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 |
|---|---|---|---|---|
| Two Rivers, WI | $1.92 | $0.00 – $78.42 | 12,585 | 3 |
| Soldotna, AK | $5.54 | $0.00 – $27.72 | 12,561 | 6 |
| Pineville, LA | $0.31 | $0.00 – $0.79 | 12,559 | 14 |
| Prattville, AL | $3.29 | $0.00 – $31.29 | 12,534 | 12 |
| Castro Valley, CA | $33.54 | $22.25 – $67.49 | 12,531 | 3 |
| Rockville Centre, NY | $62.77 | $0.19 – $723.07 | 12,472 | 6 |
| Munster, IN | $38.18 | $0.00 – $795.54 | 12,466 | 19 |
| Murrells Inlet, SC | $31.46 | $1.08 – $662.87 | 12,417 | 7 |
| South Boston, VA | $0.25 | $0.18 – $13.94 | 12,350 | 6 |
| Port Jefferson, NY | $7.69 | $0.43 – $19.82 | 12,338 | 3 |
| Port Angeles, WA | $6.37 | $0.00 – $60.28 | 12,334 | 6 |
| Richmond Heights, MO | $0.11 | $0.11 – $0.11 | 12,323 | 1 |
| La Jolla, CA | $45.53 | $0.00 – $660.48 | 12,318 | 15 |
| Los Banos, CA | $9.68 | $2.23 – $89.24 | 12,315 | 6 |
| Gaffney, SC | $10.17 | $0.02 – $88.27 | 12,302 | 9 |
| Fort Atkinson, WI | $0.08 | $0.00 – $72.43 | 12,263 | 3 |
| Laurel, MD | $57.66 | $0.00 – $59.69 | 12,256 | 4 |
| Cedar Rapids, IA | $91.53 | $0.00 – $790.74 | 12,246 | 35 |
| New Iberia, LA | $1.27 | $0.00 – $25.62 | 12,236 | 47 |
| Waterloo, IA | $15.60 | $0.00 – $326.80 | 12,196 | 43 |
| Fort Collins, CO | $205.60 | $0.00 – $1,244 | 12,194 | 35 |
| Brownsville, TN | $2.30 | $0.23 – $5.08 | 12,191 | 11 |
| Marinette, WI | $0.88 | $0.01 – $387.71 | 12,191 | 4 |
| Eatontown, NJ | $41.70 | $7.23 – $45.98 | 12,130 | 3 |
| St Thomas, VI | $62.54 | $6.71 – $62.95 | 12,123 | 2 |
| Ocean Springs, MS | $1.14 | $0.00 – $46.80 | 12,113 | 7 |
| Clifton, NJ | $4.72 | $0.28 – $22.04 | 12,109 | 15 |
| Bayside, NY | $8.64 | $0.60 – $9.43 | 12,105 | 4 |
| Willoughby, OH | $1.45 | $0.00 – $89.22 | 12,057 | 6 |
| Monterey, CA | $15.99 | $1.27 – $726.54 | 12,057 | 11 |
| Vacherie, LA | $0.23 | $0.00 – $0.53 | 12,024 | 6 |
| Hammond, LA | $3.55 | $0.00 – $83.95 | 12,013 | 46 |
| West Point, MS | $0.40 | $0.24 – $3.52 | 11,959 | 3 |
| Tompkinsville, KY | $5.43 | $2.52 – $40.14 | 11,954 | 8 |
| Marks, MS | $0.60 | $0.07 – $3.62 | 11,934 | 6 |
| Athens, OH | $2.26 | $0.00 – $74.76 | 11,928 | 15 |
| Olive Branch, MS | $0.14 | $0.00 – $37.51 | 11,883 | 10 |
| Rapid City, SD | $70.60 | $0.00 – $945.37 | 11,877 | 18 |
| Smithtown, NY | $37.88 | $0.50 – $129.16 | 11,875 | 5 |
| Clare, MI | $0.01 | $0.00 – $2.98 | 11,855 | 2 |
| Rockford, IL | $20.04 | $0.00 – $689.00 | 11,849 | 21 |
| Milpitas, CA | $21.61 | $4.78 – $22.93 | 11,839 | 3 |
| Ellensburg, WA | $33.78 | $2.64 – $930.24 | 11,836 | 4 |
| Marion, VA | $1.01 | $0.11 – $10.78 | 11,812 | 6 |
| Toppenish, WA | $0.10 | $0.01 – $6.98 | 11,798 | 3 |
| Summerville, SC | $18.77 | $0.01 – $79.31 | 11,777 | 18 |
| Camden, SC | $1.51 | $0.00 – $85.20 | 11,757 | 6 |
| Beverly, MA | $10.36 | $0.00 – $48.77 | 11,749 | 7 |
| Waipahu, HI | $113.98 | $0.00 – $1,248 | 11,748 | 8 |
| Franklin, OH | $0.69 | $0.00 – $20.25 | 11,746 | 7 |
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.