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 |
|---|---|---|---|---|
| Whittier, CA | $181.16 | $0.00 – $2,933 | 31,177 | 12 |
| Tuscaloosa, AL | $0.64 | $0.00 – $11.67 | 31,175 | 41 |
| Germantown, TN | $9.11 | $0.00 – $67.43 | 31,063 | 66 |
| Merced, CA | $23.99 | $0.00 – $1,059 | 31,049 | 24 |
| Martinsburg, WV | $17.61 | $0.00 – $34.05 | 30,910 | 9 |
| Rock Hill, SC | $2.35 | $0.20 – $520.34 | 30,908 | 17 |
| Mansfield, OH | $10.47 | $0.00 – $91.01 | 30,891 | 22 |
| Kennewick, WA | $52.27 | $0.00 – $921.55 | 30,860 | 15 |
| Madison Heights, MI | $0.28 | $0.00 – $2.20 | 30,825 | 10 |
| Bismarck, ND | $5.11 | $0.00 – $1,146 | 30,801 | 16 |
| Costa Mesa, CA | $5.34 | $0.01 – $34.61 | 30,736 | 5 |
| Mt Sterling, KY | $4.85 | $0.11 – $54.78 | 30,440 | 15 |
| Wilmington, DE | $35.70 | $0.00 – $1,118 | 30,337 | 31 |
| Parkersburg, WV | $26.65 | $0.00 – $92.50 | 30,298 | 14 |
| Laguna Hills, CA | $39.85 | $0.07 – $1,312 | 30,295 | 9 |
| St George, UT | $12.45 | $0.00 – $12.64 | 30,257 | 7 |
| Porterville, CA | $5.96 | $0.00 – $277.29 | 30,227 | 15 |
| North Myrtle Beach, SC | $1.19 | $0.80 – $12.99 | 30,218 | 3 |
| Richmond, KY | $8.65 | $0.46 – $536.25 | 30,126 | 21 |
| Centralia, WA | $3.76 | $1.00 – $21.59 | 30,051 | 6 |
| Walnut Creek, CA | $525.26 | $0.00 – $1,512 | 30,019 | 21 |
| Pinehurst, NC | $3.80 | $0.06 – $25.47 | 29,957 | 15 |
| Edmonds, WA | $1.73 | $0.04 – $1,046 | 29,956 | 3 |
| Farmville, VA | $1.23 | $0.18 – $62.92 | 29,930 | 5 |
| Bristol, TN | $0.72 | $0.00 – $15.12 | 29,876 | 19 |
| South Charleston, WV | $9.77 | $0.12 – $65.09 | 29,744 | 15 |
| Pennington, NJ | $1.73 | $1.73 – $1.73 | 29,737 | 1 |
| Mission Viejo, CA | $7.82 | $0.00 – $75.04 | 29,701 | 10 |
| Westerville, OH | $24.48 | $0.00 – $990.50 | 29,695 | 28 |
| Campbellsville, KY | $16.59 | $0.05 – $413.31 | 29,614 | 11 |
| Riverdale, GA | $0.82 | $0.14 – $10.19 | 29,475 | 3 |
| Owosso, MI | $29.71 | $9.54 – $58.64 | 29,440 | 3 |
| Sterling Heights, MI | $4.44 | $0.11 – $48.82 | 29,333 | 29 |
| Sioux Falls, SD | $14.96 | $0.00 – $646.73 | 29,217 | 22 |
| Oxnard, CA | $146.95 | $0.03 – $1,913 | 29,155 | 18 |
| Roanoke Rapids, NC | $1.72 | $0.00 – $16.87 | 29,126 | 11 |
| Brandon, MS | $0.38 | $0.00 – $5.37 | 29,114 | 7 |
| Orlando, FL | $50.90 | $0.00 – $1,139 | 28,996 | 143 |
| Alexandria, LA | $6.24 | $0.00 – $51.19 | 28,993 | 82 |
| Bellevue, WA | $19.67 | $0.00 – $1,319 | 28,966 | 15 |
| Lodi, CA | $71.90 | $0.00 – $1,124 | 28,901 | 13 |
| Columbia, LA | $0.15 | $0.00 – $13.01 | 28,767 | 13 |
| Perth Amboy, NJ | $17.94 | $0.71 – $287.47 | 28,752 | 7 |
| Hobbs, NM | $10.68 | $0.18 – $96.50 | 28,590 | 18 |
| Utica, NY | $7.54 | $0.05 – $52.96 | 28,512 | 11 |
| Wheeling, WV | $17.60 | $0.00 – $101.59 | 28,511 | 20 |
| Rialto, CA | $1.16 | $0.00 – $1.24 | 28,419 | 4 |
| Aiea, HI | $23.33 | $0.02 – $694.03 | 28,352 | 3 |
| Indianola, MS | $0.51 | $0.00 – $0.90 | 28,325 | 10 |
| Whitley City, KY | $12.76 | $0.98 – $27.49 | 28,289 | 17 |
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.