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 |
|---|---|---|---|---|
| Damariscotta, ME | $0.70 | $0.70 – $0.70 | 3,834 | 1 |
| Roseville, MI | $1.36 | $0.13 – $8.96 | 3,831 | 4 |
| Butler, AL | $0.09 | $0.00 – $0.23 | 3,826 | 3 |
| Brownwood, TX | $13.84 | $0.19 – $70.43 | 3,798 | 9 |
| Pembroke, NC | $0.81 | $0.13 – $4.55 | 3,793 | 9 |
| Saranac Lake, NY | $0.50 | $0.50 – $0.50 | 3,789 | 1 |
| Sanford, FL | $12.23 | $0.00 – $37.87 | 3,785 | 3 |
| Marksville, LA | $2.49 | $0.00 – $13.54 | 3,777 | 16 |
| Morgan Hill, CA | $32.06 | $32.06 – $32.06 | 3,775 | 1 |
| Easton, PA | $3.44 | $0.00 – $39.64 | 3,771 | 4 |
| Redwood City, CA | $8.05 | $3.79 – $9.30 | 3,769 | 4 |
| Trenton, TN | $1.22 | $0.78 – $1.72 | 3,766 | 6 |
| Newton, MA | $1.66 | $1.66 – $1.66 | 3,756 | 1 |
| Caguas, PR | $10.54 | $0.00 – $63.09 | 3,755 | 4 |
| West Bridgewater, MA | $7.04 | $7.04 – $7.04 | 3,754 | 1 |
| Blackfoot, ID | $6.31 | $0.80 – $6.39 | 3,753 | 3 |
| Vivian, LA | $1.56 | $0.00 – $108.10 | 3,747 | 7 |
| Georgiana, AL | $0.12 | $0.00 – $0.43 | 3,737 | 6 |
| Midland, TX | $11.55 | $0.00 – $57.76 | 3,731 | 11 |
| Cushing, OK | $2.83 | $0.57 – $4.33 | 3,728 | 8 |
| Clinton Township, MI | $3.33 | $0.00 – $14.91 | 3,727 | 13 |
| Abilene, TX | $14.86 | $0.00 – $70.54 | 3,724 | 13 |
| Greensboro, AL | $0.29 | $0.00 – $1.47 | 3,709 | 4 |
| Westmoreland, TN | $5.79 | $1.29 – $38.48 | 3,706 | 5 |
| Carson, CA | $24.16 | $24.16 – $24.16 | 3,704 | 1 |
| Gaithersburg, MD | $28.04 | $2.03 – $33.08 | 3,702 | 3 |
| Smyrna, TN | $7.59 | $0.00 – $66.28 | 3,694 | 23 |
| Grove, OK | $2.41 | $0.00 – $8.92 | 3,691 | 4 |
| Hermitage, TN | $4.37 | $0.11 – $9.91 | 3,690 | 16 |
| Westfield, MA | $0.96 | $0.96 – $0.96 | 3,690 | 1 |
| Kingwood, TX | $10.06 | $1.59 – $21.67 | 3,687 | 10 |
| St Louis Park, MN | $86.09 | $0.00 – $1,951 | 3,686 | 16 |
| Pembroke Pines, FL | $6.41 | $0.00 – $110.56 | 3,685 | 13 |
| Tooele, UT | $1.56 | $0.00 – $1.77 | 3,685 | 3 |
| Hardeeville, SC | $0.04 | $0.00 – $0.79 | 3,677 | 3 |
| Maricopa, AZ | $37.46 | $0.01 – $73.88 | 3,670 | 3 |
| Harris, NY | $0.42 | $0.40 – $2.35 | 3,661 | 2 |
| Oak Park, MI | $0.81 | $0.20 – $8.79 | 3,649 | 4 |
| Lake Forest Park, WA | $13.41 | $13.41 – $13.41 | 3,633 | 1 |
| Deming, NM | $20.06 | $0.55 – $596.31 | 3,632 | 11 |
| Calhoun City, MS | $0.15 | $0.00 – $0.20 | 3,624 | 5 |
| Mount Airy, NC | $0.84 | $0.11 – $12.12 | 3,611 | 10 |
| Kewanee, IL | $33.02 | $33.02 – $33.02 | 3,604 | 1 |
| Leonardtown, MD | $0.28 | $0.00 – $0.29 | 3,601 | 3 |
| Nome, AK | $55.12 | $55.12 – $55.12 | 3,600 | 1 |
| Adrian, MI | $4.38 | $0.00 – $27.43 | 3,597 | 4 |
| Farmington, MO | $0.43 | $0.43 – $0.43 | 3,596 | 1 |
| Clarkston, MI | $1.12 | $0.05 – $6.10 | 3,590 | 4 |
| Mt Pleasant, SC | $0.02 | $0.00 – $1.14 | 3,589 | 3 |
| Webster, TX | $5.16 | $1.08 – $11.49 | 3,587 | 6 |
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.