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 |
|---|---|---|---|---|
| Meadville, PA | $0.00 | $0.00 – $0.00 | 4,123 | 1 |
| Fillmore, CA | $1.43 | $1.43 – $1.43 | 4,123 | 1 |
| Gardner, MA | $9.60 | $3.21 – $9.70 | 4,122 | 2 |
| Hollis, OK | $0.97 | $0.72 – $1.33 | 4,112 | 4 |
| Salem, NJ | $2.64 | $0.08 – $39.57 | 4,112 | 4 |
| Deridder, LA | $0.43 | $0.00 – $6.63 | 4,106 | 14 |
| Low Moor, VA | $0.39 | $0.39 – $0.39 | 4,101 | 1 |
| Champaign, IL | $20.88 | $0.07 – $63.86 | 4,101 | 10 |
| Arecibo, PR | $0.44 | $0.00 – $0.70 | 4,095 | 4 |
| Sanger, CA | $0.02 | $0.00 – $0.02 | 4,090 | 2 |
| North Easton, MA | $4.99 | $0.11 – $11.89 | 4,081 | 9 |
| Linden, TN | $1.20 | $0.21 – $6.01 | 4,081 | 12 |
| Tiffin, OH | $3.02 | $0.00 – $93.77 | 4,073 | 5 |
| Dover, OH | $17.74 | $0.00 – $89.04 | 4,053 | 7 |
| Wiinnsboro, LA | $0.00 | $0.00 – $0.00 | 4,053 | 1 |
| Oberlin, OH | $0.06 | $0.04 – $0.13 | 4,052 | 3 |
| Sidney, OH | $5.44 | $0.06 – $87.00 | 4,035 | 3 |
| Mountlake Terrace, WA | $155.27 | $38.56 – $594.44 | 4,034 | 2 |
| Elko, NV | $0.15 | $0.00 – $1.70 | 4,033 | 7 |
| Vista, CA | $46.22 | $0.00 – $167.04 | 4,032 | 7 |
| Oconomowoc, WI | $0.14 | $0.00 – $9.82 | 4,029 | 2 |
| Waldorf, MD | $5.03 | $0.15 – $69.49 | 4,024 | 6 |
| Milton, MA | $2.80 | $2.80 – $2.80 | 4,015 | 1 |
| Grants, NM | $11.65 | $9.16 – $63.42 | 4,015 | 3 |
| Thomasville, NC | $4.57 | $0.00 – $52.47 | 4,011 | 7 |
| Glen Burnie, MD | $7.05 | $0.00 – $39.68 | 3,996 | 13 |
| Robbins, TN | $1.32 | $0.96 – $2.23 | 3,989 | 2 |
| Bradford, PA | $0.00 | $0.00 – $0.00 | 3,986 | 1 |
| Commerce, CA | $1,038 | $8.76 – $1,076 | 3,983 | 2 |
| Centralia, IL | $0.62 | $0.61 – $1.74 | 3,980 | 2 |
| Hammond, IN | $28.42 | $0.04 – $42.57 | 3,978 | 7 |
| Bloomington, IL | $163.21 | $0.44 – $849.30 | 3,977 | 7 |
| Lynn, MA | $20.83 | $20.83 – $20.83 | 3,977 | 1 |
| Sicily Island, LA | $0.00 | $0.00 – $0.00 | 3,961 | 4 |
| Lauderdale Lakes, FL | $1.49 | $0.00 – $2.42 | 3,956 | 4 |
| Rolling Fork, MS | $0.55 | $0.00 – $0.79 | 3,951 | 5 |
| Sarasota, FL | $124.75 | $0.00 – $548.03 | 3,950 | 10 |
| Tukwila, WA | $24.41 | $22.69 – $26.84 | 3,942 | 2 |
| Tallassee, AL | $1.69 | $0.07 – $5.97 | 3,939 | 8 |
| St Charles, IL | $13.22 | $12.96 – $28.81 | 3,938 | 2 |
| Lineville, AL | $0.86 | $0.82 – $3.71 | 3,923 | 2 |
| Cut Off, LA | $0.35 | $0.00 – $2.89 | 3,899 | 11 |
| Libby, MT | $0.25 | $0.00 – $0.25 | 3,885 | 2 |
| Tazewell, VA | $0.57 | $0.45 – $4.60 | 3,879 | 3 |
| Northglenn, CO | $9.69 | $0.18 – $17.78 | 3,875 | 3 |
| Fortuna, CA | $16.84 | $7.27 – $58.93 | 3,875 | 2 |
| Dyer, IN | $21.83 | $0.00 – $22.83 | 3,859 | 4 |
| Sacaton, AZ | $12.76 | $12.76 – $12.76 | 3,857 | 1 |
| Kamuela, HI | $0.01 | $0.01 – $0.01 | 3,851 | 1 |
| Wahiawa, HI | $108.24 | $0.04 – $399.58 | 3,844 | 2 |
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.