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 |
|---|---|---|---|---|
| Ironton, OH | $2.35 | $0.03 – $9.65 | 5,458 | 20 |
| Dover, DE | $358.66 | $0.00 – $1,673 | 5,452 | 17 |
| Forsyth, GA | $2.52 | $0.21 – $3.03 | 5,426 | 6 |
| Demorest, GA | $0.85 | $0.00 – $0.87 | 5,425 | 4 |
| Camden, TN | $2.22 | $1.54 – $6.99 | 5,408 | 11 |
| Lafayette, IN | $86.99 | $0.00 – $351.31 | 5,399 | 27 |
| Homer, LA | $3.02 | $0.00 – $40.21 | 5,397 | 11 |
| Pleasanton, CA | $16.34 | $0.00 – $313.74 | 5,393 | 5 |
| Centre, AL | $0.80 | $0.02 – $11.19 | 5,389 | 12 |
| Manati, PR | $0.35 | $0.00 – $27.06 | 5,381 | 4 |
| Mc Kenzie, TN | $1.85 | $0.36 – $4.28 | 5,377 | 15 |
| Redford, MI | $0.42 | $0.33 – $0.75 | 5,366 | 2 |
| Somerville, TN | $4.87 | $4.30 – $5.36 | 5,342 | 3 |
| Lebanon, TN | $3.82 | $0.00 – $36.97 | 5,340 | 22 |
| Loveland, CO | $517.46 | $0.00 – $994.57 | 5,327 | 10 |
| Rhinebeck, NY | $3.23 | $3.23 – $3.23 | 5,325 | 1 |
| Freehold, NJ | $2.86 | $0.00 – $2.91 | 5,324 | 5 |
| Old Bridge, NJ | $18.46 | $2.69 – $48.51 | 5,324 | 2 |
| Frankfort, KY | $29.48 | $0.00 – $74.99 | 5,312 | 13 |
| Fort Payne, AL | $1.23 | $0.00 – $24.14 | 5,289 | 22 |
| Raeford, NC | $38.41 | $0.00 – $40.42 | 5,265 | 3 |
| Santee, SC | $0.26 | $0.26 – $0.26 | 5,240 | 1 |
| Carlsbad, CA | $702.28 | $3.62 – $819.44 | 5,236 | 9 |
| Hawthorne, NY | $981.41 | $0.21 – $1,053 | 5,228 | 4 |
| Fort Gratiot, MI | $0.92 | $0.14 – $0.94 | 5,228 | 2 |
| Bartlett, TN | $51.73 | $0.00 – $1,150 | 5,199 | 18 |
| Fitchburg, WI | $4.30 | $0.00 – $4.68 | 5,186 | 3 |
| Humboldt, TN | $1.27 | $0.23 – $2.81 | 5,179 | 7 |
| Russellville, KY | $14.72 | $0.21 – $54.22 | 5,178 | 8 |
| Delran, NJ | $24.63 | $5.58 – $74.48 | 5,173 | 2 |
| Annapolis, MD | $75.37 | $0.00 – $1,771 | 5,154 | 8 |
| Morgantown, KY | $29.04 | $0.20 – $36.38 | 5,144 | 7 |
| Middletown, OH | $18.99 | $0.00 – $73.84 | 5,122 | 17 |
| Searcy, AR | $8.69 | $0.00 – $41.55 | 5,113 | 14 |
| Tylertown, MS | $0.25 | $0.00 – $0.25 | 5,106 | 3 |
| Dinuba, CA | $6.96 | $0.00 – $11.78 | 5,091 | 3 |
| South Shore, KY | $2.82 | $0.00 – $6.08 | 5,080 | 8 |
| Newburgh, IN | $38.60 | $0.00 – $337.60 | 5,043 | 22 |
| Mount Vernon, IL | $168.12 | $0.98 – $421.77 | 5,042 | 13 |
| Grand Haven, MI | $0.00 | $0.00 – $0.01 | 5,040 | 2 |
| Wapato, WA | $0.81 | $0.81 – $0.81 | 5,038 | 1 |
| Newton, NJ | $5.32 | $2.81 – $194.56 | 5,038 | 3 |
| Santa Fe Springs, CA | $5.99 | $0.40 – $6.02 | 5,021 | 2 |
| Haymarket, VA | $0.27 | $0.27 – $0.27 | 5,017 | 1 |
| White Hall, AR | $2.24 | $0.00 – $3.13 | 5,015 | 4 |
| Melbourne, FL | $5.77 | $0.00 – $34.51 | 4,991 | 13 |
| Livingston, AL | $0.08 | $0.00 – $0.08 | 4,989 | 2 |
| Decatur, IL | $21.44 | $0.59 – $798.63 | 4,979 | 13 |
| Rumford, ME | $2.64 | $0.83 – $62.48 | 4,937 | 2 |
| Vincennes, IN | $0.16 | $0.00 – $5.39 | 4,923 | 17 |
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.