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 |
|---|---|---|---|---|
| Mount Clemens, MI | $1.67 | $0.00 – $22.96 | 22,516 | 8 |
| Franklin, VA | $0.49 | $0.08 – $13.94 | 22,520 | 6 |
| Northport, AL | $1.45 | $0.26 – $1.52 | 22,527 | 10 |
| Sandusky, OH | $13.88 | $0.00 – $54.78 | 22,603 | 22 |
| Schenectady, NY | $1.96 | $0.09 – $1,276 | 22,653 | 8 |
| Greenville, NC | $18.79 | $0.00 – $974.93 | 22,736 | 92 |
| Mullica Hill, NJ | $0.86 | $0.78 – $1.97 | 22,861 | 2 |
| Lumberton, NC | $1.39 | $0.00 – $17.22 | 22,885 | 43 |
| South Weymouth, MA | $1.16 | $1.16 – $1.16 | 22,968 | 1 |
| Americus, GA | $12.12 | $0.15 – $70.57 | 23,079 | 6 |
| Georgetown, SC | $7.55 | $0.99 – $58.87 | 23,083 | 6 |
| Watertown, NY | $10.16 | $0.86 – $65.23 | 23,179 | 10 |
| East Bernstadt, KY | $3.10 | $1.27 – $5.20 | 23,325 | 8 |
| Daly City, CA | $34.93 | $0.00 – $68.29 | 23,355 | 8 |
| Wauwatosa, WI | $78.83 | $0.01 – $871.42 | 23,378 | 12 |
| Jacksonville, NC | $8.93 | $0.00 – $62.30 | 23,402 | 27 |
| Guaynabo, PR | $411.03 | $0.00 – $411.31 | 23,487 | 2 |
| Mount Holly, NJ | $2.21 | $2.21 – $2.21 | 23,512 | 1 |
| Walterboro, SC | $4.21 | $0.19 – $86.93 | 23,610 | 9 |
| Alpena, MI | $0.42 | $0.00 – $45.42 | 23,615 | 4 |
| Brick, NJ | $5.76 | $0.00 – $121.69 | 23,673 | 7 |
| Lancaster, SC | $1.19 | $0.03 – $10.86 | 23,821 | 14 |
| Holland, MI | $15.69 | $0.29 – $262.77 | 23,917 | 6 |
| Fort Thomas, KY | $4.02 | $0.00 – $4.18 | 23,974 | 4 |
| Cathedral City, CA | $0.18 | $0.01 – $0.19 | 24,001 | 3 |
| Mobile, AL | $2.08 | $0.00 – $628.21 | 24,004 | 100 |
| Chapel Hill, NC | $2.61 | $0.00 – $87.71 | 24,052 | 49 |
| Henderson, NV | $34.37 | $0.00 – $1,314 | 24,137 | 54 |
| Hartford, KY | $16.20 | $0.28 – $16.51 | 24,148 | 5 |
| Big Stone Gap, VA | $1.98 | $0.03 – $2.00 | 24,223 | 3 |
| High Point, NC | $6.53 | $0.00 – $629.48 | 24,260 | 46 |
| Poplar Bluff, MO | $1.51 | $0.00 – $7.39 | 24,265 | 7 |
| Middletown, NY | $81.89 | $0.29 – $846.24 | 24,291 | 14 |
| Beachwood, OH | $233.31 | $0.00 – $1,323 | 24,293 | 27 |
| Peoria, AZ | $38.10 | $0.00 – $321.32 | 24,358 | 24 |
| Loris, SC | $1.35 | $0.26 – $2.34 | 24,393 | 4 |
| Richlands, VA | $0.72 | $0.38 – $4.68 | 24,443 | 7 |
| Decatur, GA | $1.83 | $0.37 – $8.35 | 24,492 | 6 |
| Idaho Falls, ID | $30.79 | $0.00 – $625.79 | 24,584 | 17 |
| Mandeville, LA | $3.62 | $0.00 – $101.54 | 24,601 | 9 |
| Roseburg, OR | $33.08 | $0.00 – $658.88 | 24,632 | 26 |
| Ridgewood, NY | $45.95 | $0.52 – $125.92 | 24,686 | 3 |
| Rio Rancho, NM | $165.10 | $1.15 – $435.47 | 24,808 | 8 |
| Ponce, PR | $51.09 | $0.00 – $776.42 | 24,828 | 19 |
| Troy, NY | $0.05 | $0.01 – $3.92 | 24,834 | 3 |
| Emporia, VA | $0.24 | $0.08 – $16.47 | 24,859 | 5 |
| Wyandotte, MI | $0.69 | $0.00 – $284.50 | 24,929 | 19 |
| Eureka, CA | $16.77 | $0.00 – $48.56 | 24,949 | 8 |
| Panorama City, CA | $18.80 | $0.00 – $5,502 | 24,959 | 9 |
| Amory, MS | $0.29 | $0.00 – $1.74 | 24,995 | 18 |
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.