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 |
|---|---|---|---|---|
| Perrysburg, OH | $2.35 | $0.00 – $10.76 | 2,262 | 6 |
| East Ridge, TN | $0.39 | $0.00 – $0.66 | 2,261 | 3 |
| Northampton, MA | $4.50 | $2.20 – $76.35 | 2,260 | 5 |
| Fort Dodge, IA | $16.69 | $0.00 – $61.95 | 2,257 | 16 |
| Babylon, NY | $1.53 | $0.98 – $5.40 | 2,256 | 6 |
| Sioux City, IA | $1.29 | $0.00 – $82.50 | 2,253 | 15 |
| Carmel, NY | $0.45 | $0.08 – $14.06 | 2,252 | 2 |
| Moore, OK | $2.57 | $0.00 – $11.73 | 2,249 | 12 |
| Cherryville, NC | $0.10 | $0.06 – $0.56 | 2,248 | 5 |
| New Rochelle, NY | $0.91 | $0.91 – $0.91 | 2,246 | 1 |
| Hilliard, OH | $47.82 | $0.00 – $78.76 | 2,245 | 10 |
| Swartz Creek, MI | $3.22 | $3.21 – $4.19 | 2,241 | 2 |
| Conway, AR | $10.53 | $0.04 – $579.65 | 2,233 | 10 |
| Mc Ewen, TN | $2.33 | $2.33 – $2.33 | 2,232 | 1 |
| Hardin, MT | $0.24 | $0.24 – $0.24 | 2,232 | 1 |
| Ellicott City, MD | $12.48 | $0.00 – $19.70 | 2,230 | 4 |
| Oregon City, OR | $5.62 | $0.00 – $74.12 | 2,229 | 9 |
| Clanton, AL | $1.12 | $0.25 – $11.54 | 2,228 | 7 |
| Crowley, TX | $1.11 | $1.11 – $1.11 | 2,228 | 1 |
| Gatlinburg, TN | $0.20 | $0.07 – $1.15 | 2,225 | 2 |
| Cass City, MI | $0.81 | $0.75 – $2.83 | 2,223 | 2 |
| Festus, MO | $1.00 | $0.35 – $5.14 | 2,221 | 3 |
| Hixson, TN | $0.79 | $0.00 – $8.53 | 2,219 | 12 |
| Garland, TX | $123.46 | $0.06 – $387.58 | 2,218 | 8 |
| Fircrest, WA | $0.29 | $0.29 – $0.29 | 2,216 | 1 |
| Covington, TN | $1.39 | $0.45 – $2.30 | 2,213 | 9 |
| Bovina, TX | $1.30 | $1.30 – $1.30 | 2,212 | 1 |
| Elmhurst, IL | $1,267 | $0.00 – $1,890 | 2,207 | 8 |
| Wallingford, CT | $119.13 | $0.00 – $477.03 | 2,207 | 8 |
| Kaysville, UT | $9.11 | $0.18 – $52.57 | 2,205 | 4 |
| Danville, IL | $7.20 | $0.89 – $29.78 | 2,205 | 7 |
| Seaman, OH | $0.16 | $0.07 – $5.48 | 2,197 | 2 |
| Addison, IL | $3.97 | $2.95 – $8.07 | 2,194 | 5 |
| Hamilton Township, NJ | $0.00 | $0.00 – $0.00 | 2,180 | 1 |
| Beaumont, CA | $2.96 | $0.00 – $11.85 | 2,179 | 3 |
| Ooltewah, TN | $2.89 | $0.00 – $3.13 | 2,171 | 4 |
| Ozone Park, NY | $6.16 | $6.16 – $6.16 | 2,171 | 1 |
| Tuscumbia, AL | $1.85 | $0.86 – $2.52 | 2,171 | 6 |
| Council Bluffs, IA | $5.91 | $0.00 – $71.75 | 2,169 | 16 |
| Wasilla, AK | $5.15 | $1.10 – $9.68 | 2,160 | 5 |
| Mount Vernon, KY | $2.63 | $0.69 – $2.78 | 2,158 | 3 |
| Platteville, WI | $8.33 | $0.01 – $29.28 | 2,149 | 2 |
| Plainsboro, NJ | $0.32 | $0.32 – $0.32 | 2,149 | 1 |
| Berlin, MD | $2.20 | $0.09 – $9.77 | 2,147 | 2 |
| Nacogdoches, TX | $14.16 | $0.17 – $83.59 | 2,147 | 11 |
| Elkmont, AL | $1.04 | $0.55 – $1.11 | 2,143 | 3 |
| Carbondale, IL | $1.03 | $0.00 – $5.15 | 2,140 | 7 |
| Louisburg, NC | $10.03 | $7.97 – $10.12 | 2,138 | 2 |
| Olney, MD | $42.18 | $5.21 – $82.53 | 2,135 | 3 |
| Texarkana, TX | $29.97 | $0.68 – $76.77 | 2,134 | 10 |
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.