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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 β€” 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
New Albany, OH $0.68 $0.04 – $5.67 2,427 3
Cades, SC $0.10 $0.10 – $0.10 2,416 1
Alton, IL $9.04 $0.43 – $14.09 2,415 7
New Castle, KY $0.98 $0.98 – $0.98 2,413 1
Bad Axe, MI $0.19 $0.00 – $9.92 2,407 3
Saint Croix Falls, WI $4.20 $4.20 – $4.20 2,406 1
Marina Del Rey, CA $4.05 $0.58 – $7.58 2,406 4
Merrill, WI $0.22 $0.00 – $1.44 2,405 2
Greenwood Village, CO $5.74 $0.00 – $17.79 2,396 8
Granada Hills, CA $350.32 $2.88 – $538.76 2,394 3
Collinsville, AL $0.30 $0.00 – $0.36 2,394 3
Normal, IL $20.82 $0.26 – $44.34 2,383 3
Pelham, AL $3.75 $0.00 – $11.49 2,382 6
Iron City, TN $1.82 $1.82 – $1.82 2,375 1
Cumberland, MD $13.30 $0.03 – $14.32 2,370 5
Fenton, MI $1.06 $0.43 – $6.45 2,370 4
Ardmore, OK $2.27 $0.00 – $11.43 2,369 15
Miami, OK $10.27 $10.27 – $10.27 2,357 1
Hawkinsville, GA $29.81 $0.81 – $70.36 2,356 3
Dadeville, AL $0.17 $0.00 – $0.50 2,356 3
Lincoln, ME $0.64 $0.00 – $2.73 2,355 3
La Porte, IN $22.16 $0.00 – $42.56 2,350 11
Poteau, OK $0.78 $0.24 – $10.50 2,344 3
Pryor, OK $16.31 $0.92 – $28.72 2,342 6
Dartmouth, MA $166.06 $0.00 – $813.87 2,335 10
Huntingdon, TN $2.01 $0.13 – $5.57 2,334 10
Richardson, TX $43.87 $0.00 – $344.45 2,332 8
Sumiton, AL $1.21 $0.93 – $1.22 2,331 2
Glen Cove, NY $4.80 $4.80 – $4.80 2,329 1
Seaford, DE $11.88 $0.12 – $113.77 2,320 5
Andalusia, AL $0.75 $0.13 – $1.14 2,319 7
Millersburg, OH $0.21 $0.00 – $0.21 2,319 2
Bingham Farms, MI $29.32 $0.13 – $1,253 2,318 2
Hudson, OH $21.94 $0.00 – $95.33 2,313 10
Gulf Breeze, FL $499.01 $0.15 – $887.95 2,309 4
Norwood, MA $0.98 $0.20 – $8.20 2,304 4
Morton, PA $0.00 $0.00 – $0.00 2,298 1
Booneville, KY $13.65 $1.69 – $91.01 2,295 7
Hayes, LA $1.11 $1.11 – $1.11 2,292 1
Piedmont, AL $0.55 $0.01 – $1.59 2,283 5
Prairieville, LA $16.73 $0.00 – $55.61 2,283 5
Cross Plains, TN $0.31 $0.31 – $0.31 2,278 1
Lepanto, AR $0.22 $0.21 – $0.33 2,277 2
Parker, AZ $0.29 $0.29 – $0.29 2,276 1
Hobart, IN $2.51 $0.00 – $27.60 2,267 8
Williamstown, NJ $0.00 $0.00 – $0.00 2,267 1
Coral Springs, FL $9.97 $0.00 – $70.94 2,266 10
Grosse Ile, MI $1.14 $1.14 – $1.14 2,266 1
Saint Joseph, MO $1.89 $0.00 – $131.46 2,265 5
Blythe, CA $3.14 $0.00 – $5.67 2,264 4

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 β€”
J0120 Tetracyclin injection β€” β€” β€”
J0133 Acyclovir injection β€” β€” β€”
J0202 Injection, alemtuzumab β€” β€” β€”
J0795 Corticorelin ovine triflutal β€” β€” β€”
J1160 Digoxin injection β€” β€” β€”
J1205 Chlorothiazide sodium inj β€” β€” β€”
J1260 Dolasetron mesylate β€” β€” β€”
J1290 Ecallantide injection β€” β€” β€”
J1300 Eculizumab injection β€” β€” β€”
J1301 Injection, edaravone, 1 mg β€” β€” β€”
J1303 Inj., ravulizumab-cwvz 10 mg β€” β€” β€”
J1305 Inj, evinacumab-dgnb, 5mg β€” β€” β€”
J1320 Amitriptyline injection β€” β€” β€”
J1322 Elosulfase alfa, injection β€” β€” β€”
J1327 Eptifibatide injection β€” β€” β€”

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.