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 |
|---|---|---|---|---|
| Branford, CT | $1.28 | $0.45 – $2.14 | 11,734 | 3 |
| Oneonta, NY | $28.32 | $1.26 – $61.36 | 11,702 | 4 |
| Easley, SC | $2.41 | $0.00 – $76.14 | 11,690 | 10 |
| Cudahy, CA | $9.10 | $9.10 – $9.10 | 11,658 | 1 |
| Henderson, TN | $0.81 | $0.11 – $2.12 | 11,623 | 13 |
| Phillipsburg, NJ | $3.09 | $0.06 – $3.78 | 11,622 | 3 |
| Kenmore, NY | $0.10 | $0.09 – $5.94 | 11,602 | 2 |
| Amsterdam, NY | $3.96 | $3.21 – $74.82 | 11,591 | 9 |
| Norway, ME | $89.03 | $1.44 – $587.83 | 11,574 | 3 |
| Wytheville, VA | $0.33 | $0.00 – $6.63 | 11,532 | 9 |
| Findlay, OH | $3.96 | $0.00 – $87.20 | 11,522 | 13 |
| Weston, WI | $0.00 | $0.00 – $0.00 | 11,515 | 2 |
| Livermore, CA | $1.05 | $1.05 – $1.05 | 11,497 | 1 |
| Cottonwood, AZ | $4.67 | $0.00 – $311.58 | 11,495 | 8 |
| Attleboro, MA | $10.96 | $6.42 – $57.41 | 11,495 | 4 |
| Howell, MI | $0.02 | $0.00 – $11.89 | 11,471 | 2 |
| Blacksburg, VA | $10.55 | $0.95 – $14.97 | 11,468 | 6 |
| Lakeport, CA | $10.85 | $0.00 – $38.12 | 11,464 | 3 |
| Hagerstown, MD | $282.89 | $0.00 – $1,422 | 11,419 | 25 |
| Hainesport, NJ | $9.36 | $9.36 – $9.36 | 11,414 | 1 |
| Elmira, NY | $0.57 | $0.00 – $38.86 | 11,413 | 5 |
| North Highlands, CA | $0.97 | $0.97 – $0.97 | 11,411 | 1 |
| Pontotoc, MS | $1.12 | $0.00 – $3.56 | 11,369 | 10 |
| Lafayette, TN | $1.71 | $0.07 – $3.48 | 11,360 | 12 |
| Newnan, GA | $1.20 | $0.01 – $92.17 | 11,360 | 5 |
| Laurinburg, NC | $3.13 | $0.81 – $13.51 | 11,342 | 11 |
| Arvin, CA | $0.46 | $0.42 – $6.90 | 11,341 | 2 |
| American Fork, UT | $13.52 | $0.00 – $13.55 | 11,340 | 2 |
| Folsom, CA | $2.02 | $0.00 – $2.69 | 11,296 | 7 |
| Herndon, VA | $0.58 | $0.58 – $0.58 | 11,290 | 1 |
| Brentwood, TN | $2.65 | $0.00 – $10.31 | 11,289 | 24 |
| Huntsville, TN | $1.62 | $0.95 – $3.46 | 11,282 | 7 |
| Ashtabula, OH | $0.58 | $0.00 – $5.75 | 11,273 | 7 |
| Garfield Heights, OH | $2.33 | $0.00 – $31.28 | 11,253 | 5 |
| Rancho Cucamonga, CA | $3.63 | $0.00 – $40.86 | 11,249 | 20 |
| Monroe, MI | $0.69 | $0.00 – $19.40 | 11,236 | 11 |
| Gloucester, VA | $14.24 | $0.31 – $58.27 | 11,234 | 2 |
| La Grange, KY | $3.38 | $1.17 – $3.39 | 11,209 | 3 |
| Brea, CA | $45.38 | $6.85 – $1,531 | 11,127 | 5 |
| Fairfield, CT | $38.82 | $0.50 – $498.13 | 11,114 | 7 |
| Leitchfield, KY | $11.01 | $0.66 – $59.05 | 11,103 | 7 |
| Yonkers, NY | $10.47 | $0.02 – $44.41 | 11,086 | 10 |
| Morgan City, LA | $28.13 | $0.00 – $61.28 | 11,081 | 16 |
| Escanaba, MI | $0.44 | $0.00 – $5.54 | 11,071 | 4 |
| Bossier City, LA | $4.17 | $0.00 – $416.58 | 11,045 | 39 |
| Cedar City, UT | $9.87 | $0.00 – $9.91 | 11,045 | 2 |
| Tyler, TX | $14.43 | $0.00 – $509.02 | 11,022 | 28 |
| Louisville, MS | $0.58 | $0.00 – $51.78 | 11,020 | 5 |
| Manning, SC | $1.24 | $0.14 – $18.43 | 10,967 | 9 |
| Red Bluff, CA | $3.84 | $3.34 – $8.66 | 10,940 | 2 |
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.