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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
Union Springs, AL $0.17 $0.11 – $1.15 1,230 2
Coos Bay, OR $5.85 $0.00 – $70.12 1,232 10
Marietta, GA $16.59 $0.00 – $92.35 1,234 9
Saint Clair Shores, MI $0.00 $0.00 – $0.00 1,234 1
Carrollton, KY $7.57 $0.00 – $7.65 1,234 2
Whitefish Bay, WI $580.64 $580.64 – $580.64 1,235 1
Laguna Niguel, CA $1.01 $1.01 – $1.01 1,238 1
Oviedo, FL $2.49 $2.49 – $2.49 1,239 1
Shelbyville, IN $107.15 $1.69 – $277.32 1,240 3
Batesville, AR $3.37 $0.00 – $25.91 1,244 8
Carrollton, GA $7.62 $0.00 – $8.67 1,245 7
Bunnell, FL $19.42 $1.30 – $36.67 1,245 4
Opp, AL $1.07 $0.56 – $1.11 1,247 2
Inez, KY $3.92 $0.28 – $8.64 1,249 6
Logansport, LA $0.00 $0.00 – $0.00 1,251 3
Byhalia, MS $0.87 $0.16 – $1.02 1,255 4
Lewisburg, WV $10.32 $0.40 – $25.25 1,260 2
Mantachie, MS $0.50 $0.25 – $0.79 1,263 4
Plymouth Meeting, PA $975.79 $718.08 – $2,092 1,265 7
Fort Bragg, CA $9.56 $9.56 – $9.56 1,267 1
Marlton, NJ $4.15 $0.00 – $6.14 1,267 6
Bedford, IN $21.44 $0.00 – $81.75 1,268 4
Orange, CT $22.82 $0.61 – $23.38 1,271 2
Lincolnton, NC $9.39 $0.14 – $40.34 1,271 9
Salinas, PR $0.01 $0.00 – $0.01 1,271 2
Hawaiian Gardens, CA $25.35 $25.35 – $25.35 1,276 1
Orrville, OH $0.93 $0.93 – $0.93 1,277 1
New Richmond, WI $15.56 $0.09 – $57.02 1,277 2
East Patchogue, NY $207.80 $1.34 – $608.35 1,277 6
Villa Rica, GA $0.90 $0.00 – $0.96 1,277 6
Rio Grande City, TX $1.04 $0.00 – $7.01 1,280 7
Ecru, MS $0.73 $0.31 – $1.17 1,281 6
Welsh, LA $1.01 $0.36 – $1.15 1,282 2
Petersburg, WV $15.68 $0.52 – $24.26 1,284 3
Beverly Hills, FL $1.51 $0.53 – $1.54 1,290 2
Shiloh, IL $2.63 $0.98 – $4.77 1,291 4
Gleason, TN $1.59 $1.57 – $1.90 1,292 2
Lenoir City, TN $1.14 $0.00 – $7.35 1,294 13
Holdenville, OK $0.51 $0.00 – $0.64 1,295 3
Russellville, AR $15.00 $0.00 – $51.90 1,297 7
Flossmoor, IL $40.19 $40.19 – $40.19 1,297 1
Sparta, IL $0.00 $0.00 – $0.00 1,299 1
Southport, NC $3.44 $1.95 – $3.84 1,300 3
Milford, DE $31.29 $0.00 – $66.96 1,301 4
Oskaloosa, IA $8.89 $1.04 – $31.97 1,301 5
Clearwater, FL $2.53 $0.00 – $41.81 1,302 8
Castle Rock, CO $7.36 $0.11 – $8.43 1,303 4
Chesterton, IN $10.00 $0.00 – $20.26 1,304 9
Milton, FL $3.89 $0.05 – $54.25 1,307 6
Brunswick, GA $0.84 $0.84 – $0.84 1,308 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.