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 |
|---|---|---|---|---|
| La Puente, CA | $8.72 | $0.00 – $8.74 | 25,036 | 3 |
| Monticello, KY | $8.11 | $0.07 – $45.97 | 25,045 | 30 |
| Twin Falls, ID | $38.36 | $0.00 – $1,345 | 25,077 | 11 |
| Kent, WA | $15.58 | $0.10 – $776.74 | 25,176 | 7 |
| Parma Heights, OH | $1.04 | $0.00 – $1.30 | 25,337 | 4 |
| Port Gibson, MS | $3.54 | $0.00 – $3.94 | 25,378 | 11 |
| Moses Lake, WA | $2.65 | $0.07 – $92.98 | 25,403 | 15 |
| Wayne, MI | $3.04 | $0.00 – $739.33 | 25,500 | 2 |
| Oroville, CA | $10.09 | $0.00 – $13.06 | 25,502 | 8 |
| Santa Fe, NM | $36.04 | $0.01 – $784.43 | 25,518 | 22 |
| Blairs, VA | $0.02 | $0.02 – $0.02 | 25,536 | 1 |
| Williamsburg, VA | $9.50 | $0.06 – $851.79 | 25,542 | 13 |
| Prestonsburg, KY | $9.30 | $0.00 – $74.94 | 25,592 | 29 |
| Martin, TN | $0.78 | $0.00 – $5.78 | 25,725 | 13 |
| Lawrenceburg, TN | $8.69 | $0.01 – $347.51 | 25,746 | 41 |
| Pensacola, FL | $9.31 | $0.00 – $337.33 | 25,805 | 43 |
| Taylor, MI | $77.57 | $0.00 – $797.05 | 26,106 | 12 |
| Gary, IN | $1.44 | $0.00 – $34.72 | 26,227 | 13 |
| Bozeman, MT | $3.62 | $0.54 – $601.06 | 26,255 | 8 |
| Wisconsin Rapids, WI | $0.76 | $0.00 – $16.85 | 26,342 | 3 |
| Calabash, NC | $0.99 | $0.99 – $0.99 | 26,400 | 1 |
| Leesville, LA | $0.51 | $0.00 – $27.93 | 26,423 | 22 |
| Ellsworth, ME | $0.01 | $0.00 – $0.03 | 26,437 | 2 |
| Natchez, MS | $0.56 | $0.00 – $2.70 | 26,469 | 18 |
| Des Moines, IA | $101.32 | $0.00 – $1,428 | 26,526 | 82 |
| Oak Creek, WI | $0.07 | $0.00 – $6.07 | 26,594 | 4 |
| Garden City, MI | $1.66 | $0.00 – $17.74 | 26,640 | 9 |
| Helena, MT | $11.72 | $0.00 – $1,052 | 26,679 | 10 |
| Burien, WA | $1.12 | $0.29 – $1,202 | 26,730 | 4 |
| Shiprock, NM | $3.12 | $3.12 – $3.12 | 26,755 | 1 |
| Burbank, CA | $6.98 | $0.00 – $14.62 | 26,971 | 13 |
| Somers Point, NJ | $9.05 | $1.96 – $706.14 | 26,971 | 7 |
| Northridge, CA | $40.23 | $1.50 – $765.23 | 26,992 | 10 |
| Kingsport, TN | $25.05 | $0.00 – $1,029 | 27,003 | 49 |
| Fremont, CA | $29.12 | $0.00 – $1,072 | 27,009 | 14 |
| Long Branch, NJ | $4.13 | $0.94 – $54.19 | 27,014 | 3 |
| Starkville, MS | $1.63 | $0.00 – $63.06 | 27,126 | 17 |
| Greer, SC | $0.20 | $0.00 – $6.59 | 27,287 | 6 |
| Sun City West, AZ | $1.74 | $0.00 – $151.17 | 27,504 | 8 |
| Corpus Christi, TX | $10.69 | $0.00 – $121.90 | 27,609 | 85 |
| Nassawadox, VA | $0.13 | $0.13 – $0.13 | 27,630 | 1 |
| Coushatta, LA | $0.57 | $0.00 – $39.24 | 27,669 | 15 |
| Putnam, CT | $0.05 | $0.01 – $1.71 | 27,722 | 5 |
| Flagstaff, AZ | $10.00 | $0.00 – $1,095 | 27,738 | 26 |
| Flowood, MS | $0.39 | $0.00 – $8.02 | 27,761 | 18 |
| Michigan City, IN | $1.08 | $0.00 – $49.75 | 27,825 | 10 |
| Henderson, KY | $7.39 | $0.16 – $74.59 | 27,904 | 16 |
| Morehead, KY | $14.33 | $0.28 – $47.41 | 27,907 | 22 |
| Savannah, TN | $1.73 | $0.00 – $10.37 | 27,931 | 25 |
| Fond Du Lac, WI | $1.05 | $0.01 – $85.50 | 27,985 | 9 |
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.