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 |
|---|---|---|---|---|
| Prattville, AL | $3.29 | $0.00 – $31.29 | 12,534 | 12 |
| Pineville, LA | $0.31 | $0.00 – $0.79 | 12,559 | 14 |
| Soldotna, AK | $5.54 | $0.00 – $27.72 | 12,561 | 6 |
| Two Rivers, WI | $1.92 | $0.00 – $78.42 | 12,585 | 3 |
| Union City, TN | $3.76 | $0.19 – $55.92 | 12,595 | 22 |
| Elk Grove, CA | $14.20 | $0.46 – $385.74 | 12,617 | 6 |
| Cullman, AL | $5.00 | $0.00 – $605.65 | 12,620 | 30 |
| Austin, TX | $8.69 | $0.00 – $444.40 | 12,625 | 39 |
| Minden, LA | $1.29 | $0.00 – $7.67 | 12,652 | 21 |
| Waynesboro, MS | $1.47 | $0.00 – $16.66 | 12,671 | 16 |
| Sikeston, MO | $0.00 | $0.00 – $0.00 | 12,679 | 3 |
| Augusta, GA | $5.72 | $0.00 – $83.01 | 12,680 | 24 |
| Bloomfield, NJ | $251.42 | $0.46 – $768.73 | 12,723 | 9 |
| Topeka, KS | $15.77 | $0.17 – $347.44 | 12,738 | 30 |
| Skowhegan, ME | $3.17 | $2.77 – $6.58 | 12,747 | 2 |
| Sterling, VA | $0.12 | $0.12 – $0.12 | 12,759 | 1 |
| San Carlos, CA | $88.28 | $0.00 – $91.54 | 12,766 | 4 |
| Watsonville, CA | $49.55 | $4.86 – $123.38 | 12,770 | 5 |
| Sanford, NC | $0.36 | $0.00 – $9.13 | 12,799 | 7 |
| Selmer, TN | $1.88 | $0.29 – $5.49 | 12,809 | 17 |
| Galveston, TX | $11.13 | $0.00 – $79.08 | 12,817 | 17 |
| Barbourville, KY | $6.32 | $0.00 – $22.57 | 12,822 | 20 |
| Grayling, MI | $0.60 | $0.00 – $50.22 | 12,842 | 2 |
| Hamilton, NJ | $16.71 | $0.88 – $102.71 | 12,844 | 7 |
| Fort Mohave, AZ | $0.23 | $0.23 – $0.28 | 12,874 | 2 |
| Commerce Township, MI | $13.11 | $13.11 – $13.11 | 12,959 | 1 |
| San Dimas, CA | $7.14 | $5.01 – $19.85 | 12,971 | 3 |
| Hastings, MI | $1.59 | $0.00 – $67.15 | 12,977 | 5 |
| Globe, AZ | $0.04 | $0.04 – $0.04 | 12,989 | 1 |
| Three Rivers, MI | $3.36 | $0.00 – $25.41 | 13,017 | 5 |
| Stearns, KY | $12.45 | $1.18 – $19.70 | 13,075 | 10 |
| Cape Girardeau, MO | $0.04 | $0.00 – $4.16 | 13,126 | 9 |
| Alcoa, TN | $1.97 | $0.23 – $42.84 | 13,143 | 7 |
| Newark, DE | $336.27 | $0.00 – $1,072 | 13,154 | 17 |
| Mankato, MN | $48.47 | $0.00 – $1,889 | 13,178 | 21 |
| Kailua, HI | $4.61 | $0.00 – $6.05 | 13,208 | 3 |
| Shelton, WA | $12.00 | $0.00 – $30.20 | 13,225 | 3 |
| Oxon Hill, MD | $8.34 | $0.00 – $76.08 | 13,225 | 7 |
| Metairie, LA | $50.70 | $0.00 – $1,054 | 13,234 | 67 |
| San Luis, AZ | $0.02 | $0.00 – $0.13 | 13,244 | 8 |
| Oregon, OH | $17.77 | $0.00 – $95.12 | 13,296 | 17 |
| Hyattsville, MD | $2.09 | $0.00 – $81.34 | 13,301 | 7 |
| Rhinelander, WI | $5.31 | $0.68 – $491.20 | 13,302 | 3 |
| Lincoln, NE | $26.48 | $0.00 – $749.00 | 13,320 | 20 |
| Reidsville, NC | $1.86 | $0.29 – $7.77 | 13,343 | 9 |
| Florence, AL | $2.34 | $0.03 – $92.78 | 13,366 | 50 |
| Prosser, WA | $9.30 | $9.11 – $18.78 | 13,393 | 3 |
| Carlsbad, NM | $6.88 | $0.00 – $97.68 | 13,482 | 15 |
| Holyoke, MA | $5.41 | $0.00 – $5.55 | 13,489 | 4 |
| Elkins, WV | $28.52 | $0.73 – $28.85 | 13,522 | 3 |
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.