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 |
|---|---|---|---|---|
| Dakota Dunes, SD | $142.90 | $0.11 – $359.16 | 1,487 | 9 |
| Maplewood, NJ | $5.79 | $5.69 – $10.79 | 1,484 | 2 |
| Sardis, MS | $0.37 | $0.09 – $0.46 | 1,484 | 3 |
| Arlington Heights, IL | $335.86 | $0.46 – $1,282 | 1,483 | 3 |
| Bolivia, NC | $25.30 | $14.21 – $60.08 | 1,481 | 11 |
| Lawrenceburg, IN | $4.84 | $0.00 – $31.34 | 1,480 | 8 |
| Kings Mtn, NC | $5.80 | $5.80 – $5.80 | 1,477 | 1 |
| Auxier, KY | $21.56 | $1.29 – $55.97 | 1,475 | 3 |
| Mattoon, IL | $16.01 | $1.15 – $76.77 | 1,474 | 7 |
| Viera, FL | $35.75 | $35.75 – $35.75 | 1,472 | 1 |
| Marion, LA | $0.02 | $0.00 – $0.07 | 1,471 | 3 |
| Camarillo, CA | $129.92 | $15.20 – $1,133 | 1,469 | 4 |
| Dodgeville, WI | $0.12 | $0.12 – $0.12 | 1,464 | 1 |
| Port Deposit, MD | $41.73 | $41.73 – $41.73 | 1,464 | 1 |
| Oconto, WI | $43.23 | $0.00 – $61.20 | 1,461 | 2 |
| Brookfield, WI | $4.04 | $0.00 – $78.61 | 1,459 | 2 |
| Bailey, MS | $0.94 | $0.94 – $0.94 | 1,453 | 1 |
| Ottawa, IL | $42.82 | $4.81 – $80.67 | 1,450 | 6 |
| Ringgold, LA | $0.00 | $0.00 – $0.00 | 1,450 | 3 |
| Quitman, MS | $0.11 | $0.07 – $0.29 | 1,448 | 3 |
| Kapaa, HI | $0.02 | $0.02 – $0.02 | 1,447 | 1 |
| Andover, MA | $7.68 | $6.34 – $7.88 | 1,446 | 3 |
| Plainwell, MI | $13.29 | $0.00 – $27.69 | 1,444 | 2 |
| Cumberland Gap, TN | $0.85 | $0.85 – $0.85 | 1,444 | 1 |
| Dresden, TN | $1.48 | $0.11 – $6.64 | 1,439 | 8 |
| Attalla, AL | $2.75 | $1.40 – $4.42 | 1,439 | 2 |
| Red Boiling Springs, TN | $2.37 | $0.64 – $3.18 | 1,438 | 2 |
| Vonore, TN | $0.83 | $0.44 – $0.97 | 1,437 | 6 |
| Eden, NC | $2.98 | $0.05 – $16.81 | 1,434 | 10 |
| Healdsburg, CA | $9.65 | $7.03 – $10.80 | 1,434 | 2 |
| Harrisburg, IL | $0.01 | $0.00 – $0.51 | 1,432 | 2 |
| Spanish Fork, UT | $0.06 | $0.00 – $1.50 | 1,431 | 3 |
| Monticello, AR | $11.01 | $0.21 – $81.30 | 1,430 | 8 |
| Rocky River, OH | $88.67 | $2.26 – $92.49 | 1,430 | 3 |
| Covington, VA | $3.73 | $0.08 – $9.40 | 1,429 | 4 |
| Laurium, MI | $0.25 | $0.00 – $14.86 | 1,428 | 3 |
| Schaumburg, IL | $13.87 | $0.00 – $19.08 | 1,421 | 6 |
| Lincolnshire, IL | $9.17 | $8.00 – $10.86 | 1,421 | 5 |
| Hanahan, SC | $9.41 | $9.41 – $9.41 | 1,420 | 1 |
| Newark, NY | $42.52 | $0.19 – $75.95 | 1,419 | 3 |
| Albemarle, NC | $30.87 | $0.00 – $43.44 | 1,418 | 10 |
| Dulles, VA | $0.04 | $0.04 – $0.04 | 1,418 | 1 |
| Smithville, MS | $0.46 | $0.46 – $0.46 | 1,416 | 1 |
| Mc Dowell, KY | $3.75 | $3.75 – $3.75 | 1,410 | 1 |
| Elgin, TN | $0.99 | $0.99 – $0.99 | 1,410 | 1 |
| Ruidoso, NM | $6.44 | $0.61 – $6.61 | 1,409 | 4 |
| Ladson, SC | $0.74 | $0.74 – $0.74 | 1,409 | 1 |
| Parkville, MD | $72.31 | $72.31 – $72.31 | 1,407 | 1 |
| Urbana, OH | $0.10 | $0.04 – $0.40 | 1,402 | 2 |
| Westwood, NJ | $2.18 | $2.18 – $2.18 | 1,399 | 1 |
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.