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 |
|---|---|---|---|---|
| Painesville, OH | $22.80 | $9.98 – $31.54 | 817 | 2 |
| Aledo, TX | $0.59 | $0.59 – $0.59 | 818 | 2 |
| Hillsville, VA | $10.07 | $10.07 – $10.07 | 819 | 1 |
| Hamlet, NC | $3.16 | $3.16 – $3.16 | 820 | 1 |
| Saint Ignace, MI | $0.01 | $0.01 – $0.01 | 820 | 1 |
| Groton, CT | $38.77 | $10.98 – $55.89 | 821 | 2 |
| South Pasadena, FL | $0.28 | $0.28 – $0.28 | 821 | 1 |
| Bloomington, MN | $103.06 | $0.00 – $1,859 | 822 | 19 |
| Harriman, TN | $0.80 | $0.00 – $2.11 | 822 | 8 |
| Pahrump, NV | $3.08 | $0.42 – $28.44 | 822 | 10 |
| Ephrata, WA | $10.38 | $10.38 – $10.38 | 824 | 1 |
| Midwest City, OK | $0.59 | $0.00 – $1.27 | 824 | 9 |
| Pontiac, IL | $55.42 | $55.42 – $55.42 | 824 | 1 |
| Mount Pleasant, SC | $1.06 | $0.93 – $1.17 | 828 | 5 |
| Rockingham, VA | $444.91 | $0.44 – $636.51 | 829 | 6 |
| El Cerrito, CA | $0.01 | $0.01 – $0.01 | 829 | 1 |
| Montrose, CO | $0.37 | $0.00 – $0.58 | 831 | 5 |
| Homewood, AL | $1.33 | $0.93 – $1.99 | 831 | 3 |
| Centreville, MS | $0.00 | $0.00 – $0.00 | 831 | 2 |
| Montebello, NY | $0.08 | $0.08 – $0.08 | 831 | 1 |
| Niles, OH | $67.22 | $4.01 – $83.97 | 832 | 3 |
| Tea, SD | $2.91 | $2.91 – $2.91 | 832 | 1 |
| Fairdale, KY | $49.16 | $49.16 – $49.16 | 835 | 1 |
| Checotah, OK | $8.04 | $0.41 – $11.03 | 837 | 5 |
| Bruceton, TN | $2.00 | $2.00 – $2.00 | 837 | 1 |
| Bay St Louis, MS | $40.64 | $40.64 – $40.64 | 838 | 1 |
| Swainsboro, GA | $0.09 | $0.00 – $0.10 | 838 | 2 |
| Joliet, IL | $7.72 | $0.00 – $14.68 | 840 | 7 |
| White Oak, PA | $6.39 | $6.39 – $6.39 | 840 | 1 |
| Jacksboro, TX | $0.00 | $0.00 – $0.00 | 840 | 1 |
| Hornell, NY | $0.09 | $0.09 – $0.09 | 841 | 1 |
| Johnston, RI | $1.88 | $1.27 – $35.77 | 841 | 3 |
| Sparta, TN | $1.28 | $0.00 – $4.25 | 842 | 7 |
| Lincoln, AL | $0.20 | $0.00 – $3.31 | 843 | 3 |
| Carlinville, IL | $12.54 | $12.54 – $12.54 | 844 | 1 |
| Humble, TX | $35.49 | $0.00 – $71.76 | 846 | 4 |
| Naperville, IL | $0.90 | $0.90 – $0.90 | 846 | 1 |
| Wailea, HI | $0.69 | $0.69 – $0.69 | 847 | 1 |
| Byrdstown, TN | $2.30 | $1.03 – $2.72 | 848 | 3 |
| Wellston, MI | $0.79 | $0.79 – $0.79 | 849 | 1 |
| Dowagiac, MI | $0.21 | $0.20 – $0.49 | 850 | 2 |
| Purchase, NY | $7.58 | $7.54 – $9.16 | 850 | 2 |
| Bound Brook, NJ | $31.03 | $3.35 – $60.29 | 851 | 3 |
| Newbern, TN | $0.34 | $0.34 – $0.35 | 851 | 3 |
| Port Clinton, OH | $0.87 | $0.52 – $10.75 | 852 | 2 |
| Warwick, RI | $136.30 | $1.53 – $942.36 | 854 | 7 |
| Winter Garden, FL | $8.41 | $0.00 – $46.03 | 855 | 4 |
| Port Washington, NY | $76.95 | $76.95 – $76.95 | 856 | 1 |
| East Providence, RI | $9.33 | $2.55 – $17.17 | 857 | 5 |
| Florence, MA | $4.81 | $4.81 – $4.81 | 857 | 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 | — |
| 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.