campbell, CA $693.57 $330.07 – $807.35 646 2
Livingston, MT $0.79 $0.79 – $0.79 647 1
Lockesburg, AR $13.02 $2.86 – $13.25 647 2
Astoria, OR $16.40 $16.40 – $16.40 649 1
Olive Hill, KY $1.00 $0.93 – $1.27 649 2
Stonewall, LA $0.85 $0.00 – $1.00 650 3
Wilmington, CA $12.58 $2.25 – $16.21 651 2
Grapevine, TX $0.76 $0.76 – $0.76 653 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.