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 |
|---|---|---|---|---|
| Van Buren Twp, MI | $0.92 | $0.82 – $1.20 | 2,947 | 2 |
| Hoover, AL | $1.82 | $0.58 – $3.83 | 2,948 | 8 |
| Defiance, OH | $1.02 | $0.09 – $2.19 | 2,963 | 2 |
| Middleton, TN | $0.96 | $0.41 – $1.85 | 2,965 | 2 |
| Porter, TX | $0.70 | $0.69 – $3.58 | 2,970 | 2 |
| Hiawatha, IA | $522.93 | $0.71 – $840.87 | 2,984 | 9 |
| Fulton, MS | $13.83 | $0.16 – $41.93 | 2,989 | 7 |
| Kannapolis, NC | $9.53 | $0.10 – $22.88 | 2,989 | 3 |
| Oceana, WV | $11.20 | $0.00 – $15.00 | 2,992 | 3 |
| Weston, WV | $66.17 | $26.10 – $66.72 | 2,997 | 3 |
| Carolina, PR | $591.05 | $0.00 – $1,874 | 2,998 | 5 |
| Fitchburg, MA | $5.06 | $0.00 – $5.80 | 3,001 | 4 |
| Iuka, MS | $1.32 | $0.00 – $1.94 | 3,001 | 7 |
| Kalkaska, MI | $8.40 | $0.01 – $652.51 | 3,002 | 4 |
| Portage, WI | $1.87 | $0.01 – $18.24 | 3,007 | 4 |
| Coral Gables, FL | $0.77 | $0.00 – $6.89 | 3,018 | 12 |
| Rensselaer, IN | $3.97 | $3.13 – $4.19 | 3,028 | 2 |
| Mohave Valley, AZ | $5.58 | $5.58 – $5.58 | 3,032 | 1 |
| Livingston, CA | $3.43 | $0.03 – $10.10 | 3,035 | 5 |
| Coldwater, MI | $3.44 | $0.00 – $52.62 | 3,038 | 8 |
| Copperhill, TN | $2.26 | $1.62 – $3.12 | 3,039 | 3 |
| Beaverton, OR | $3.84 | $0.00 – $4.07 | 3,047 | 3 |
| Ankeny, IA | $2.85 | $1.43 – $28.11 | 3,053 | 4 |
| Geneva, OH | $0.25 | $0.25 – $0.25 | 3,053 | 1 |
| Sidney, MT | $2.34 | $2.05 – $69.13 | 3,054 | 2 |
| Milledgeville, GA | $0.80 | $0.00 – $2.62 | 3,056 | 3 |
| Waianae, HI | $0.02 | $0.00 – $0.34 | 3,059 | 4 |
| Owings Mills, MD | $201.51 | $0.00 – $1,264 | 3,062 | 10 |
| Evergreen Park, IL | $9.72 | $4.08 – $38.94 | 3,068 | 4 |
| Blue Ash, OH | $845.30 | $0.09 – $1,069 | 3,069 | 6 |
| Lewistown, PA | $0.90 | $0.00 – $68.82 | 3,075 | 3 |
| Caldwell, ID | $1.36 | $0.97 – $60.00 | 3,076 | 3 |
| Griffin, GA | $0.37 | $0.22 – $0.79 | 3,077 | 8 |
| Broken Bow, OK | $1.36 | $0.49 – $1.74 | 3,080 | 5 |
| Bulls Gap, TN | $0.80 | $0.36 – $4.78 | 3,090 | 4 |
| Novato, CA | $22.46 | $22.46 – $22.46 | 3,094 | 1 |
| College Point, NY | $35.77 | $35.77 – $35.77 | 3,102 | 1 |
| Bremerton, WA | $92.77 | $17.38 – $136.58 | 3,117 | 4 |
| Lewisport, KY | $7.30 | $2.63 – $14.92 | 3,119 | 2 |
| North Bend, OR | $568.04 | $0.00 – $1,027 | 3,120 | 5 |
| Daytona Beach, FL | $3.59 | $0.00 – $86.36 | 3,123 | 18 |
| Waverly, OH | $20.23 | $0.00 – $79.61 | 3,123 | 8 |
| Lexington, VA | $11.81 | $0.03 – $74.68 | 3,125 | 4 |
| Bountiful, UT | $0.34 | $0.00 – $0.68 | 3,126 | 4 |
| Springfield, VA | $3.03 | $0.73 – $8.37 | 3,126 | 2 |
| Jasper, GA | $1.52 | $0.15 – $9.08 | 3,127 | 4 |
| Mt Pleasant, TX | $3.52 | $0.00 – $3.59 | 3,130 | 4 |
| Galesburg, IL | $48.58 | $0.00 – $85.42 | 3,131 | 10 |
| Kinston, NC | $12.23 | $0.00 – $171.34 | 3,134 | 14 |
| Vacaville, CA | $36.57 | $0.85 – $278.47 | 3,135 | 7 |
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.