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 |
|---|---|---|---|---|
| Danbury, CT | $32.29 | $0.00 – $786.64 | 67,135 | 10 |
| Federal Way, WA | $21.32 | $0.07 – $1,118 | 66,547 | 15 |
| Albany, GA | $20.24 | $0.39 – $560.86 | 66,341 | 11 |
| Novi, MI | $0.97 | $0.00 – $2,446 | 66,207 | 12 |
| Manchester, CT | $205.05 | $0.00 – $633.74 | 65,999 | 15 |
| Roseville, CA | $10.19 | $0.00 – $319.91 | 65,838 | 11 |
| New Hyde Park, NY | $52.86 | $0.00 – $170.51 | 65,640 | 14 |
| Dyersburg, TN | $1.24 | $0.00 – $4.28 | 65,288 | 43 |
| Pomona, CA | $11.03 | $0.00 – $81.63 | 64,419 | 19 |
| La Crosse, WI | $14.85 | $0.00 – $812.57 | 64,004 | 13 |
| Van Nuys, CA | $52.68 | $0.00 – $1,555 | 63,697 | 30 |
| Turlock, CA | $34.23 | $0.00 – $72.40 | 63,592 | 23 |
| Lewiston, ME | $20.28 | $13.52 – $28.55 | 63,314 | 2 |
| Brownsville, TX | $5.47 | $0.00 – $149.63 | 62,697 | 59 |
| Stafford, VA | $0.22 | $0.00 – $67.28 | 62,610 | 10 |
| Midland, MI | $2.34 | $0.00 – $45.61 | 62,384 | 8 |
| Jackson, TN | $15.42 | $0.00 – $651.55 | 62,291 | 130 |
| Modesto, CA | $50.08 | $0.00 – $2,106 | 62,251 | 43 |
| Boise, ID | $40.96 | $0.00 – $1,340 | 62,229 | 15 |
| Berkeley, CA | $16.35 | $0.00 – $901.98 | 62,164 | 20 |
| Anderson, SC | $1.67 | $0.18 – $745.81 | 62,142 | 28 |
| Mccomb, MS | $9.72 | $0.00 – $32.03 | 61,872 | 25 |
| Corbin, KY | $3.67 | $0.21 – $85.75 | 61,861 | 32 |
| Clarksdale, MS | $1.11 | $0.00 – $10.97 | 61,227 | 28 |
| Inglewood, CA | $10.41 | $0.00 – $231.04 | 60,979 | 19 |
| Albany, NY | $72.19 | $0.00 – $1,358 | 60,696 | 26 |
| Eau Claire, WI | $0.89 | $0.00 – $98.06 | 60,083 | 13 |
| Pascagoula, MS | $12.21 | $0.51 – $17.38 | 60,047 | 7 |
| Chattanooga, TN | $9.15 | $0.00 – $446.56 | 59,705 | 140 |
| West Columbia, SC | $125.52 | $0.00 – $1,146 | 59,671 | 29 |
| Winston Salem, NC | $56.24 | $0.00 – $1,662 | 59,516 | 100 |
| Norwalk, CT | $16.55 | $0.00 – $821.74 | 59,423 | 13 |
| Saint Joseph, MI | $27.50 | $0.00 – $1,035 | 59,292 | 5 |
| Dothan, AL | $4.57 | $0.00 – $192.30 | 59,227 | 44 |
| Mount Vernon, WA | $18.03 | $0.53 – $53.97 | 59,124 | 6 |
| Ontario, CA | $7.81 | $0.00 – $88.00 | 58,779 | 15 |
| Wilmington, NC | $17.89 | $0.00 – $699.39 | 58,541 | 62 |
| Westminster, CA | $16.07 | $0.00 – $57.28 | 58,485 | 14 |
| Silverdale, WA | $3.88 | $0.87 – $1,084 | 58,347 | 6 |
| Hayward, CA | $30.22 | $0.00 – $673.14 | 58,232 | 13 |
| Wausau, WI | $15.88 | $0.00 – $592.56 | 58,077 | 8 |
| London, KY | $14.03 | $0.05 – $259.88 | 57,868 | 50 |
| Mcallen, TX | $4.38 | $0.00 – $707.79 | 57,668 | 65 |
| La Mesa, CA | $20.13 | $0.24 – $916.15 | 57,433 | 22 |
| Winchester, VA | $10.34 | $0.00 – $1,668 | 57,397 | 28 |
| Stratford, NJ | $1.56 | $0.00 – $1.56 | 57,374 | 3 |
| Syracuse, NY | $6.90 | $0.00 – $640.83 | 57,321 | 29 |
| Minneapolis, MN | $178.21 | $0.00 – $1,766 | 57,244 | 107 |
| Sheboygan, WI | $0.62 | $0.00 – $166.14 | 56,876 | 10 |
| Corona, CA | $34.83 | $0.00 – $3,490 | 56,624 | 26 |
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.