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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
Ilwaco, WA $11.89 $11.89 – $11.89 1,610 1
Seminole, TX $18.70 $0.00 – $30.63 1,609 4
Lone Tree, CO $115.94 $0.00 – $681.49 1,606 13
Joplin, MO $62.91 $0.00 – $291.02 1,591 11
Page, AZ $5.63 $5.63 – $5.63 1,587 1
Barron, WI $0.42 $0.11 – $8.07 1,587 2
Magnolia, TX $0.44 $0.44 – $0.44 1,583 1
Coal Grove, OH $31.52 $0.00 – $33.06 1,583 3
Wedowee, AL $0.07 $0.00 – $0.70 1,583 3
Columbus, WI $0.13 $0.13 – $0.13 1,581 1
Yukon, OK $0.39 $0.00 – $11.26 1,580 9
Guttenberg, NJ $2.61 $0.70 – $3.12 1,580 2
Socorro, NM $6.09 $0.69 – $9.95 1,580 3
Acoma, NM $4.68 $4.68 – $4.68 1,579 1
Massena, NY $5.26 $5.26 – $5.26 1,578 1
Boynton Beach, FL $37.35 $0.00 – $775.30 1,574 13
Moss Bluff, LA $0.93 $0.81 – $0.94 1,569 2
West Memphis, AR $3.77 $0.00 – $11.84 1,564 10
Jefferson, NC $13.90 $0.13 – $47.39 1,564 3
Raceland, LA $12.50 $0.12 – $319.55 1,559 13
Vanceburg, KY $1.82 $0.81 – $11.57 1,557 3
Northbrook, IL $18.65 $1.32 – $39.51 1,551 2
Waimea, HI $0.07 $0.07 – $0.07 1,541 1
Lebanon, PA $46.56 $0.00 – $469.13 1,539 3
Westland, MI $0.39 $0.11 – $6.77 1,535 4
Pitkin, LA $4.14 $4.14 – $4.14 1,534 1
Canon City, CO $0.28 $0.22 – $5.10 1,529 3
Alameda, CA $9.13 $9.13 – $9.13 1,524 1
Jasper, TX $3.46 $3.36 – $4.11 1,524 2
Superior, WI $0.33 $0.12 – $4.73 1,523 2
Tipton, IN $0.12 $0.12 – $0.12 1,523 1
Logansport, IN $6.91 $0.00 – $10.45 1,522 3
Williamston, NC $9.90 $0.11 – $34.36 1,520 3
Castro Valley 94546, CA $3.30 $3.30 – $3.30 1,520 1
Arlington, KY $7.94 $7.94 – $7.94 1,519 1
Linwood, NJ $29.60 $3.58 – $186.69 1,518 3
Hyden, KY $19.19 $2.06 – $38.76 1,518 4
Longmont, CO $899.02 $0.00 – $1,520 1,516 12
Farmerville, LA $0.21 $0.00 – $0.58 1,515 6
Burr Ridge, IL $9.85 $9.85 – $9.85 1,514 1
Plainfield, IL $41.71 $41.71 – $41.71 1,512 1
Leesburg, AL $0.83 $0.30 – $0.84 1,512 2
Coldwater, OH $0.12 $0.00 – $0.12 1,510 2
Frisco, TX $4.63 $0.00 – $23.98 1,500 10
Nettleton, MS $0.42 $0.24 – $0.72 1,500 3
Opelika, AL $0.88 $0.00 – $6.85 1,495 13
Wyomissing, PA $14.58 $13.46 – $16.06 1,494 2
Smyrna, GA $1.22 $0.61 – $3.05 1,494 3
Ridgecrest, CA $8.79 $0.00 – $9.09 1,490 2
El Cajon, CA $1.43 $0.01 – $1.57 1,490 3

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.