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 |
|---|---|---|---|---|
| Madison, MS | $165.95 | $0.14 – $369.43 | 1,398 | 3 |
| Bartlesville, OK | $4.68 | $0.00 – $15.82 | 1,397 | 14 |
| Port Orchard, WA | $103.03 | $103.03 – $103.03 | 1,397 | 1 |
| Baskin, LA | $0.70 | $0.70 – $0.70 | 1,397 | 1 |
| Little Falls, NY | $23.85 | $23.85 – $23.85 | 1,395 | 1 |
| Queensbury, NY | $509.09 | $8.96 – $1,133 | 1,392 | 6 |
| Rye Brook, NY | $6.08 | $5.89 – $6.16 | 1,392 | 2 |
| Halifax, NC | $18.18 | $17.39 – $20.78 | 1,392 | 2 |
| Erlanger, KY | $6.84 | $3.75 – $7.09 | 1,391 | 2 |
| Waverly, TN | $1.00 | $0.36 – $1.71 | 1,389 | 6 |
| Rocky Hill, CT | $5.47 | $1.47 – $6.01 | 1,388 | 4 |
| Sturgis, MI | $0.09 | $0.00 – $0.28 | 1,386 | 2 |
| Fairfield, ME | $3.14 | $3.14 – $3.14 | 1,385 | 1 |
| Cape Coral, FL | $2.14 | $0.00 – $4.76 | 1,383 | 8 |
| Clive, IA | $64.18 | $0.00 – $947.94 | 1,379 | 11 |
| West Jefferson, OH | $0.00 | $0.00 – $0.00 | 1,378 | 1 |
| Glassboro, NJ | $24.10 | $11.77 – $24.22 | 1,378 | 2 |
| Brewerton, NY | $10.26 | $10.26 – $10.26 | 1,376 | 1 |
| Poland, OH | $18.90 | $0.00 – $27.24 | 1,373 | 6 |
| Aibonito, PR | $123.14 | $0.83 – $132.34 | 1,373 | 2 |
| Wheelersburg, OH | $5.61 | $0.00 – $86.86 | 1,368 | 8 |
| Sartell, MN | $172.03 | $1.63 – $1,489 | 1,366 | 10 |
| Parker, CO | $199.69 | $0.07 – $615.83 | 1,362 | 3 |
| Innis, LA | $0.69 | $0.00 – $0.80 | 1,361 | 3 |
| Chewelah, WA | $34.28 | $34.28 – $34.28 | 1,359 | 1 |
| New City, NY | $789.25 | $789.25 – $789.25 | 1,357 | 1 |
| Granger, IN | $84.33 | $0.51 – $420.56 | 1,353 | 2 |
| Jersey Village, TX | $2.47 | $2.47 – $2.47 | 1,347 | 1 |
| Niles, MI | $50.58 | $0.00 – $72.48 | 1,346 | 3 |
| Citrus Heights, CA | $0.59 | $0.50 – $10.38 | 1,345 | 2 |
| Richton, MS | $0.01 | $0.00 – $0.30 | 1,343 | 4 |
| Braintree, MA | $150.92 | $2.28 – $441.43 | 1,342 | 6 |
| Eagle Pass, TX | $47.60 | $0.00 – $70.44 | 1,340 | 6 |
| Oconto Falls, WI | $0.00 | $0.00 – $0.00 | 1,339 | 1 |
| Atlantis, FL | $0.62 | $0.00 – $0.91 | 1,338 | 5 |
| San Juan, TX | $1.62 | $0.07 – $1.72 | 1,334 | 3 |
| Hinton, WV | $11.85 | $0.00 – $62.02 | 1,331 | 5 |
| Killeen, TX | $3.38 | $0.71 – $9.03 | 1,330 | 6 |
| Cadiz, KY | $6.41 | $0.42 – $10.32 | 1,330 | 4 |
| Oneonta, AL | $0.62 | $0.00 – $0.78 | 1,330 | 5 |
| Harper Woods, MI | $1.07 | $0.00 – $1.69 | 1,329 | 5 |
| Loves Park, IL | $47.80 | $0.00 – $68.90 | 1,329 | 2 |
| Juana Diaz, PR | $2.35 | $0.00 – $16.44 | 1,328 | 6 |
| Benson, NC | $4.26 | $0.00 – $4.44 | 1,328 | 3 |
| Palos Heights, IL | $40.91 | $1.79 – $1,154 | 1,326 | 4 |
| Charlevoix, MI | $0.00 | $0.00 – $0.00 | 1,325 | 1 |
| Sale Creek, TN | $1.48 | $0.37 – $1.59 | 1,325 | 2 |
| Ahoskie, NC | $3.94 | $0.00 – $10.94 | 1,319 | 4 |
| Jena, LA | $0.00 | $0.00 – $0.05 | 1,319 | 6 |
| Sylva, NC | $4.18 | $0.70 – $6.18 | 1,315 | 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.