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 |
|---|---|---|---|---|
| Sahuarita, AZ | $0.02 | $0.02 – $0.02 | 6,832 | 1 |
| Saint Cloud, MN | $193.65 | $3.04 – $426.46 | 6,829 | 7 |
| Calhoun, LA | $0.15 | $0.00 – $0.76 | 6,814 | 3 |
| Rainsville, AL | $3.04 | $0.73 – $5.60 | 6,790 | 15 |
| Annandale, VA | $1.86 | $0.03 – $17.66 | 6,780 | 3 |
| Warrendale, PA | $734.09 | $734.09 – $734.09 | 6,774 | 1 |
| Antigo, WI | $0.13 | $0.13 – $0.13 | 6,757 | 1 |
| Pineville, KY | $3.29 | $0.08 – $7.31 | 6,743 | 10 |
| Myrtle Beach, SC | $8.48 | $0.00 – $292.93 | 6,733 | 18 |
| Hyannis, MA | $33.84 | $0.15 – $444.68 | 6,716 | 11 |
| Grand Junction, CO | $254.65 | $0.00 – $545.32 | 6,708 | 18 |
| Circleville, OH | $1.98 | $0.00 – $101.37 | 6,686 | 9 |
| Reed City, MI | $0.01 | $0.01 – $0.36 | 6,685 | 2 |
| Weslaco, TX | $2.50 | $0.00 – $69.12 | 6,680 | 21 |
| Framingham, MA | $1.45 | $0.00 – $3.51 | 6,678 | 4 |
| Harvey, IL | $377.78 | $0.05 – $1,117 | 6,662 | 8 |
| Elkhorn, WI | $0.16 | $0.00 – $85.50 | 6,649 | 2 |
| Brandon, FL | $28.46 | $0.00 – $274.95 | 6,642 | 22 |
| Bedford, VA | $0.06 | $0.06 – $0.06 | 6,635 | 1 |
| Chelsea, MI | $0.00 | $0.00 – $0.00 | 6,625 | 1 |
| York, PA | $0.01 | $0.00 – $6.11 | 6,619 | 5 |
| Amherst, NY | $80.49 | $0.17 – $1,034 | 6,581 | 25 |
| Tawas City, MI | $0.14 | $0.00 – $12.18 | 6,579 | 3 |
| Lenoir, NC | $11.91 | $1.09 – $30.00 | 6,574 | 12 |
| Jackson, AL | $3.56 | $2.55 – $57.85 | 6,562 | 3 |
| Crestview Hills, KY | $173.05 | $0.00 – $489.19 | 6,556 | 10 |
| Shelbyville, KY | $5.62 | $0.41 – $6.51 | 6,553 | 6 |
| Anacortes, WA | $0.66 | $0.66 – $1.60 | 6,523 | 2 |
| Campton, KY | $12.81 | $0.67 – $32.62 | 6,513 | 11 |
| Glen Dale, WV | $9.95 | $0.00 – $16.13 | 6,505 | 5 |
| Rahway, NJ | $1.08 | $0.10 – $1.63 | 6,497 | 2 |
| West Des Moines, IA | $353.44 | $0.24 – $709.94 | 6,495 | 24 |
| Norwalk, OH | $1.95 | $0.02 – $61.56 | 6,491 | 6 |
| Cambridge, MD | $2.28 | $1.41 – $14.10 | 6,489 | 3 |
| San Angelo, TX | $39.24 | $0.00 – $752.62 | 6,487 | 16 |
| Middletown, DE | $0.56 | $0.56 – $0.56 | 6,482 | 1 |
| Surprise, AZ | $4.04 | $0.00 – $71.81 | 6,479 | 11 |
| Irvington, NJ | $15.21 | $0.00 – $29.85 | 6,470 | 3 |
| Batavia, NY | $9.46 | $5.15 – $9.47 | 6,467 | 2 |
| Garden City, NY | $427.95 | $0.17 – $884.54 | 6,465 | 8 |
| Coeur D Alene, ID | $3.57 | $0.10 – $379.33 | 6,458 | 7 |
| Williamstown, KY | $6.12 | $5.46 – $11.36 | 6,451 | 5 |
| Lebanon, KY | $3.16 | $0.64 – $14.08 | 6,441 | 8 |
| Ontario, OH | $5.09 | $0.05 – $6.08 | 6,432 | 3 |
| Oswego, NY | $1.77 | $0.05 – $25.12 | 6,419 | 2 |
| Lake Wales, FL | $4.56 | $0.28 – $4.78 | 6,412 | 2 |
| Harrogate, TN | $1.63 | $0.09 – $3.53 | 6,412 | 8 |
| Hazlehurst, MS | $0.93 | $0.00 – $3.83 | 6,410 | 7 |
| East Wenatchee, WA | $0.38 | $0.38 – $0.38 | 6,385 | 1 |
| Haleyville, AL | $4.78 | $0.02 – $11.55 | 6,380 | 13 |
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.