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 |
|---|---|---|---|---|
| King City, CA | $8.64 | $0.00 – $9.91 | 16,527 | 4 |
| Picayune, MS | $0.81 | $0.05 – $17.02 | 16,530 | 7 |
| Tulare, CA | $5.57 | $0.00 – $170.99 | 16,546 | 19 |
| North Charleston, SC | $10.02 | $0.11 – $76.35 | 16,559 | 24 |
| South Hill, VA | $4.63 | $0.04 – $66.75 | 16,607 | 6 |
| Placentia, CA | $8.77 | $8.77 – $8.77 | 16,624 | 1 |
| Gretna, LA | $3.77 | $0.00 – $53.21 | 16,625 | 38 |
| Euclid, OH | $2.91 | $0.00 – $17.74 | 16,661 | 11 |
| Lihue, HI | $9.36 | $0.00 – $578.09 | 16,708 | 4 |
| Harlingen, TX | $5.93 | $0.00 – $71.25 | 16,734 | 28 |
| Bridgeton, NJ | $12.87 | $12.76 – $18.34 | 16,755 | 2 |
| Fairview, NJ | $3.45 | $3.45 – $3.45 | 16,761 | 1 |
| Plattsburgh, NY | $144.62 | $0.00 – $815.21 | 16,797 | 7 |
| Seatac, WA | $18.16 | $16.61 – $18.92 | 16,815 | 3 |
| Lake Havasu City, AZ | $2.21 | $1.35 – $79.80 | 16,863 | 4 |
| Oak Grove, LA | $0.96 | $0.00 – $16.10 | 16,871 | 8 |
| Logan, UT | $9.41 | $0.87 – $921.61 | 16,931 | 5 |
| West Bloomfield, MI | $9.09 | $0.03 – $875.21 | 16,940 | 4 |
| San Marcos, CA | $148.23 | $0.00 – $1,584 | 16,998 | 12 |
| Greenbelt, MD | $336.79 | $-0.01 – $1,743 | 17,009 | 17 |
| Grafton, WI | $0.18 | $0.03 – $17.12 | 17,144 | 3 |
| Queen Creek, AZ | $1.06 | $0.00 – $81.60 | 17,167 | 3 |
| Ocala, FL | $5.15 | $0.00 – $280.42 | 17,182 | 26 |
| Waterford, MI | $9.34 | $0.00 – $9.75 | 17,194 | 7 |
| South Gate, CA | $40.26 | $0.02 – $139.08 | 17,220 | 9 |
| Hillsdale, MI | $1.84 | $0.70 – $11.58 | 17,225 | 4 |
| Terre Haute, IN | $43.73 | $0.00 – $340.03 | 17,305 | 39 |
| Aberdeen, WA | $0.79 | $0.04 – $20.96 | 17,323 | 6 |
| Yazoo City, MS | $0.61 | $0.00 – $0.84 | 17,330 | 7 |
| Safford, AZ | $0.15 | $0.03 – $7.79 | 17,349 | 3 |
| Spring Hill, TN | $0.64 | $0.29 – $2.20 | 17,370 | 5 |
| Beckley, WV | $33.19 | $0.00 – $145.84 | 17,425 | 23 |
| Napa, CA | $73.42 | $2.91 – $1,059 | 17,433 | 5 |
| Carthage, MS | $0.92 | $0.00 – $4.87 | 17,449 | 15 |
| Concord, CA | $7.34 | $0.00 – $54.98 | 17,531 | 10 |
| Hartsville, SC | $2.10 | $0.10 – $87.79 | 17,533 | 15 |
| Cherry Hill, NJ | $37.82 | $0.00 – $430.99 | 17,580 | 9 |
| Lorain, OH | $1.76 | $0.00 – $168.39 | 17,584 | 23 |
| Greensboro, GA | $0.29 | $0.07 – $6.08 | 17,600 | 3 |
| Buena Park, CA | $6.22 | $0.79 – $6.81 | 17,644 | 7 |
| Willimantic, CT | $0.06 | $0.00 – $56.38 | 17,654 | 3 |
| Opelousas, LA | $5.95 | $0.00 – $19.41 | 17,714 | 37 |
| Salyersville, KY | $4.59 | $0.17 – $22.00 | 17,755 | 12 |
| Petoskey, MI | $0.11 | $0.02 – $5.57 | 17,779 | 2 |
| Covington, LA | $28.19 | $0.00 – $170.50 | 17,820 | 40 |
| Biloxi, MS | $0.66 | $0.00 – $32.81 | 17,916 | 15 |
| Jamestown, TN | $2.63 | $0.00 – $7.38 | 17,972 | 14 |
| Covington, WA | $0.13 | $0.13 – $0.36 | 18,042 | 2 |
| Reedley, CA | $5.39 | $0.00 – $10.14 | 18,077 | 9 |
| Dillon, SC | $1.53 | $0.10 – $80.08 | 18,116 | 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.