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 |
|---|---|---|---|---|
| Salem, NJ | $2.64 | $0.08 – $39.57 | 4,112 | 4 |
| Gardner, MA | $9.60 | $3.21 – $9.70 | 4,122 | 2 |
| Stanton, CA | $3.94 | $3.94 – $3.94 | 4,123 | 1 |
| Meadville, PA | $0.00 | $0.00 – $0.00 | 4,123 | 1 |
| Fillmore, CA | $1.43 | $1.43 – $1.43 | 4,123 | 1 |
| Pittsburgh, PA | $62.21 | $0.00 – $1,441 | 4,134 | 37 |
| Ferndale, MI | $0.20 | $0.17 – $0.22 | 4,141 | 2 |
| Lithia, FL | $2.74 | $1.47 – $10.18 | 4,163 | 13 |
| Mauston, WI | $0.03 | $0.03 – $0.03 | 4,183 | 1 |
| Dublin, GA | $3.98 | $0.00 – $5.03 | 4,186 | 5 |
| Monroe, WI | $0.01 | $0.01 – $0.01 | 4,190 | 1 |
| N Charleston, SC | $0.48 | $0.41 – $1.36 | 4,199 | 9 |
| Grove Hill, AL | $0.26 | $0.04 – $0.90 | 4,210 | 4 |
| Lake Orion, MI | $76.87 | $1.26 – $77.14 | 4,210 | 2 |
| Cheektowaga, NY | $1.22 | $0.03 – $358.18 | 4,211 | 2 |
| Bedford, OH | $26.12 | $0.02 – $81.88 | 4,225 | 2 |
| East Liverpool, OH | $10.60 | $0.08 – $93.09 | 4,229 | 7 |
| Williamsburg, KY | $7.11 | $0.39 – $22.13 | 4,240 | 15 |
| Hardinsburg, KY | $4.92 | $3.97 – $5.46 | 4,244 | 3 |
| Lawton, OK | $4.17 | $0.00 – $1,123 | 4,248 | 15 |
| Mount Vernon, IN | $3.02 | $2.99 – $4.78 | 4,258 | 3 |
| Roslyn, NY | $0.60 | $0.60 – $0.60 | 4,260 | 1 |
| Water Valley, MS | $0.55 | $0.14 – $0.83 | 4,261 | 5 |
| North Dartmouth, MA | $347.00 | $2.48 – $920.13 | 4,264 | 12 |
| Daphne, AL | $0.75 | $0.41 – $6.43 | 4,270 | 3 |
| Coshocton, OH | $51.71 | $0.09 – $87.90 | 4,272 | 4 |
| South Bend, IN | $6.19 | $0.00 – $491.12 | 4,273 | 19 |
| Dover Foxcroft, ME | $2.01 | $2.01 – $2.01 | 4,276 | 1 |
| Carmel, IN | $398.82 | $0.00 – $1,423 | 4,277 | 21 |
| Homer, AK | $15.34 | $0.00 – $15.39 | 4,303 | 2 |
| Hialeah, FL | $67.34 | $0.00 – $1,244 | 4,315 | 22 |
| Malone, NY | $1.06 | $0.25 – $78.30 | 4,343 | 2 |
| Belen, NM | $0.67 | $0.67 – $0.67 | 4,347 | 1 |
| Pennington Gap, VA | $1.91 | $0.42 – $11.36 | 4,349 | 4 |
| Valdese, NC | $2.14 | $0.73 – $2.48 | 4,351 | 3 |
| Gilbertown, AL | $0.31 | $0.31 – $0.31 | 4,353 | 1 |
| Fort Walton Beach, FL | $1.81 | $0.00 – $35.30 | 4,356 | 8 |
| Delhi, LA | $0.12 | $0.00 – $17.81 | 4,359 | 9 |
| Exeter, CA | $1.75 | $0.00 – $16.98 | 4,359 | 4 |
| Delaware, OH | $1.65 | $0.00 – $42.61 | 4,384 | 7 |
| Peabody, MA | $8.22 | $1.51 – $42.42 | 4,395 | 19 |
| Shirley, NY | $41.49 | $40.10 – $42.09 | 4,411 | 2 |
| Oneida, NY | $0.13 | $0.05 – $2.62 | 4,412 | 2 |
| Tomah, WI | $0.05 | $0.00 – $9.47 | 4,420 | 3 |
| Jefferson City, TN | $1.77 | $0.18 – $4.86 | 4,431 | 13 |
| Capitola, CA | $131.06 | $3.70 – $135.11 | 4,435 | 3 |
| Jurupa Valley, CA | $0.00 | $0.00 – $0.00 | 4,472 | 1 |
| Welch, WV | $3.80 | $1.36 – $50.92 | 4,473 | 4 |
| Goose Creek, SC | $0.04 | $0.04 – $0.04 | 4,484 | 1 |
| Stanley, ND | $1.76 | $1.76 – $1.76 | 4,487 | 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 | — |
| 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.