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 |
|---|---|---|---|---|
| Butte, MT | $0.50 | $0.00 – $8.60 | 14,789 | 4 |
| Henrico, VA | $45.56 | $0.03 – $57.19 | 14,781 | 7 |
| Decatur, AL | $6.24 | $0.00 – $76.21 | 14,780 | 29 |
| Goldsboro, NC | $17.10 | $0.00 – $46.40 | 14,745 | 29 |
| Alhambra, CA | $39.30 | $0.03 – $112.51 | 14,691 | 17 |
| South San Francisco, CA | $50.01 | $15.40 – $78.12 | 14,686 | 2 |
| Manahawkin, NJ | $3.68 | $0.95 – $58.20 | 14,678 | 5 |
| Mayfield Hts, OH | $0.16 | $0.07 – $0.16 | 14,677 | 3 |
| Bellflower, CA | $8.88 | $0.00 – $502.78 | 14,668 | 14 |
| Clinton, MS | $0.31 | $0.31 – $0.62 | 14,658 | 3 |
| Sweetwater, TN | $0.53 | $0.00 – $1.45 | 14,607 | 11 |
| Dover, NH | $2.64 | $2.63 – $4.00 | 14,584 | 4 |
| Fairfield, OH | $3.87 | $0.00 – $704.42 | 14,547 | 17 |
| Santa Maria, CA | $10.44 | $0.00 – $185.06 | 14,512 | 20 |
| Berea, KY | $10.55 | $0.52 – $11.35 | 14,454 | 5 |
| Shawano, WI | $0.03 | $0.00 – $0.03 | 14,453 | 2 |
| Silver City, NM | $6.63 | $1.51 – $12.10 | 14,324 | 4 |
| Jamestown, NY | $0.27 | $0.17 – $9.61 | 14,268 | 6 |
| Hickory, NC | $43.07 | $0.20 – $1,148 | 14,245 | 26 |
| Clinton Twp, MI | $0.19 | $0.12 – $10.30 | 14,241 | 4 |
| Flemington, NJ | $6.24 | $3.73 – $15.49 | 14,228 | 11 |
| Waynesboro, TN | $0.65 | $0.06 – $1.07 | 14,212 | 9 |
| Eugene, OR | $357.07 | $0.00 – $1,139 | 14,177 | 38 |
| Duluth, MN | $39.01 | $0.00 – $817.12 | 14,165 | 20 |
| Davis, CA | $12.26 | $5.17 – $68.31 | 14,111 | 4 |
| Potsdam, NY | $4.14 | $0.00 – $4.14 | 14,055 | 2 |
| Clinton, SC | $1.92 | $0.00 – $87.26 | 14,041 | 9 |
| Steubenville, OH | $1.06 | $0.00 – $10.17 | 14,037 | 9 |
| Natchitoches, LA | $9.64 | $0.00 – $28.83 | 14,030 | 39 |
| Cape May Court House, NJ | $2.60 | $2.29 – $38.86 | 14,007 | 4 |
| Gadsden, AL | $1.75 | $0.00 – $8.60 | 14,002 | 35 |
| Stony Brook, NY | $3.02 | $0.00 – $215.07 | 13,988 | 7 |
| Plaquemine, LA | $0.49 | $0.00 – $0.64 | 13,970 | 5 |
| Rice Lake, WI | $0.52 | $0.00 – $0.53 | 13,941 | 2 |
| Ewa Beach, HI | $0.01 | $0.00 – $1.07 | 13,940 | 4 |
| Ridgeland, MS | $37.02 | $0.06 – $726.18 | 13,920 | 9 |
| Louisa, KY | $9.42 | $0.41 – $12.71 | 13,917 | 9 |
| Fort Myers, FL | $56.69 | $0.00 – $344.78 | 13,906 | 44 |
| Winfield, AL | $0.54 | $0.18 – $1.59 | 13,901 | 10 |
| Oro Valley, AZ | $0.05 | $0.05 – $0.79 | 13,791 | 5 |
| Hoboken, NJ | $2.12 | $0.00 – $32.18 | 13,767 | 12 |
| Irvine, CA | $90.30 | $0.00 – $2,576 | 13,746 | 11 |
| Erie, PA | $0.15 | $0.00 – $57.87 | 13,736 | 17 |
| Culver City, CA | $66.38 | $0.00 – $218.06 | 13,707 | 7 |
| Onancock, VA | $0.39 | $0.23 – $13.02 | 13,706 | 3 |
| Rochester, MN | $146.49 | $0.00 – $907.50 | 13,688 | 45 |
| Kayenta, AZ | $0.00 | $0.00 – $0.00 | 13,678 | 1 |
| Onalaska, WI | $1.04 | $0.02 – $1.63 | 13,628 | 2 |
| Bogalusa, LA | $0.19 | $0.02 – $2.39 | 13,605 | 8 |
| Tarzana, CA | $4.76 | $0.56 – $22.37 | 13,595 | 5 |
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.