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 |
|---|---|---|---|---|
| Dalton, GA | $1.76 | $0.00 – $4.87 | 2,132 | 19 |
| Allentown, PA | $1.49 | $0.00 – $6.99 | 2,131 | 13 |
| Lake Mary, FL | $4.14 | $0.09 – $5.75 | 2,131 | 5 |
| Kapolei, HI | $228.03 | $221.58 – $246.30 | 2,130 | 2 |
| Payson, UT | $460.55 | $0.00 – $1,674 | 2,130 | 6 |
| Media, PA | $47.54 | $0.00 – $600.49 | 2,122 | 3 |
| Avondale, AZ | $11.89 | $0.00 – $60.77 | 2,122 | 11 |
| Woodbridge, NJ | $16.15 | $0.00 – $16.24 | 2,119 | 2 |
| Naples, FL | $9.49 | $0.00 – $65.30 | 2,116 | 23 |
| Athens, AL | $1.11 | $0.00 – $6.68 | 2,115 | 14 |
| Woodhaven, MI | $0.72 | $0.72 – $0.72 | 2,113 | 1 |
| Kaunakakai, HI | $0.41 | $0.00 – $5.92 | 2,110 | 3 |
| East Hartford, CT | $48.19 | $0.00 – $337.67 | 2,108 | 8 |
| Stillwater, OK | $0.98 | $0.00 – $10.50 | 2,107 | 9 |
| Independence, LA | $3.22 | $0.00 – $24.71 | 2,104 | 6 |
| North Platte, NE | $8.98 | $0.00 – $432.77 | 2,103 | 7 |
| Fair Lawn, NJ | $13.18 | $0.00 – $73.90 | 2,101 | 6 |
| Macon, GA | $2.54 | $0.21 – $24.97 | 2,101 | 12 |
| Vienna, VA | $75.73 | $0.00 – $2,209 | 2,096 | 5 |
| Plymouth, NC | $29.60 | $3.03 – $35.75 | 2,092 | 4 |
| Mer Rouge, LA | $0.26 | $0.00 – $1.52 | 2,091 | 3 |
| Santa Teresa, NM | $7.03 | $1.72 – $38.07 | 2,090 | 6 |
| Englewood, CO | $107.67 | $0.00 – $929.10 | 2,089 | 15 |
| Templeton, CA | $15.07 | $5.89 – $39.93 | 2,085 | 4 |
| Charlotte, MI | $5.91 | $0.00 – $19.98 | 2,084 | 5 |
| Borrego Springs, CA | $0.01 | $0.00 – $0.01 | 2,082 | 2 |
| Richfield, UT | $72.62 | $72.62 – $72.62 | 2,079 | 1 |
| Grand Forks, ND | $26.84 | $0.05 – $412.25 | 2,078 | 9 |
| Montpelier, VA | $0.34 | $0.34 – $0.34 | 2,077 | 1 |
| San Ramon, CA | $15.61 | $1.87 – $195.64 | 2,074 | 5 |
| Marysville, MI | $7.19 | $7.19 – $7.19 | 2,074 | 1 |
| Farmington, WV | $21.28 | $17.67 – $24.36 | 2,074 | 2 |
| Caro, MI | $7.13 | $0.01 – $14.47 | 2,071 | 2 |
| North Conway, NH | $5.83 | $3.99 – $27.17 | 2,067 | 2 |
| Edmond, OK | $233.05 | $0.00 – $2,025 | 2,064 | 12 |
| Salem, KY | $9.11 | $0.52 – $15.25 | 2,058 | 4 |
| Marion, IN | $30.94 | $0.00 – $41.05 | 2,053 | 5 |
| Collierville, TN | $2.90 | $0.00 – $8.75 | 2,052 | 9 |
| Willmar, MN | $35.05 | $1.12 – $35.30 | 2,050 | 2 |
| Baldwin, NY | $1.81 | $1.81 – $1.81 | 2,048 | 1 |
| Roxbury, MA | $29.12 | $0.00 – $88.50 | 2,043 | 3 |
| Wayne, NJ | $83.38 | $6.05 – $939.34 | 2,042 | 6 |
| Youngsville, LA | $1.79 | $0.09 – $12.62 | 2,040 | 5 |
| Auburn, AL | $0.37 | $0.22 – $1.04 | 2,040 | 8 |
| Maryville, TN | $1.24 | $0.00 – $4.69 | 2,037 | 16 |
| Rowlett, TX | $1.27 | $0.99 – $1.28 | 2,025 | 2 |
| Orland Park, IL | $32.83 | $6.50 – $40.02 | 2,023 | 6 |
| White Cloud, MI | $20.06 | $20.06 – $20.06 | 2,020 | 1 |
| Fairlawn, OH | $4.49 | $0.00 – $6.26 | 2,019 | 6 |
| Aurora, IL | $27.56 | $0.70 – $82.34 | 2,016 | 7 |
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.