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 |
|---|---|---|---|---|
| Cooperstown, NY | $11.88 | $9.47 – $70.19 | 20,055 | 4 |
| Parkland, WA | $0.05 | $0.05 – $0.05 | 20,189 | 1 |
| Lawrence, MA | $17.96 | $0.00 – $591.12 | 20,268 | 13 |
| Lovington, NM | $136.86 | $0.00 – $976.17 | 20,439 | 8 |
| Highland, CA | $0.22 | $0.00 – $8.48 | 20,445 | 3 |
| Woodville, MS | $0.10 | $0.00 – $0.29 | 20,449 | 5 |
| Marysville, CA | $10.29 | $5.19 – $28.64 | 20,540 | 3 |
| Ukiah, CA | $13.21 | $0.00 – $76.59 | 20,541 | 5 |
| Cadillac, MI | $2.63 | $0.00 – $43.45 | 20,607 | 5 |
| Stevens Point, WI | $15.49 | $0.00 – $378.97 | 20,730 | 5 |
| Silver Spring, MD | $1.97 | $0.00 – $9.33 | 20,732 | 15 |
| Harbor City, CA | $6.12 | $0.00 – $6.24 | 20,780 | 5 |
| Richmond Hill, NY | $10.15 | $0.77 – $65.59 | 20,795 | 3 |
| Albertville, AL | $2.45 | $0.30 – $6.87 | 20,893 | 18 |
| Davenport, IA | $2.81 | $0.00 – $342.92 | 20,926 | 25 |
| Chino, CA | $0.81 | $0.06 – $4.24 | 21,026 | 4 |
| North Las Vegas, NV | $2.27 | $0.00 – $72.52 | 21,074 | 11 |
| Menomonee Falls, WI | $0.03 | $0.00 – $0.03 | 21,132 | 2 |
| Pueblo, CO | $33.03 | $0.00 – $709.18 | 21,156 | 71 |
| Walla Walla, WA | $14.22 | $0.07 – $578.38 | 21,161 | 6 |
| Mission, TX | $0.95 | $0.00 – $19.93 | 21,180 | 32 |
| Montclair, NJ | $8.66 | $1.97 – $17.52 | 21,181 | 3 |
| Lebanon, NH | $85.48 | $0.78 – $663.14 | 21,364 | 15 |
| Huntington Beach, CA | $31.00 | $0.03 – $618.30 | 21,426 | 12 |
| Southfield, MI | $136.29 | $0.00 – $910.27 | 21,564 | 24 |
| Tracy, CA | $718.34 | $0.00 – $1,756 | 21,606 | 7 |
| Alma, MI | $0.06 | $0.00 – $9.35 | 21,613 | 3 |
| Grenada, MS | $0.88 | $0.00 – $37.50 | 21,736 | 16 |
| Manhasset, NY | $8.35 | $1.48 – $8.35 | 21,747 | 2 |
| Yuba City, CA | $6.20 | $0.00 – $11.28 | 21,771 | 12 |
| San Gabriel, CA | $14.01 | $0.29 – $37.50 | 21,779 | 10 |
| Nashua, NH | $1.00 | $0.00 – $10.32 | 21,793 | 7 |
| Passaic, NJ | $6.19 | $0.64 – $7.43 | 21,797 | 7 |
| Nampa, ID | $2.17 | $0.00 – $98.84 | 21,806 | 9 |
| Manchester, KY | $11.97 | $0.57 – $81.67 | 21,832 | 14 |
| Gig Harbor, WA | $0.19 | $0.16 – $22.46 | 21,924 | 2 |
| Albany, KY | $11.98 | $0.51 – $32.93 | 21,935 | 11 |
| Eastvale, CA | $0.13 | $0.10 – $0.27 | 22,029 | 3 |
| Mayfield, KY | $4.70 | $1.98 – $43.69 | 22,060 | 13 |
| Saratoga Springs, NY | $3.70 | $1.16 – $39.46 | 22,107 | 6 |
| Batesville, MS | $0.47 | $0.00 – $2.91 | 22,166 | 17 |
| Mountain View, CA | $319.48 | $2.28 – $1,632 | 22,228 | 10 |
| West Islip, NY | $0.59 | $0.12 – $0.59 | 22,326 | 3 |
| Georgetown, KY | $10.60 | $0.13 – $75.43 | 22,337 | 9 |
| Troy, OH | $2.55 | $0.00 – $97.41 | 22,343 | 13 |
| Leesburg, VA | $3.55 | $0.05 – $73.27 | 22,358 | 8 |
| Columbia, TN | $3.53 | $0.00 – $21.52 | 22,402 | 30 |
| Lexington, MS | $0.85 | $0.00 – $9.16 | 22,422 | 6 |
| Tuba City, AZ | $0.01 | $0.01 – $0.01 | 22,471 | 1 |
| Hamilton, OH | $12.15 | $0.00 – $370.96 | 22,475 | 21 |
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.