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 |
|---|---|---|---|---|
| Chalmette, LA | $4.85 | $0.00 – $30.74 | 1,901 | 11 |
| Cassopolis, MI | $73.19 | $73.19 – $73.19 | 1,901 | 1 |
| Niles, IL | $1,038 | $1,018 – $1,076 | 1,900 | 2 |
| Waynesville, MO | $0.05 | $0.05 – $0.05 | 1,900 | 1 |
| Guntersville, AL | $4.52 | $0.00 – $66.42 | 1,897 | 10 |
| Aurora, IN | $2.49 | $0.71 – $3.47 | 1,894 | 2 |
| Standish, MI | $0.00 | $0.00 – $0.00 | 1,894 | 1 |
| Elizabethtown, NC | $30.73 | $0.62 – $39.98 | 1,891 | 4 |
| Canandaigua, NY | $15.53 | $0.52 – $374.01 | 1,886 | 5 |
| Ionia, MI | $3.48 | $0.00 – $39.94 | 1,886 | 4 |
| Clay City, KY | $10.44 | $1.04 – $21.30 | 1,886 | 4 |
| Springhill, LA | $1.02 | $0.00 – $57.29 | 1,885 | 8 |
| Plano, TX | $77.41 | $0.30 – $1,400 | 1,884 | 12 |
| Puryear, TN | $2.01 | $2.01 – $2.01 | 1,883 | 1 |
| Marysville, WA | $2.70 | $0.03 – $37.69 | 1,881 | 3 |
| Denham Springs, LA | $168.99 | $0.00 – $1,102 | 1,877 | 12 |
| Greenwood, IN | $114.47 | $0.00 – $621.55 | 1,873 | 12 |
| Beaver, UT | $1.24 | $1.24 – $1.24 | 1,872 | 1 |
| Hillside, IL | $1.53 | $1.53 – $1.53 | 1,872 | 1 |
| Ripley, WV | $10.35 | $0.33 – $20.03 | 1,868 | 3 |
| Naugatuck, CT | $0.10 | $0.09 – $0.10 | 1,867 | 2 |
| Minocqua, WI | $0.00 | $0.00 – $0.00 | 1,865 | 1 |
| Atwater, CA | $5.15 | $2.28 – $6.36 | 1,863 | 3 |
| Yankton, SD | $82.04 | $20.58 – $305.98 | 1,862 | 3 |
| Westfield, IN | $705.38 | $5.11 – $995.39 | 1,859 | 4 |
| Fowler, CA | $0.01 | $0.00 – $2.16 | 1,857 | 3 |
| Moundville, AL | $0.07 | $0.07 – $0.29 | 1,856 | 2 |
| Clintwood, VA | $0.13 | $0.13 – $0.13 | 1,847 | 1 |
| Lake City, SC | $0.12 | $0.03 – $6.08 | 1,847 | 2 |
| Shawnee, OK | $10.48 | $0.00 – $16.20 | 1,846 | 7 |
| Big Spring, TX | $2.35 | $0.00 – $20.33 | 1,846 | 5 |
| Westmont, IL | $18.92 | $18.92 – $18.92 | 1,845 | 1 |
| Montgomery, LA | $0.00 | $0.00 – $0.00 | 1,845 | 1 |
| Wethersfield, CT | $469.92 | $0.00 – $481.70 | 1,841 | 2 |
| Mcminnville, OR | $0.51 | $0.00 – $13.09 | 1,841 | 3 |
| Lagrange, GA | $4.01 | $0.38 – $7.61 | 1,839 | 7 |
| Ogdensburg, NY | $0.30 | $0.00 – $0.32 | 1,835 | 3 |
| Edmore, MI | $5.49 | $5.49 – $5.49 | 1,835 | 1 |
| Canton, IL | $0.01 | $0.01 – $0.01 | 1,832 | 1 |
| City Of Industry, CA | $17.20 | $0.00 – $23.68 | 1,831 | 4 |
| Horn Lake, MS | $1.81 | $0.43 – $2.34 | 1,831 | 2 |
| Madison, TN | $0.23 | $0.03 – $0.73 | 1,829 | 3 |
| Glendale, NY | $11.78 | $11.78 – $11.78 | 1,829 | 1 |
| Carrollton, TX | $0.01 | $0.00 – $0.90 | 1,828 | 3 |
| White House, TN | $3.11 | $0.67 – $3.25 | 1,824 | 3 |
| Lynn Haven, FL | $35.32 | $0.00 – $257.82 | 1,822 | 6 |
| Fort Lauderdale, FL | $3.64 | $0.00 – $23.46 | 1,819 | 9 |
| Sterling, IL | $27.48 | $3.36 – $75.67 | 1,819 | 5 |
| Tonasket, WA | $18.11 | $18.11 – $18.11 | 1,814 | 1 |
| East China, MI | $0.42 | $0.00 – $10.60 | 1,811 | 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.