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 |
|---|---|---|---|---|
| Plainfield, NJ | $31.77 | $1.09 – $112.67 | 8,673 | 4 |
| Sun City, CA | $2.26 | $2.10 – $2.26 | 8,662 | 2 |
| Russellville, AL | $2.13 | $0.00 – $3.25 | 8,662 | 19 |
| Tujunga, CA | $2.99 | $0.90 – $3.03 | 8,660 | 3 |
| Monroe, WA | $3.00 | $1.19 – $44.02 | 8,646 | 2 |
| Eupora, MS | $3.14 | $0.00 – $58.50 | 8,637 | 13 |
| Glen Allen, VA | $1.21 | $0.41 – $1.46 | 8,605 | 4 |
| Rockport, ME | $0.03 | $0.03 – $0.03 | 8,599 | 1 |
| Columbia, MD | $34.66 | $0.00 – $77.30 | 8,598 | 13 |
| Newberry, SC | $17.20 | $0.29 – $86.72 | 8,585 | 3 |
| Greenville, AL | $0.42 | $0.00 – $3.66 | 8,564 | 9 |
| Santa Cruz, CA | $15.45 | $0.00 – $838.24 | 8,537 | 12 |
| O Fallon, IL | $36.94 | $0.70 – $545.51 | 8,532 | 5 |
| Buckeye, AZ | $0.01 | $0.00 – $5.65 | 8,531 | 2 |
| Barstow, CA | $2.36 | $2.19 – $8.14 | 8,521 | 3 |
| Temple, TX | $49.79 | $0.00 – $398.00 | 8,519 | 28 |
| Sonora, CA | $11.90 | $0.00 – $41.37 | 8,519 | 5 |
| Dickson, TN | $8.07 | $0.00 – $29.21 | 8,513 | 24 |
| Smithville, TN | $1.02 | $0.29 – $1.43 | 8,499 | 7 |
| Jacksonville, FL | $82.36 | $0.00 – $922.08 | 8,493 | 73 |
| Taylorsville, UT | $0.11 | $0.00 – $0.24 | 8,453 | 4 |
| Tappahannock, VA | $0.86 | $0.31 – $6.91 | 8,434 | 3 |
| Mount Vernon, OH | $5.82 | $0.00 – $85.04 | 8,420 | 15 |
| Roswell, GA | $3.51 | $0.46 – $81.05 | 8,414 | 5 |
| Bolivar, TN | $0.80 | $0.00 – $2.10 | 8,404 | 8 |
| West Hartford, CT | $572.21 | $4.28 – $751.74 | 8,385 | 10 |
| Bayonne, NJ | $17.46 | $0.00 – $545.87 | 8,366 | 10 |
| Marshall, MI | $11.88 | $0.00 – $60.77 | 8,350 | 5 |
| Holly Springs, MS | $0.44 | $0.00 – $0.99 | 8,323 | 9 |
| Egg Harbor Township, NJ | $4.84 | $0.05 – $274.46 | 8,294 | 3 |
| Artesia, NM | $7.43 | $0.92 – $22.18 | 8,293 | 5 |
| Watervliet, MI | $2.21 | $0.00 – $11.94 | 8,286 | 3 |
| Richmond, IN | $143.81 | $0.00 – $616.17 | 8,249 | 23 |
| Oakdale, CA | $8.66 | $5.59 – $8.67 | 8,239 | 2 |
| Athens, TN | $2.81 | $0.00 – $83.11 | 8,237 | 20 |
| Enumclaw, WA | $33.50 | $0.00 – $34.12 | 8,226 | 3 |
| Zillah, WA | $0.67 | $0.67 – $0.67 | 8,226 | 1 |
| Medford, MA | $4.71 | $0.00 – $5.54 | 8,201 | 3 |
| Burlington, WI | $0.04 | $0.00 – $9.05 | 8,198 | 3 |
| Manitowoc, WI | $1.46 | $0.05 – $19.50 | 8,189 | 6 |
| Bluefield, VA | $1.51 | $0.39 – $29.00 | 8,189 | 5 |
| Batavia, OH | $3.45 | $0.00 – $95.54 | 8,185 | 9 |
| Brookline, MA | $5.68 | $0.10 – $470.36 | 8,180 | 2 |
| Polacca, AZ | $0.00 | $0.00 – $0.00 | 8,176 | 1 |
| Exeter, NH | $5.08 | $5.08 – $5.08 | 8,175 | 1 |
| Dorchester Center, MA | $14.52 | $0.90 – $54.37 | 8,173 | 2 |
| Clearlake, CA | $29.88 | $11.57 – $442.49 | 8,133 | 3 |
| Jacksboro, TN | $0.35 | $0.06 – $1.41 | 8,128 | 14 |
| Sunnyvale, CA | $17.76 | $12.01 – $108.71 | 8,124 | 3 |
| Sayre, PA | $0.41 | $0.00 – $19.73 | 8,122 | 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.