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 |
|---|---|---|---|---|
| Crossville, TN | $1.78 | $0.00 – $9.68 | 5,926 | 20 |
| Salem, MA | $2.34 | $0.00 – $23.11 | 5,942 | 5 |
| Jackson, CA | $11.64 | $5.53 – $11.68 | 5,945 | 2 |
| Beaumont, TX | $15.17 | $0.00 – $66.95 | 5,947 | 19 |
| Yreka, CA | $10.13 | $0.00 – $16.87 | 5,950 | 3 |
| Baytown, TX | $1.11 | $0.00 – $10.24 | 5,958 | 10 |
| Apache Junction, AZ | $0.03 | $0.01 – $11.77 | 5,963 | 2 |
| Elma, WA | $5.94 | $0.37 – $6.08 | 5,981 | 3 |
| Smithfield, NC | $7.29 | $0.00 – $25.18 | 5,992 | 15 |
| Hollywood, CA | $5.67 | $5.67 – $5.67 | 6,003 | 1 |
| East Lansing, MI | $1,188 | $3.04 – $2,808 | 6,007 | 8 |
| Riverton, UT | $7.79 | $7.79 – $7.79 | 6,014 | 1 |
| Shafter, CA | $5.46 | $0.00 – $11.71 | 6,017 | 8 |
| Hope Mills, NC | $1.59 | $0.09 – $2.84 | 6,026 | 2 |
| Manistee, MI | $0.26 | $0.10 – $25.91 | 6,028 | 2 |
| Tazewell, TN | $0.53 | $0.13 – $1.63 | 6,035 | 11 |
| Dearborn Heights, MI | $139.43 | $0.11 – $1,176 | 6,035 | 13 |
| Galion, OH | $6.95 | $0.00 – $95.84 | 6,054 | 6 |
| Summersville, WV | $9.87 | $3.80 – $36.79 | 6,054 | 7 |
| Winter Park, FL | $0.52 | $0.00 – $14.79 | 6,099 | 6 |
| Auburn, CA | $15.53 | $0.00 – $25.63 | 6,124 | 5 |
| Vidalia, LA | $0.30 | $0.00 – $0.83 | 6,124 | 7 |
| Gallatin, TN | $33.31 | $0.00 – $155.93 | 6,148 | 20 |
| Crowley, LA | $0.65 | $0.00 – $20.52 | 6,151 | 16 |
| Reedsburg, WI | $0.14 | $0.08 – $0.81 | 6,165 | 2 |
| New Milford, CT | $0.18 | $0.00 – $1.23 | 6,178 | 2 |
| Flemingsburg, KY | $4.34 | $0.33 – $10.71 | 6,184 | 7 |
| Colville, WA | $23.95 | $23.95 – $23.95 | 6,197 | 1 |
| Pittsfield, ME | $2.41 | $2.41 – $2.41 | 6,201 | 1 |
| Gilroy, CA | $22.32 | $0.78 – $29.93 | 6,201 | 3 |
| Hohenwald, TN | $1.24 | $0.22 – $4.82 | 6,207 | 12 |
| Monroeville, PA | $1,856 | $0.00 – $1,859 | 6,241 | 2 |
| Ravenna, OH | $0.68 | $0.00 – $40.24 | 6,251 | 7 |
| Edina, MN | $69.69 | $0.03 – $1,681 | 6,272 | 15 |
| Boardman, OH | $26.07 | $0.00 – $88.79 | 6,272 | 27 |
| Hollister, CA | $5.52 | $2.03 – $5.54 | 6,279 | 4 |
| Bamberg, SC | $1.45 | $0.16 – $27.70 | 6,283 | 3 |
| Woodstock, VA | $0.87 | $0.63 – $53.09 | 6,284 | 3 |
| Portales, NM | $3.00 | $1.45 – $19.33 | 6,290 | 5 |
| Kew Gardens, NY | $3.19 | $0.12 – $12.69 | 6,313 | 8 |
| Bend, OR | $172.59 | $0.00 – $1,413 | 6,321 | 28 |
| Pell City, AL | $4.69 | $0.11 – $9.17 | 6,325 | 19 |
| Antioch, TN | $0.85 | $0.00 – $4.12 | 6,326 | 9 |
| Plantsville, CT | $3.52 | $1.84 – $4.49 | 6,328 | 3 |
| Enfield, CT | $23.23 | $0.31 – $69.48 | 6,334 | 6 |
| Elmer, NJ | $1.20 | $1.20 – $1.20 | 6,334 | 1 |
| Paris, TN | $2.99 | $0.00 – $28.01 | 6,335 | 17 |
| Abbeville, LA | $0.66 | $0.00 – $17.29 | 6,342 | 15 |
| Kingston, NY | $17.87 | $0.09 – $565.46 | 6,346 | 7 |
| Massillon, OH | $4.40 | $0.00 – $22.34 | 6,347 | 14 |
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.