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 |
|---|---|---|---|---|
| North Charleston, SC | $10.02 | $0.11 – $76.35 | 16,559 | 24 |
| Tulare, CA | $5.57 | $0.00 – $170.99 | 16,546 | 19 |
| Picayune, MS | $0.81 | $0.05 – $17.02 | 16,530 | 7 |
| King City, CA | $8.64 | $0.00 – $9.91 | 16,527 | 4 |
| North Chesterfield, VA | $1.15 | $0.03 – $26.28 | 16,472 | 10 |
| Arlington, WA | $8.54 | $2.24 – $50.13 | 16,416 | 2 |
| Fenton, MO | $0.41 | $0.00 – $0.41 | 16,399 | 2 |
| Rockville, MD | $45.85 | $0.00 – $1,493 | 16,347 | 21 |
| Pharr, TX | $0.48 | $0.06 – $1.57 | 16,282 | 8 |
| Valencia, CA | $37.50 | $0.00 – $1,341 | 16,239 | 8 |
| Rochester, MI | $0.67 | $0.00 – $7.12 | 16,167 | 3 |
| Chesterfield, MO | $2,389 | $2,389 – $2,389 | 16,156 | 1 |
| Harlan, KY | $8.29 | $0.12 – $15.63 | 16,111 | 10 |
| Oceanside, CA | $94.95 | $0.80 – $603.07 | 16,080 | 11 |
| Burlington, NC | $1.82 | $0.05 – $26.63 | 15,965 | 21 |
| Lancaster, OH | $1.80 | $0.00 – $75.97 | 15,946 | 20 |
| Issaquah, WA | $0.05 | $0.00 – $0.05 | 15,923 | 2 |
| Fremont, MI | $2.69 | $0.00 – $47.62 | 15,865 | 5 |
| Mt Pleasant, MI | $1.58 | $0.01 – $6.94 | 15,852 | 4 |
| Greenwich, CT | $0.89 | $0.07 – $492.59 | 15,832 | 4 |
| Chester, VA | $1.60 | $0.01 – $7.07 | 15,828 | 6 |
| Greenville, MI | $5.41 | $0.00 – $51.84 | 15,784 | 3 |
| St. Louis, MO | $0.24 | $0.24 – $0.24 | 15,707 | 1 |
| Vernon, CT | $2.74 | $0.01 – $342.21 | 15,661 | 5 |
| Salisbury, MD | $24.98 | $0.00 – $397.69 | 15,643 | 25 |
| Myrlte Beach, SC | $4.49 | $4.49 – $4.49 | 15,605 | 1 |
| Santa Monica, CA | $8.39 | $0.20 – $11.13 | 15,596 | 8 |
| Boaz, AL | $1.48 | $0.00 – $6.60 | 15,525 | 22 |
| San Juan Capistrano, CA | $2.51 | $0.00 – $2.51 | 15,463 | 3 |
| Calexico, CA | $1.04 | $0.04 – $6.75 | 15,436 | 7 |
| Brunswick, ME | $43.37 | $4.53 – $44.03 | 15,430 | 3 |
| Temecula, CA | $101.91 | $0.00 – $1,142 | 15,397 | 21 |
| Willingboro, NJ | $9.61 | $5.45 – $27.65 | 15,335 | 2 |
| Brookhaven, MS | $1.86 | $0.10 – $4.07 | 15,311 | 14 |
| Bay Shore, NY | $5.43 | $0.00 – $15.84 | 15,294 | 6 |
| Lapeer, MI | $2.71 | $0.00 – $104.49 | 15,290 | 5 |
| Danville, KY | $13.11 | $0.00 – $468.12 | 15,265 | 16 |
| Bullhead City, AZ | $0.62 | $0.12 – $36.06 | 15,250 | 11 |
| Arcadia, CA | $7.46 | $4.53 – $9.91 | 15,220 | 5 |
| Alliance, OH | $1.26 | $0.00 – $93.05 | 15,213 | 16 |
| New York City, NY | $76.63 | $76.63 – $76.63 | 15,184 | 1 |
| Pompton Plains, NJ | $2.73 | $2.73 – $2.73 | 15,170 | 1 |
| Middlesboro, KY | $4.29 | $0.18 – $119.41 | 15,079 | 17 |
| Bastrop, LA | $1.67 | $0.00 – $20.42 | 15,036 | 19 |
| Ridgewood, NJ | $29.67 | $8.68 – $864.83 | 14,993 | 3 |
| Marquette, MI | $2.43 | $0.00 – $59.61 | 14,991 | 3 |
| Hamden, CT | $208.06 | $0.69 – $1,087 | 14,882 | 14 |
| Pocatello, ID | $4.48 | $0.00 – $26.26 | 14,865 | 13 |
| Woodland, CA | $14.60 | $0.00 – $112.17 | 14,855 | 5 |
| Methuen, MA | $0.54 | $0.00 – $5.53 | 14,791 | 3 |
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.