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 |
|---|---|---|---|---|
| Salem, OR | $147.10 | $0.00 – $1,148 | 56,505 | 47 |
| Tulsa, OK | $14.20 | $0.00 – $1,509 | 56,457 | 134 |
| Chula Vista, CA | $74.10 | $0.09 – $1,512 | 56,295 | 37 |
| Redding, CA | $56.71 | $0.00 – $944.56 | 56,177 | 37 |
| Chico, CA | $16.83 | $0.00 – $35.67 | 56,164 | 11 |
| Winnsboro, LA | $0.90 | $0.00 – $19.80 | 56,129 | 39 |
| Laredo, TX | $30.90 | $0.00 – $686.49 | 55,998 | 36 |
| Missoula, MT | $2.88 | $0.00 – $1,073 | 55,634 | 14 |
| Longview, WA | $5.98 | $0.42 – $499.61 | 55,228 | 9 |
| Lakewood, WA | $0.89 | $0.04 – $491.34 | 55,216 | 8 |
| Lafayette, LA | $6.38 | $0.00 – $121.32 | 55,188 | 142 |
| Concord, NC | $3.22 | $0.00 – $337.72 | 54,994 | 22 |
| Janesville, WI | $0.76 | $0.00 – $76.72 | 54,817 | 12 |
| New Bern, NC | $22.32 | $0.00 – $540.36 | 54,650 | 23 |
| Hilo, HI | $1.67 | $0.00 – $896.34 | 54,387 | 4 |
| Orangeburg, SC | $2.02 | $0.09 – $56.32 | 54,205 | 14 |
| Hanford, CA | $10.19 | $0.00 – $11.62 | 54,183 | 15 |
| Redlands, CA | $18.92 | $0.00 – $3,566 | 53,153 | 26 |
| Colorado Springs, CO | $194.23 | $0.00 – $1,118 | 52,791 | 152 |
| Meriden, CT | $1.25 | $0.00 – $55.98 | 52,739 | 7 |
| Glasgow, KY | $7.30 | $0.05 – $44.39 | 52,579 | 20 |
| Belleville, NJ | $2.34 | $0.00 – $14.74 | 52,567 | 12 |
| Elyria, OH | $0.42 | $0.00 – $92.05 | 52,486 | 18 |
| Monterey Park, CA | $20.10 | $0.00 – $552.81 | 52,327 | 24 |
| Harrisonburg, VA | $2.15 | $0.13 – $623.35 | 52,236 | 6 |
| Manassas, VA | $1.07 | $0.00 – $897.74 | 52,077 | 9 |
| San Antonio, TX | $28.31 | $0.00 – $1,013 | 51,984 | 189 |
| Woodbridge, VA | $0.32 | $0.00 – $2.55 | 51,632 | 10 |
| Great Falls, MT | $3.14 | $0.00 – $1,238 | 51,275 | 12 |
| Greenwood, SC | $9.04 | $0.24 – $87.00 | 51,131 | 20 |
| Kettering, OH | $0.19 | $0.00 – $5.28 | 50,905 | 44 |
| Arlington, VA | $6.33 | $0.00 – $75.08 | 50,872 | 11 |
| Palmdale, CA | $5.05 | $0.00 – $65.33 | 50,805 | 18 |
| Laveen, AZ | $0.03 | $0.03 – $0.12 | 50,694 | 2 |
| Fairfax, VA | $3.78 | $0.13 – $950.05 | 50,660 | 15 |
| Englewood, NJ | $23.21 | $3.47 – $77.45 | 49,891 | 7 |
| Morristown, NJ | $35.54 | $0.00 – $1,024 | 49,220 | 12 |
| Midlothian, VA | $1.08 | $0.04 – $386.60 | 49,110 | 9 |
| Warren, OH | $16.78 | $0.00 – $807.15 | 49,091 | 47 |
| Fargo, ND | $79.17 | $0.17 – $1,530 | 48,999 | 61 |
| Rome, GA | $3.58 | $0.00 – $3.59 | 48,843 | 5 |
| Middletown, CT | $21.08 | $0.00 – $24.52 | 48,829 | 14 |
| Falls Church, VA | $15.77 | $14.38 – $491.64 | 48,670 | 4 |
| Edinburg, TX | $7.50 | $0.00 – $84.33 | 48,509 | 55 |
| Sun City, AZ | $2.22 | $0.00 – $457.45 | 48,093 | 15 |
| Vicksburg, MS | $0.95 | $0.00 – $14.51 | 47,893 | 24 |
| Medford, OR | $109.98 | $0.00 – $1,436 | 47,484 | 41 |
| Trenton, NJ | $28.21 | $1.00 – $106.42 | 47,361 | 7 |
| Spokane Valley, WA | $1.70 | $0.00 – $489.87 | 47,138 | 22 |
| Oxford, MS | $10.27 | $0.00 – $67.61 | 47,118 | 22 |
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.