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 |
|---|---|---|---|---|
| Rainsville, AL | $3.04 | $0.73 – $5.60 | 6,790 | 15 |
| Calhoun, LA | $0.15 | $0.00 – $0.76 | 6,814 | 3 |
| Saint Cloud, MN | $193.65 | $3.04 – $426.46 | 6,829 | 7 |
| Sahuarita, AZ | $0.02 | $0.02 – $0.02 | 6,832 | 1 |
| Greeneville, TN | $0.98 | $0.00 – $4.38 | 6,846 | 19 |
| Southbridge, MA | $4.16 | $1.96 – $6.88 | 6,847 | 5 |
| Shelbyville, TN | $1.35 | $0.08 – $9.85 | 6,851 | 16 |
| Grove City, OH | $5.57 | $0.00 – $98.57 | 6,852 | 10 |
| Laconia, NH | $3.82 | $3.82 – $3.82 | 6,857 | 1 |
| Benton Harbor, MI | $34.03 | $0.32 – $46.47 | 6,858 | 5 |
| Pickens, SC | $1.23 | $0.91 – $13.70 | 6,860 | 3 |
| New Hartford, NY | $172.14 | $0.20 – $836.18 | 6,877 | 12 |
| Mathiston, MS | $0.34 | $0.25 – $0.90 | 6,877 | 3 |
| Southgate, MI | $1.56 | $0.57 – $8.28 | 6,891 | 9 |
| Winslow, AZ | $0.04 | $0.04 – $0.04 | 6,919 | 1 |
| Ashland, WI | $0.07 | $0.04 – $5.86 | 6,924 | 2 |
| Seat Pleasant, MD | $1.07 | $1.07 – $1.07 | 6,926 | 1 |
| Juneau, AK | $9.16 | $9.16 – $9.16 | 6,944 | 1 |
| Fulton, AL | $0.39 | $0.24 – $0.77 | 6,955 | 5 |
| Blairsville, GA | $0.75 | $0.73 – $4.09 | 6,956 | 4 |
| Reston, VA | $4.66 | $0.19 – $26.04 | 6,973 | 4 |
| Greensburg, KY | $4.85 | $0.45 – $18.66 | 6,977 | 11 |
| Bremen, GA | $1.38 | $0.42 – $3.54 | 6,998 | 3 |
| Coldwater, MS | $0.80 | $0.12 – $1.11 | 7,007 | 3 |
| Newport, TN | $1.47 | $0.12 – $44.95 | 7,054 | 20 |
| Union, SC | $19.58 | $0.12 – $89.43 | 7,056 | 5 |
| Mishawaka, IN | $14.77 | $0.00 – $330.21 | 7,062 | 20 |
| South El Monte, CA | $14.97 | $0.96 – $104.41 | 7,105 | 3 |
| Far Rockaway, NY | $3.11 | $0.00 – $12.67 | 7,122 | 7 |
| Milford, OH | $11.33 | $0.00 – $101.33 | 7,139 | 9 |
| Anaconda, MT | $1.33 | $1.33 – $1.33 | 7,140 | 1 |
| Coachella, CA | $3.71 | $0.00 – $80.57 | 7,149 | 4 |
| Independence, OH | $4.39 | $0.15 – $5.90 | 7,155 | 5 |
| Irving, TX | $125.36 | $0.00 – $1,123 | 7,163 | 22 |
| Willits, CA | $15.71 | $15.71 – $15.71 | 7,165 | 1 |
| Cheraw, SC | $4.33 | $0.34 – $84.56 | 7,169 | 6 |
| Irvine, KY | $3.31 | $1.84 – $11.16 | 7,193 | 4 |
| Omak, WA | $18.98 | $0.00 – $19.09 | 7,218 | 3 |
| Gallup, NM | $10.80 | $0.00 – $209.11 | 7,275 | 6 |
| Tustin, CA | $4.67 | $0.00 – $156.88 | 7,290 | 4 |
| Fairfax, SC | $16.35 | $0.00 – $86.07 | 7,297 | 4 |
| Bayamon, PR | $31.85 | $0.00 – $33.68 | 7,299 | 4 |
| Rome, NY | $0.85 | $0.85 – $0.85 | 7,307 | 1 |
| Beaver Dam, WI | $0.01 | $0.00 – $0.01 | 7,307 | 2 |
| South Williamson, KY | $11.81 | $0.70 – $23.98 | 7,310 | 6 |
| Joshua Tree, CA | $3.20 | $3.20 – $3.20 | 7,316 | 1 |
| Bethpage, NY | $1.04 | $0.25 – $21.88 | 7,334 | 3 |
| Chester, SC | $0.58 | $0.00 – $19.20 | 7,334 | 6 |
| Poway, CA | $244.42 | $0.00 – $1,576 | 7,337 | 9 |
| Sulphur, LA | $3.28 | $0.00 – $44.25 | 7,337 | 13 |
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.