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 |
|---|---|---|---|---|
| Bay City, MI | $16.01 | $0.00 – $366.16 | 33,572 | 14 |
| Aiken, SC | $25.05 | $0.08 – $894.90 | 33,608 | 15 |
| Wilson, NC | $10.35 | $0.00 – $822.51 | 33,633 | 24 |
| Kenosha, WI | $2.44 | $0.11 – $82.65 | 33,704 | 10 |
| Aurora, CO | $96.85 | $0.00 – $1,617 | 33,795 | 137 |
| Livonia, MI | $169.23 | $0.00 – $1,685 | 34,030 | 18 |
| Clarksville, TN | $1.27 | $0.00 – $88.79 | 34,334 | 38 |
| Somerset, KY | $9.83 | $0.04 – $105.98 | 34,400 | 40 |
| Omaha, NE | $50.13 | $0.00 – $763.22 | 34,448 | 83 |
| Madisonville, KY | $4.31 | $0.33 – $42.68 | 34,465 | 20 |
| Roswell, NM | $8.38 | $0.56 – $97.12 | 34,753 | 24 |
| Mission Hills, CA | $6.28 | $0.09 – $25.75 | 34,927 | 7 |
| San Jacinto, CA | $0.11 | $0.07 – $1.44 | 35,003 | 2 |
| Reno, NV | $41.11 | $0.00 – $926.99 | 35,237 | 42 |
| Lakewood, NJ | $17.18 | $0.81 – $73.70 | 35,428 | 8 |
| Pasco, WA | $2.95 | $0.64 – $19.77 | 35,462 | 5 |
| Portsmouth, OH | $18.10 | $0.00 – $98.02 | 35,657 | 37 |
| Whitesburg, KY | $7.00 | $0.00 – $15.98 | 35,741 | 21 |
| Fort Worth, TX | $71.28 | $0.00 – $1,956 | 35,754 | 117 |
| Saint Paul, MN | $33.06 | $0.00 – $3,417 | 35,888 | 49 |
| New Albany, MS | $18.23 | $0.00 – $21.57 | 35,929 | 28 |
| Wailuku, HI | $2.26 | $0.00 – $282.39 | 36,064 | 12 |
| Fall River, MA | $14.11 | $0.08 – $691.38 | 36,147 | 19 |
| Winchester, KY | $20.27 | $4.05 – $598.04 | 36,250 | 11 |
| Wichita, KS | $17.99 | $0.00 – $1,402 | 36,467 | 61 |
| West Monroe, LA | $36.51 | $0.00 – $783.53 | 36,714 | 46 |
| Lynwood, CA | $14.25 | $0.00 – $119.42 | 36,821 | 8 |
| Kalispell, MT | $12.68 | $0.00 – $1,034 | 37,062 | 8 |
| Provo, UT | $31.72 | $0.00 – $1,212 | 37,083 | 18 |
| Huntington Park, CA | $5.07 | $0.00 – $17.28 | 37,149 | 9 |
| Greenfield, WI | $17.44 | $0.00 – $652.35 | 37,273 | 9 |
| Salem, VA | $0.57 | $0.15 – $12.87 | 37,425 | 6 |
| Fairfield, CA | $35.27 | $1.80 – $1,095 | 37,466 | 11 |
| Brockton, MA | $7.24 | $1.42 – $64.27 | 37,534 | 15 |
| Escondido, CA | $7.85 | $0.00 – $40.42 | 37,534 | 12 |
| Florence, KY | $4.20 | $0.00 – $41.71 | 37,579 | 19 |
| Livingston, NJ | $13.03 | $0.00 – $1,063 | 37,844 | 6 |
| Hopkinsville, KY | $9.24 | $0.05 – $67.65 | 38,410 | 27 |
| Toms River, NJ | $9.95 | $0.00 – $15.44 | 38,668 | 8 |
| Biddeford, ME | $19.24 | $2.31 – $514.33 | 38,837 | 4 |
| Grand Blanc, MI | $71.42 | $0.00 – $1,292 | 38,853 | 15 |
| Antioch, CA | $9.63 | $0.00 – $191.34 | 38,881 | 9 |
| Grosse Pointe, MI | $0.00 | $0.00 – $3.44 | 38,955 | 3 |
| Dublin, OH | $40.26 | $0.00 – $1,352 | 39,121 | 21 |
| Newark, OH | $20.98 | $0.00 – $505.43 | 39,191 | 46 |
| Lowell, MA | $8.76 | $0.00 – $33.53 | 39,496 | 8 |
| Cambridge, MA | $22.88 | $0.94 – $865.10 | 39,512 | 8 |
| Edison, NJ | $73.82 | $0.81 – $1,234 | 39,518 | 14 |
| Binghamton, NY | $6.30 | $0.15 – $84.05 | 39,531 | 7 |
| Perris, CA | $0.08 | $0.00 – $0.21 | 39,765 | 4 |
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.