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 |
|---|---|---|---|---|
| Lake Providence, LA | $0.00 | $0.00 – $0.01 | 18,120 | 10 |
| Seneca, SC | $0.46 | $0.00 – $18.65 | 18,163 | 13 |
| Elmhurst, NY | $36.79 | $0.09 – $538.78 | 18,292 | 10 |
| Valhalla, NY | $1.09 | $0.21 – $646.85 | 18,314 | 3 |
| Logan, WV | $37.69 | $0.08 – $49.50 | 18,351 | 9 |
| Concord, NH | $3.92 | $0.00 – $12.60 | 18,365 | 7 |
| Alamogordo, NM | $5.03 | $0.08 – $86.46 | 18,378 | 12 |
| Glens Falls, NY | $2.29 | $0.00 – $1,226 | 18,395 | 8 |
| Fairbanks, AK | $20.32 | $1.30 – $20.59 | 18,446 | 3 |
| Lakewood, CO | $23.00 | $0.00 – $488.28 | 18,479 | 17 |
| Warrenton, VA | $0.65 | $0.26 – $8.09 | 18,510 | 3 |
| Maplewood, MN | $102.72 | $0.00 – $1,468 | 18,523 | 9 |
| Hesperia, CA | $0.43 | $0.00 – $82.45 | 18,533 | 5 |
| Baldwin Park, CA | $5.37 | $4.30 – $5.38 | 18,554 | 2 |
| Morristown, TN | $1.16 | $0.00 – $10.98 | 18,571 | 51 |
| Philadelphia, MS | $0.28 | $0.00 – $4.22 | 18,576 | 17 |
| Shelby, NC | $5.13 | $0.03 – $385.18 | 18,606 | 29 |
| Marrero, LA | $1.13 | $0.00 – $7.91 | 18,724 | 37 |
| Poughkeepsie, NY | $63.83 | $0.00 – $775.45 | 18,736 | 13 |
| St Francis, WI | $0.01 | $0.01 – $1.06 | 18,744 | 2 |
| Gallipolis, OH | $51.53 | $0.00 – $707.89 | 18,830 | 26 |
| Front Royal, VA | $0.37 | $0.16 – $50.92 | 18,841 | 5 |
| Union City, CA | $1.17 | $1.17 – $1.17 | 18,887 | 1 |
| Elizabeth City, NC | $2.51 | $0.00 – $67.31 | 18,888 | 11 |
| Gastonia, NC | $9.56 | $0.00 – $71.84 | 19,127 | 33 |
| Layton, UT | $1.72 | $0.00 – $45.94 | 19,203 | 6 |
| Milford, CT | $10.11 | $0.00 – $698.25 | 19,210 | 7 |
| Bardstown, KY | $3.80 | $2.97 – $65.02 | 19,320 | 5 |
| Evergreen, AL | $3.76 | $0.00 – $10.06 | 19,361 | 7 |
| Glendora, CA | $10.24 | $0.00 – $11.75 | 19,400 | 7 |
| West Chester, OH | $84.56 | $1.03 – $892.48 | 19,408 | 11 |
| Pasadena, CA | $34.12 | $0.00 – $629.82 | 19,459 | 26 |
| Presque Isle, ME | $38.31 | $2.29 – $39.24 | 19,484 | 2 |
| Lakewood, CA | $16.61 | $0.00 – $71.45 | 19,515 | 12 |
| Greenbrae, CA | $42.10 | $0.70 – $122.60 | 19,549 | 4 |
| Capitol Heights, MD | $0.56 | $0.56 – $0.56 | 19,549 | 1 |
| Huntsville, AL | $2.16 | $0.00 – $406.04 | 19,565 | 59 |
| Lawrence, NY | $33.61 | $28.49 – $387.64 | 19,568 | 2 |
| Paramount, CA | $16.67 | $2.55 – $19.81 | 19,584 | 4 |
| Maywood, NJ | $13.76 | $13.76 – $13.76 | 19,630 | 1 |
| Cookeville, TN | $1.74 | $0.00 – $9.09 | 19,651 | 57 |
| Marion, OH | $3.35 | $0.00 – $93.22 | 19,655 | 17 |
| Jamaica, NY | $13.34 | $0.00 – $69.50 | 19,773 | 11 |
| Trenton, MI | $0.10 | $0.00 – $6.40 | 19,857 | 7 |
| Lubbock, TX | $11.65 | $0.00 – $505.49 | 19,885 | 54 |
| Beavercreek, OH | $22.94 | $0.00 – $1,211 | 19,908 | 10 |
| Christiansburg, VA | $5.24 | $0.53 – $1,564 | 19,913 | 6 |
| Big Rapids, MI | $6.88 | $0.00 – $56.65 | 19,924 | 6 |
| Jeffersonville, IN | $1,062 | $0.00 – $1,249 | 20,001 | 16 |
| Burlington, MA | $80.68 | $80.68 – $80.68 | 20,039 | 1 |
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.