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 |
|---|---|---|---|---|
| Cupertino, CA | $27.21 | $27.21 – $27.21 | 10,207 | 1 |
| Lewiston, NY | $7.34 | $7.34 – $7.34 | 10,199 | 1 |
| Grundy, VA | $1.37 | $0.05 – $1.54 | 10,186 | 8 |
| West Jordan, UT | $6.43 | $0.00 – $1,344 | 10,184 | 4 |
| Providence, RI | $167.82 | $0.22 – $1,124 | 10,176 | 40 |
| Portage, MI | $3.46 | $1.07 – $9.47 | 10,174 | 3 |
| Millville, NJ | $3.31 | $3.31 – $3.31 | 10,152 | 1 |
| Galax, VA | $0.50 | $0.41 – $10.10 | 10,137 | 4 |
| Germantown, MD | $1.81 | $0.62 – $8.59 | 10,134 | 4 |
| Waterford, CT | $471.11 | $455.68 – $483.38 | 10,133 | 2 |
| Clovis, NM | $22.14 | $1.42 – $1,061 | 10,128 | 10 |
| El Monte, CA | $4.23 | $0.00 – $34.40 | 10,123 | 6 |
| Lucedale, MS | $0.26 | $0.00 – $1.24 | 10,107 | 10 |
| Ithaca, NY | $1.56 | $0.04 – $69.80 | 10,094 | 8 |
| Summit, WI | $0.09 | $0.00 – $1.23 | 10,088 | 3 |
| Scarborough, ME | $221.87 | $0.02 – $347.83 | 10,037 | 5 |
| Kansas City, KS | $9.99 | $0.00 – $388.80 | 10,030 | 19 |
| Muncie, IN | $301.00 | $0.00 – $1,693 | 10,029 | 33 |
| Kealakekua, HI | $0.02 | $0.02 – $0.11 | 9,974 | 2 |
| Coronado, CA | $3.07 | $0.00 – $6.31 | 9,968 | 4 |
| Westlake, OH | $9.27 | $0.00 – $76.87 | 9,961 | 15 |
| Caribou, ME | $0.71 | $0.00 – $8.75 | 9,960 | 4 |
| Peoria, IL | $76.68 | $0.00 – $1,552 | 9,953 | 39 |
| Oceanside, NY | $0.32 | $0.32 – $0.32 | 9,952 | 1 |
| Hannibal, MO | $0.08 | $0.00 – $3.22 | 9,928 | 4 |
| Grayson, KY | $4.69 | $0.15 – $54.82 | 9,917 | 10 |
| Lancaster, PA | $13.16 | $0.00 – $793.22 | 9,909 | 5 |
| West Branch, MI | $1.73 | $0.04 – $13.00 | 9,907 | 4 |
| Sedro Woolley, WA | $35.41 | $23.19 – $834.62 | 9,892 | 2 |
| Menlo Park, CA | $80.35 | $0.00 – $82.62 | 9,864 | 2 |
| Ruston, LA | $1.85 | $0.00 – $12.59 | 9,836 | 28 |
| Auburn, NY | $1.22 | $0.29 – $27.70 | 9,808 | 7 |
| Red Bank, NJ | $2.04 | $0.00 – $8.22 | 9,806 | 4 |
| Ludington, MI | $45.21 | $0.00 – $875.03 | 9,749 | 6 |
| Winchester, TN | $2.71 | $0.00 – $9.85 | 9,718 | 21 |
| Palo Alto, CA | $24.61 | $0.00 – $951.31 | 9,715 | 12 |
| Nyack, NY | $2.14 | $0.00 – $51.89 | 9,704 | 4 |
| Sault Sainte Marie, MI | $2.15 | $0.00 – $35.99 | 9,702 | 3 |
| Hatch, NM | $8.45 | $8.45 – $8.45 | 9,686 | 1 |
| Lake Geneva, WI | $0.72 | $0.00 – $72.41 | 9,664 | 4 |
| Crescent City, CA | $11.33 | $0.00 – $11.44 | 9,646 | 4 |
| Demopolis, AL | $0.83 | $0.00 – $6.85 | 9,630 | 14 |
| Camillus, NY | $0.18 | $0.18 – $0.18 | 9,621 | 1 |
| Clarkston, WA | $4.46 | $3.03 – $35.93 | 9,613 | 2 |
| Suffern, NY | $270.94 | $0.15 – $588.92 | 9,608 | 2 |
| Waterville, ME | $189.00 | $2.09 – $742.07 | 9,608 | 5 |
| Simi Valley, CA | $31.56 | $5.15 – $2,129 | 9,535 | 5 |
| Hawthorne, CA | $10.85 | $0.00 – $12.07 | 9,526 | 7 |
| Lexington, TN | $1.38 | $0.00 – $5.71 | 9,524 | 22 |
| Ketchikan, AK | $33.56 | $33.56 – $33.56 | 9,519 | 1 |
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.