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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 β€” 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
Temple City, CA $44.26 $44.26 – $44.26 7,337 1
Bethlehem, PA $1.19 $0.00 – $11.17 7,345 8
Newburgh, NY $46.93 $0.00 – $817.15 7,379 13
Petaluma, CA $18.32 $9.93 – $68.50 7,379 3
Longview, TX $4.12 $0.00 – $81.72 7,392 18
Hudson, NY $0.01 $0.01 – $0.01 7,402 1
Lebanon, VA $0.24 $0.16 – $1.07 7,420 4
Dale City, VA $0.39 $0.39 – $0.39 7,438 1
Cordova, TN $18.75 $0.00 – $46.45 7,445 15
Beverly Hills, CA $24.70 $0.00 – $550.51 7,455 12
Panama City Beach, FL $0.33 $0.31 – $3.15 7,463 2
Sevierville, TN $20.56 $0.23 – $82.40 7,464 29
Santa Isabel, PR $1.65 $1.65 – $1.65 7,471 1
Denville, NJ $3.86 $3.86 – $3.86 7,481 1
West Valley City, UT $0.98 $0.00 – $0.98 7,484 3
South Plainfield, NJ $31.04 $8.64 – $31.27 7,492 3
Cortland, NY $0.58 $0.06 – $84.00 7,495 5
Oak Ridge, TN $1.17 $0.18 – $63.69 7,506 23
Manchester, TN $1.59 $0.03 – $4.65 7,513 15
Durango, CO $220.62 $0.00 – $706.52 7,526 20
Panama City, FL $11.95 $0.00 – $39.87 7,528 32
Odessa, TX $12.84 $0.00 – $65.28 7,532 23
Fabens, TX $1.04 $1.04 – $1.04 7,537 1
Allen Park, MI $0.99 $0.08 – $15.28 7,546 7
Sandy, UT $7.95 $0.00 – $9.82 7,584 3
Mount Laurel, NJ $35.30 $1.17 – $69.96 7,591 4
Sylacauga, AL $7.68 $0.20 – $63.69 7,606 13
Tehachapi, CA $3.29 $3.29 – $3.29 7,626 1
District Heights, MD $2.10 $0.00 – $26.74 7,626 3
Centreville, AL $0.42 $0.00 – $6.71 7,655 9
Thornton, CO $22.20 $0.00 – $265.97 7,664 25
North Windham, CT $3.98 $3.98 – $3.98 7,703 1
North Chelmsford, MA $4.10 $2.02 – $8.00 7,713 9
Randallstown, MD $0.39 $0.00 – $0.44 7,726 4
Wilmington, OH $5.44 $0.00 – $86.51 7,735 7
Greeley, CO $24.64 $0.00 – $337.55 7,736 23
Cerritos, CA $7.20 $0.00 – $9.83 7,748 8
La Palma, CA $22.79 $0.43 – $26.29 7,753 3
Gloversville, NY $0.14 $0.11 – $2.76 7,815 2
Rogersville, TN $0.66 $0.21 – $8.79 7,817 9
Avon, OH $0.08 $0.00 – $2.09 7,820 7
Franklin, WI $23.04 $0.00 – $517.88 7,825 4
Payson, AZ $2.17 $0.01 – $2.34 7,843 3
Jonesboro, LA $1.65 $0.00 – $2.17 7,882 7
Zeeland, MI $0.00 $0.00 – $0.00 7,885 1
North Hollywood, CA $23.18 $0.00 – $23.65 7,954 5
Brooklawn, NJ $8.39 $8.39 – $8.39 7,960 1
Easton, MD $14.88 $0.00 – $546.99 7,978 17
Huber Heights, OH $1.00 $0.00 – $10.92 7,983 6
Oak Park, IL $10.00 $0.00 – $43.55 8,026 5

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 β€”
J0120 Tetracyclin injection β€” β€” β€”
J0133 Acyclovir injection β€” β€” β€”
J0202 Injection, alemtuzumab β€” β€” β€”
J0795 Corticorelin ovine triflutal β€” β€” β€”
J1160 Digoxin injection β€” β€” β€”
J1205 Chlorothiazide sodium inj β€” β€” β€”
J1260 Dolasetron mesylate β€” β€” β€”
J1290 Ecallantide injection β€” β€” β€”
J1300 Eculizumab injection β€” β€” β€”
J1301 Injection, edaravone, 1 mg β€” β€” β€”
J1303 Inj., ravulizumab-cwvz 10 mg β€” β€” β€”
J1305 Inj, evinacumab-dgnb, 5mg β€” β€” β€”
J1320 Amitriptyline injection β€” β€” β€”
J1322 Elosulfase alfa, injection β€” β€” β€”
J1327 Eptifibatide injection β€” β€” β€”

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.