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 |
|---|---|---|---|---|
| Clinton, MD | $9.08 | $0.00 – $41.89 | 9,502 | 12 |
| Sheffield Village, OH | $17.11 | $0.00 – $91.02 | 9,501 | 14 |
| Bowling Green, OH | $1.87 | $0.37 – $17.73 | 9,487 | 7 |
| Mangham, LA | $0.06 | $0.00 – $0.35 | 9,456 | 6 |
| Mount Rainier, MD | $0.04 | $0.04 – $0.04 | 9,422 | 1 |
| Gardena, CA | $3.73 | $0.01 – $4.46 | 9,414 | 4 |
| Whitefish, MT | $0.59 | $0.59 – $0.59 | 9,412 | 1 |
| Paw Paw, MI | $3.10 | $0.01 – $40.14 | 9,407 | 2 |
| Iron Mountain, MI | $0.01 | $0.01 – $0.01 | 9,355 | 1 |
| Simpsonville, SC | $10.90 | $0.23 – $563.37 | 9,350 | 7 |
| Williamsville, NY | $6.83 | $0.00 – $1,133 | 9,329 | 17 |
| Thibodaux, LA | $3.65 | $0.00 – $61.06 | 9,325 | 34 |
| Upper Marlboro, MD | $1.12 | $0.31 – $6.01 | 9,323 | 3 |
| West Bend, WI | $2.12 | $0.02 – $18.34 | 9,282 | 3 |
| Miamisburg, OH | $0.36 | $0.00 – $3.33 | 9,268 | 7 |
| Santa Barbara, CA | $1,048 | $0.46 – $1,816 | 9,266 | 22 |
| Norton, VA | $8.81 | $0.00 – $82.27 | 9,256 | 10 |
| Mount Pleasant, TX | $12.42 | $0.00 – $689.66 | 9,223 | 13 |
| Valdosta, GA | $2.91 | $0.04 – $275.44 | 9,211 | 8 |
| Thousand Oaks, CA | $189.90 | $0.86 – $2,859 | 9,171 | 7 |
| Placerville, CA | $8.77 | $2.35 – $63.05 | 9,155 | 5 |
| Cambridge, OH | $28.50 | $0.00 – $90.87 | 9,149 | 12 |
| Portsmouth, NH | $58.45 | $1.37 – $1,022 | 9,134 | 6 |
| Olean, NY | $0.34 | $0.18 – $28.78 | 9,125 | 4 |
| Fresh Meadows, NY | $122.81 | $0.40 – $197.21 | 9,111 | 9 |
| Bronxville, NY | $144.94 | $0.46 – $868.85 | 9,102 | 4 |
| Taos, NM | $5.68 | $0.21 – $13.94 | 9,099 | 5 |
| Magee, MS | $0.49 | $0.00 – $1.46 | 9,041 | 10 |
| Springfield, IL | $245.09 | $0.00 – $1,483 | 9,031 | 38 |
| Franklin, TN | $123.40 | $0.00 – $972.76 | 9,021 | 20 |
| Pulaski, VA | $0.35 | $0.29 – $8.30 | 9,017 | 2 |
| Baraboo, WI | $0.05 | $0.00 – $6.92 | 9,015 | 2 |
| Roosevelt, UT | $60.67 | $0.63 – $106.31 | 9,009 | 3 |
| Bellefontaine, OH | $2.45 | $0.00 – $90.96 | 8,985 | 9 |
| Guntown, MS | $0.42 | $0.02 – $1.43 | 8,969 | 5 |
| Cuyahoga Falls, OH | $265.30 | $0.00 – $1,347 | 8,961 | 14 |
| Clio, MI | $10.70 | $0.87 – $63.96 | 8,937 | 3 |
| Warrensville Heights, OH | $13.62 | $0.04 – $81.02 | 8,898 | 5 |
| Amarillo, TX | $124.84 | $0.00 – $1,891 | 8,897 | 33 |
| Gonzales, LA | $33.25 | $0.00 – $47.68 | 8,831 | 18 |
| West Hollywood, CA | $1,311 | $0.00 – $2,735 | 8,829 | 14 |
| Rocky Mount, VA | $0.05 | $0.05 – $0.05 | 8,818 | 1 |
| Gainesville, FL | $22.12 | $0.00 – $744.75 | 8,801 | 57 |
| Baldwyn, MS | $0.06 | $0.00 – $1.92 | 8,738 | 5 |
| Delta, LA | $0.80 | $0.80 – $0.80 | 8,733 | 1 |
| Radford, VA | $0.34 | $0.16 – $4.25 | 8,713 | 2 |
| Havre, MT | $0.26 | $0.00 – $0.26 | 8,711 | 3 |
| Oneida, TN | $2.09 | $0.00 – $4.54 | 8,703 | 18 |
| Tallulah, LA | $0.02 | $0.00 – $1.30 | 8,693 | 8 |
| Gaylord, MI | $9.56 | $0.00 – $55.93 | 8,687 | 4 |
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.