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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
Vancleave, MS $1.47 $1.35 – $6.32 1,309 2
Hurricane, WV $4.06 $0.31 – $27.22 1,311 7
Palm Beach Gardens, FL $4.25 $0.85 – $5.97 1,311 3
Wagoner, OK $8.69 $0.59 – $11.13 1,314 3
Sylva, NC $4.18 $0.70 – $6.18 1,315 7
Ahoskie, NC $3.94 $0.00 – $10.94 1,319 4
Jena, LA $0.00 $0.00 – $0.05 1,319 6
Charlevoix, MI $0.00 $0.00 – $0.00 1,325 1
Sale Creek, TN $1.48 $0.37 – $1.59 1,325 2
Palos Heights, IL $40.91 $1.79 – $1,154 1,326 4
Juana Diaz, PR $2.35 $0.00 – $16.44 1,328 6
Benson, NC $4.26 $0.00 – $4.44 1,328 3
Harper Woods, MI $1.07 $0.00 – $1.69 1,329 5
Loves Park, IL $47.80 $0.00 – $68.90 1,329 2
Killeen, TX $3.38 $0.71 – $9.03 1,330 6
Cadiz, KY $6.41 $0.42 – $10.32 1,330 4
Oneonta, AL $0.62 $0.00 – $0.78 1,330 5
Hinton, WV $11.85 $0.00 – $62.02 1,331 5
San Juan, TX $1.62 $0.07 – $1.72 1,334 3
Atlantis, FL $0.62 $0.00 – $0.91 1,338 5
Oconto Falls, WI $0.00 $0.00 – $0.00 1,339 1
Eagle Pass, TX $47.60 $0.00 – $70.44 1,340 6
Braintree, MA $150.92 $2.28 – $441.43 1,342 6
Richton, MS $0.01 $0.00 – $0.30 1,343 4
Citrus Heights, CA $0.59 $0.50 – $10.38 1,345 2
Niles, MI $50.58 $0.00 – $72.48 1,346 3
Jersey Village, TX $2.47 $2.47 – $2.47 1,347 1
Granger, IN $84.33 $0.51 – $420.56 1,353 2
New City, NY $789.25 $789.25 – $789.25 1,357 1
Chewelah, WA $34.28 $34.28 – $34.28 1,359 1
Innis, LA $0.69 $0.00 – $0.80 1,361 3
Parker, CO $199.69 $0.07 – $615.83 1,362 3
Sartell, MN $172.03 $1.63 – $1,489 1,366 10
Wheelersburg, OH $5.61 $0.00 – $86.86 1,368 8
Poland, OH $18.90 $0.00 – $27.24 1,373 6
Aibonito, PR $123.14 $0.83 – $132.34 1,373 2
Brewerton, NY $10.26 $10.26 – $10.26 1,376 1
West Jefferson, OH $0.00 $0.00 – $0.00 1,378 1
Glassboro, NJ $24.10 $11.77 – $24.22 1,378 2
Clive, IA $64.18 $0.00 – $947.94 1,379 11
Cape Coral, FL $2.14 $0.00 – $4.76 1,383 8
Fairfield, ME $3.14 $3.14 – $3.14 1,385 1
Sturgis, MI $0.09 $0.00 – $0.28 1,386 2
Rocky Hill, CT $5.47 $1.47 – $6.01 1,388 4
Waverly, TN $1.00 $0.36 – $1.71 1,389 6
Erlanger, KY $6.84 $3.75 – $7.09 1,391 2
Queensbury, NY $509.09 $8.96 – $1,133 1,392 6
Rye Brook, NY $6.08 $5.89 – $6.16 1,392 2
Halifax, NC $18.18 $17.39 – $20.78 1,392 2
Little Falls, NY $23.85 $23.85 – $23.85 1,395 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.