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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 β€” 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
Murfreesboro, TN $9.88 $0.00 – $930.04 28,013 54
Kansas City, MO $0.53 $0.00 – $430.64 28,205 30
Waukesha, WI $5.05 $2.82 – $389.68 28,233 3
National City, CA $3.66 $2.41 – $101.79 28,242 3
Whitley City, KY $12.76 $0.98 – $27.49 28,289 17
Indianola, MS $0.51 $0.00 – $0.90 28,325 10
Aiea, HI $23.33 $0.02 – $694.03 28,352 3
Rialto, CA $1.16 $0.00 – $1.24 28,419 4
Wheeling, WV $17.60 $0.00 – $101.59 28,511 20
Utica, NY $7.54 $0.05 – $52.96 28,512 11
Hobbs, NM $10.68 $0.18 – $96.50 28,590 18
Perth Amboy, NJ $17.94 $0.71 – $287.47 28,752 7
Columbia, LA $0.15 $0.00 – $13.01 28,767 13
Lodi, CA $71.90 $0.00 – $1,124 28,901 13
Bellevue, WA $19.67 $0.00 – $1,319 28,966 15
Alexandria, LA $6.24 $0.00 – $51.19 28,993 82
Orlando, FL $50.90 $0.00 – $1,139 28,996 143
Brandon, MS $0.38 $0.00 – $5.37 29,114 7
Roanoke Rapids, NC $1.72 $0.00 – $16.87 29,126 11
Oxnard, CA $146.95 $0.03 – $1,913 29,155 18
Sioux Falls, SD $14.96 $0.00 – $646.73 29,217 22
Sterling Heights, MI $4.44 $0.11 – $48.82 29,333 29
Owosso, MI $29.71 $9.54 – $58.64 29,440 3
Riverdale, GA $0.82 $0.14 – $10.19 29,475 3
Campbellsville, KY $16.59 $0.05 – $413.31 29,614 11
Westerville, OH $24.48 $0.00 – $990.50 29,695 28
Mission Viejo, CA $7.82 $0.00 – $75.04 29,701 10
Pennington, NJ $1.73 $1.73 – $1.73 29,737 1
South Charleston, WV $9.77 $0.12 – $65.09 29,744 15
Bristol, TN $0.72 $0.00 – $15.12 29,876 19
Farmville, VA $1.23 $0.18 – $62.92 29,930 5
Edmonds, WA $1.73 $0.04 – $1,046 29,956 3
Pinehurst, NC $3.80 $0.06 – $25.47 29,957 15
Walnut Creek, CA $525.26 $0.00 – $1,512 30,019 21
Centralia, WA $3.76 $1.00 – $21.59 30,051 6
Richmond, KY $8.65 $0.46 – $536.25 30,126 21
North Myrtle Beach, SC $1.19 $0.80 – $12.99 30,218 3
Porterville, CA $5.96 $0.00 – $277.29 30,227 15
St George, UT $12.45 $0.00 – $12.64 30,257 7
Laguna Hills, CA $39.85 $0.07 – $1,312 30,295 9
Parkersburg, WV $26.65 $0.00 – $92.50 30,298 14
Wilmington, DE $35.70 $0.00 – $1,118 30,337 31
Mt Sterling, KY $4.85 $0.11 – $54.78 30,440 15
Costa Mesa, CA $5.34 $0.01 – $34.61 30,736 5
Bismarck, ND $5.11 $0.00 – $1,146 30,801 16
Madison Heights, MI $0.28 $0.00 – $2.20 30,825 10
Kennewick, WA $52.27 $0.00 – $921.55 30,860 15
Mansfield, OH $10.47 $0.00 – $91.01 30,891 22
Rock Hill, SC $2.35 $0.20 – $520.34 30,908 17
Martinsburg, WV $17.61 $0.00 – $34.05 30,910 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 β€”
J0120 Tetracyclin injection β€” β€” β€”
J0133 Acyclovir injection β€” β€” β€”
J0202 Injection, alemtuzumab β€” β€” β€”
J0795 Corticorelin ovine triflutal β€” β€” β€”
J1160 Digoxin injection β€” β€” β€”
J1205 Chlorothiazide sodium inj β€” β€” β€”
J1260 Dolasetron mesylate β€” β€” β€”
J1290 Ecallantide injection β€” β€” β€”
J1300 Eculizumab injection β€” β€” β€”
J1301 Injection, edaravone, 1 mg β€” β€” β€”
J1303 Inj., ravulizumab-cwvz 10 mg β€” β€” β€”
J1305 Inj, evinacumab-dgnb, 5mg β€” β€” β€”
J1320 Amitriptyline injection β€” β€” β€”
J1322 Elosulfase alfa, injection β€” β€” β€”
J1327 Eptifibatide injection β€” β€” β€”

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.