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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
Eaton, OH $3.47 $1.36 – $5.20 1,154 4
West Paterson, NJ $0.77 $0.77 – $0.78 1,155 2
Fairview, TN $1.42 $0.46 – $1.74 1,155 4
Texarkana, AR $14.45 $2.04 – $28.13 1,156 8
Larose, LA $0.00 $0.00 – $0.00 1,159 3
Whitwell, TN $1.80 $0.66 – $2.59 1,159 3
Ham Lake, MN $0.56 $0.56 – $0.56 1,159 1
Fruita, CO $1.74 $0.00 – $5.43 1,162 5
Shelby, MI $0.00 $0.00 – $0.00 1,162 1
Carthage, TN $3.48 $0.27 – $15.98 1,163 5
Clemmons, NC $2.62 $0.12 – $100.34 1,164 2
Counce, TN $1.84 $0.47 – $2.23 1,164 4
Liberty, MS $2.07 $0.00 – $2.17 1,166 2
Logan, OH $0.64 $0.12 – $1.33 1,167 3
Fern Park, FL $0.00 $0.00 – $0.00 1,167 1
Addison, AL $0.51 $0.26 – $0.52 1,168 2
De Kalb, MS $0.24 $0.24 – $0.24 1,172 1
Maxwell Afb, AL $0.95 $0.95 – $0.95 1,173 1
Tama, IA $0.00 $0.00 – $0.00 1,173 2
Onawa, IA $0.13 $0.00 – $0.21 1,177 2
Freeport, NY $9.63 $0.08 – $12.48 1,180 4
Lake Isabella, CA $2.16 $2.16 – $2.16 1,180 1
Stuart, VA $11.01 $1.45 – $12.59 1,186 3
Woodlawn, VA $0.59 $0.37 – $0.60 1,186 2
Greenfield, MA $5.85 $4.08 – $6.08 1,187 3
Kailua Kona, HI $0.00 $0.00 – $0.00 1,188 1
College Park, MD $27.14 $0.01 – $50.88 1,188 3
Woodruff, WI $0.00 $0.00 – $0.00 1,188 2
Hendersonville, NC $349.56 $0.00 – $627.32 1,191 11
Lily, KY $0.57 $0.57 – $0.57 1,197 1
Victoria, TX $64.38 $0.00 – $724.03 1,198 18
Concord, MA $2.50 $0.08 – $2.63 1,198 3
Annville, KY $4.45 $4.45 – $4.45 1,199 1
Sheridan, IL $26.22 $26.22 – $26.22 1,199 1
Muskogee, OK $124.39 $0.00 – $247.07 1,200 5
San Andreas, CA $27.05 $0.00 – $28.68 1,202 3
Greenlawn, NY $13.19 $13.19 – $13.19 1,204 1
Freeport, IL $70.14 $0.00 – $105.55 1,205 5
Pierre Part, LA $0.00 $0.00 – $0.00 1,207 1
Atoka, TN $1.67 $0.90 – $3.22 1,208 5
Benson, AZ $0.00 $0.00 – $0.00 1,209 1
Lehi, UT $0.00 $0.00 – $0.00 1,210 2
Bennettsville, SC $50.89 $17.25 – $83.16 1,212 3
Webster Springs, WV $18.62 $1.32 – $25.99 1,213 4
New Castle, IN $0.57 $0.00 – $4.76 1,215 7
Dyer, TN $1.74 $1.49 – $2.35 1,215 2
Ackerman, MS $0.27 $0.00 – $1.23 1,218 7
Huntersville, NC $1.79 $0.18 – $16.63 1,220 8
Brownstown Twp, MI $3.44 $0.70 – $6.28 1,220 2
Maumee, OH $0.78 $0.01 – $9.75 1,224 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.