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 |
|---|---|---|---|---|
| Charlottesville, VA | $28.01 | $0.00 – $1,415 | 176,648 | 17 |
| Baltimore, MD | $34.38 | $0.00 – $2,148 | 174,778 | 133 |
| Camden, NJ | $18.79 | $0.00 – $417.11 | 173,461 | 17 |
| Ann Arbor, MI | $28.60 | $0.00 – $720.92 | 171,752 | 21 |
| Houston, TX | $18.66 | $0.00 – $4,971 | 170,155 | 294 |
| Atlanta, GA | $19.85 | $0.00 – $1,096 | 168,617 | 44 |
| Moreno Valley, CA | $8.76 | $0.00 – $180.00 | 166,555 | 21 |
| Indianapolis, IN | $34.24 | $0.00 – $4,325 | 166,458 | 186 |
| Victorville, CA | $2.03 | $0.00 – $50.65 | 165,627 | 32 |
| Waterbury, CT | $32.30 | $0.00 – $653.37 | 163,721 | 35 |
| Newport News, VA | $17.25 | $0.01 – $1,093 | 159,661 | 42 |
| Roanoke, VA | $21.65 | $0.00 – $2,253 | 159,256 | 48 |
| Birmingham, AL | $8.80 | $0.00 – $982.90 | 152,859 | 170 |
| Las Vegas, NV | $48.58 | $0.00 – $2,235 | 149,078 | 219 |
| Salt Lake City, UT | $144.12 | $0.00 – $1,192 | 148,712 | 41 |
| Paterson, NJ | $4.34 | $0.18 – $127.04 | 147,770 | 24 |
| Toledo, OH | $34.15 | $0.00 – $1,190 | 145,662 | 167 |
| Loma Linda, CA | $34.64 | $0.00 – $1,407 | 143,783 | 26 |
| Fountain Valley, CA | $9.34 | $0.00 – $1,110 | 141,222 | 50 |
| Columbia, SC | $9.18 | $0.00 – $778.47 | 138,835 | 85 |
| Charlotte, NC | $49.73 | $0.00 – $1,368 | 138,341 | 197 |
| Vancouver, WA | $9.42 | $0.00 – $943.62 | 136,279 | 27 |
| Florence, SC | $17.43 | $0.00 – $551.35 | 135,866 | 37 |
| Portland, ME | $50.65 | $0.00 – $1,118 | 133,948 | 23 |
| Springfield, MA | $27.54 | $0.00 – $1,464 | 133,110 | 41 |
| Stockton, CA | $9.14 | $0.00 – $1,761 | 132,614 | 49 |
| Bowling Green, KY | $8.87 | $0.00 – $60.69 | 130,489 | 61 |
| Nashville, TN | $24.15 | $0.00 – $887.57 | 129,877 | 279 |
| Farmington, CT | $31.32 | $0.00 – $805.07 | 129,174 | 39 |
| Kalamazoo, MI | $9.31 | $0.00 – $75.21 | 128,206 | 16 |
| Hattiesburg, MS | $8.66 | $0.00 – $618.66 | 127,343 | 62 |
| Saginaw, MI | $9.05 | $0.00 – $1,130 | 126,437 | 26 |
| Montgomery, AL | $7.77 | $0.00 – $302.65 | 122,486 | 86 |
| Baton Rouge, LA | $17.80 | $0.00 – $1,033 | 121,254 | 339 |
| Scottsdale, AZ | $2.93 | $0.00 – $1,598 | 120,700 | 45 |
| Owensboro, KY | $14.10 | $0.03 – $382.51 | 119,644 | 61 |
| Dearborn, MI | $3.22 | $0.01 – $1,489 | 119,018 | 46 |
| Santa Ana, CA | $40.45 | $0.00 – $3,357 | 118,051 | 32 |
| Raleigh, NC | $96.76 | $0.00 – $973.67 | 117,270 | 115 |
| Fullerton, CA | $12.26 | $0.05 – $2,274 | 114,497 | 15 |
| Saint Louis, MO | $10.33 | $0.00 – $1,624 | 113,900 | 81 |
| Colton, CA | $2.59 | $0.00 – $22.38 | 113,059 | 22 |
| Greensboro, NC | $5.55 | $0.00 – $837.69 | 112,424 | 100 |
| Yakima, WA | $5.45 | $0.00 – $668.48 | 112,175 | 22 |
| Royal Oak, MI | $110.29 | $0.00 – $1,109 | 111,945 | 11 |
| Spartanburg, SC | $2.03 | $0.00 – $141.14 | 111,604 | 31 |
| Portsmouth, VA | $1.06 | $0.01 – $81.28 | 111,161 | 13 |
| Tupelo, MS | $22.06 | $0.00 – $229.88 | 110,321 | 60 |
| Ashland, KY | $6.41 | $0.00 – $623.84 | 110,243 | 42 |
| Wenatchee, WA | $15.48 | $0.00 – $22.04 | 108,367 | 6 |
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.