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 |
|---|---|---|---|---|
| Morehead City, NC | $7.47 | $0.00 – $14.72 | 3,344 | 15 |
| Lufkin, TX | $32.07 | $0.00 – $72.37 | 3,347 | 10 |
| Erwin, TN | $0.65 | $0.00 – $3.32 | 3,349 | 9 |
| Middlebury, CT | $181.34 | $0.03 – $424.27 | 3,359 | 12 |
| Hollywood, FL | $2.07 | $0.00 – $62.62 | 3,366 | 30 |
| Bellevue, OH | $67.34 | $0.00 – $684.67 | 3,376 | 7 |
| Colonial Heights, VA | $3.44 | $0.01 – $9.94 | 3,376 | 11 |
| Hartford, WI | $0.21 | $0.00 – $5.53 | 3,384 | 2 |
| Bedford Heights, OH | $89.64 | $50.53 – $91.69 | 3,384 | 4 |
| Burlington, VT | $24.03 | $0.00 – $324.43 | 3,385 | 7 |
| Nicholasville, KY | $8.68 | $5.72 – $9.13 | 3,388 | 2 |
| Keyser, WV | $13.47 | $5.94 – $29.73 | 3,398 | 3 |
| Senatobia, MS | $0.65 | $0.00 – $2.10 | 3,402 | 12 |
| Gray, KY | $6.27 | $0.67 – $11.18 | 3,404 | 5 |
| Burton, MI | $32.15 | $0.48 – $62.96 | 3,406 | 5 |
| East Boston, MA | $22.53 | $7.97 – $24.50 | 3,408 | 2 |
| Vernal, UT | $4.39 | $0.00 – $4.71 | 3,412 | 4 |
| Perry, FL | $0.57 | $0.47 – $1.58 | 3,413 | 4 |
| University, MS | $0.63 | $0.63 – $0.63 | 3,417 | 1 |
| Bloomfield Hills, MI | $2.86 | $0.31 – $8.42 | 3,432 | 5 |
| Lexington, SC | $8.17 | $0.63 – $12.58 | 3,435 | 9 |
| Ashburn, VA | $0.11 | $0.11 – $0.11 | 3,436 | 1 |
| Selma, CA | $0.90 | $0.05 – $4.73 | 3,455 | 6 |
| Borger, TX | $2.81 | $2.81 – $2.81 | 3,465 | 1 |
| Columbus, IN | $2.78 | $0.00 – $18.49 | 3,467 | 13 |
| Mansfield, LA | $0.08 | $0.00 – $0.35 | 3,468 | 5 |
| Thomasville, AL | $0.68 | $0.00 – $1.28 | 3,468 | 7 |
| Sheffield, AL | $1.85 | $0.00 – $6.33 | 3,470 | 17 |
| Viroqua, WI | $0.47 | $0.42 – $0.52 | 3,475 | 2 |
| Scottsville, KY | $17.77 | $0.47 – $44.57 | 3,476 | 6 |
| Dayton, TN | $0.84 | $0.00 – $2.10 | 3,477 | 11 |
| Spring Creek, NV | $1.06 | $0.00 – $1.08 | 3,485 | 2 |
| Wareham, MA | $4.60 | $2.04 – $15.04 | 3,490 | 2 |
| Wheat Ridge, CO | $0.05 | $0.00 – $6.10 | 3,490 | 10 |
| Stoughton, WI | $0.08 | $0.08 – $0.08 | 3,497 | 1 |
| Mount Pleasant, MI | $19.41 | $19.41 – $19.41 | 3,502 | 1 |
| Dunkirk, NY | $1.62 | $0.09 – $7.91 | 3,504 | 5 |
| Valley Stream, NY | $7.46 | $0.32 – $13.42 | 3,511 | 5 |
| Berlin, WI | $2.28 | $0.04 – $394.66 | 3,517 | 2 |
| Pine Bluff, AR | $23.74 | $0.00 – $45.43 | 3,531 | 12 |
| South Lake Tahoe, CA | $8.17 | $8.17 – $8.17 | 3,531 | 1 |
| Kissimmee, FL | $9.40 | $0.00 – $91.88 | 3,536 | 20 |
| North Canton, OH | $23.51 | $0.23 – $91.81 | 3,543 | 13 |
| Christiansted, St. Croix, VI | $62.71 | $62.71 – $62.71 | 3,550 | 1 |
| Orem, UT | $18.23 | $0.00 – $33.33 | 3,551 | 3 |
| Ronan, MT | $0.45 | $0.45 – $0.45 | 3,551 | 1 |
| Vienna, WV | $0.83 | $0.66 – $50.58 | 3,555 | 2 |
| Kingwood, WV | $23.72 | $0.89 – $67.80 | 3,558 | 6 |
| Darlington, SC | $12.37 | $12.37 – $12.37 | 3,562 | 1 |
| Forest Hills, NY | $67.63 | $1.26 – $496.32 | 3,579 | 6 |
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.