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 |
|---|---|---|---|---|
| Charlestown, MA | $1,190 | $4.62 – $1,621 | 702 | 3 |
| Harold, KY | $3.20 | $0.49 – $3.64 | 702 | 4 |
| Saint Cloud, FL | $0.24 | $0.00 – $1.02 | 700 | 4 |
| Kenai, AK | $25.15 | $0.00 – $51.94 | 700 | 2 |
| Fayetteville, WV | $14.20 | $11.62 – $31.44 | 700 | 2 |
| Kearny, NJ | $4.93 | $4.93 – $4.93 | 698 | 1 |
| North Sioux City, SD | $610.09 | $610.09 – $610.09 | 696 | 1 |
| Batesville, IN | $0.07 | $0.00 – $0.13 | 695 | 4 |
| Seguin, TX | $80.93 | $0.33 – $112.23 | 695 | 5 |
| Skokie, IL | $319.88 | $0.74 – $651.35 | 695 | 5 |
| Port Allen, LA | $0.19 | $0.00 – $0.91 | 693 | 5 |
| Edgewood, MD | $13.24 | $13.16 – $16.21 | 693 | 2 |
| Woodbury, MN | $464.49 | $0.00 – $935.50 | 692 | 5 |
| Alexander City, AL | $0.56 | $0.00 – $6.25 | 692 | 7 |
| Calabasas, CA | $18.83 | $3.72 – $807.12 | 691 | 3 |
| Broken Arrow, OK | $0.00 | $0.00 – $0.00 | 689 | 4 |
| Fulton, KY | $30.30 | $1.95 – $43.00 | 689 | 3 |
| Fort Benning, GA | $0.52 | $0.52 – $0.52 | 689 | 1 |
| Bonifay, FL | $3.83 | $0.00 – $18.58 | 688 | 4 |
| Brimingham, AL | $0.00 | $0.00 – $0.00 | 688 | 1 |
| Greensburg, LA | $1.27 | $0.47 – $1.53 | 687 | 3 |
| Edmonton, KY | $6.41 | $0.58 – $41.94 | 685 | 4 |
| Sturgeon Bay, WI | $0.43 | $0.43 – $0.43 | 684 | 1 |
| Cornwall, NY | $0.00 | $0.00 – $0.00 | 683 | 1 |
| Mckinney, TX | $5.97 | $0.76 – $12.62 | 679 | 5 |
| Swansea, IL | $0.19 | $0.18 – $0.57 | 678 | 2 |
| Eutaw, AL | $0.01 | $0.01 – $0.01 | 677 | 1 |
| Storm Lake, IA | $22.32 | $21.33 – $46.08 | 677 | 2 |
| Kearney, NE | $15.12 | $0.00 – $95.30 | 676 | 7 |
| Nauvoo, AL | $0.62 | $0.62 – $0.62 | 676 | 1 |
| Dallas, GA | $0.43 | $0.43 – $0.44 | 674 | 2 |
| Dededo, GU | $71.95 | $13.35 – $86.66 | 674 | 3 |
| Forest City, NC | $0.12 | $0.12 – $0.19 | 673 | 2 |
| Shaker Heights, OH | $1.01 | $1.01 – $1.01 | 673 | 1 |
| Lantana, FL | $13.93 | $13.93 – $13.93 | 673 | 1 |
| Zephyrhills, FL | $672.81 | $0.00 – $1,011 | 671 | 8 |
| Snow Hill, MD | $15.47 | $14.74 – $15.88 | 671 | 2 |
| Madison, AL | $3.62 | $0.00 – $5.16 | 671 | 4 |
| Wooster, OH | $0.76 | $0.00 – $7.58 | 669 | 5 |
| La Junta, CO | $2.57 | $0.00 – $2.69 | 665 | 2 |
| Wolf Point, MT | $0.26 | $0.26 – $0.26 | 665 | 1 |
| Spindale, NC | $56.90 | $56.90 – $56.90 | 664 | 1 |
| Deland, FL | $8.18 | $0.00 – $14.69 | 664 | 7 |
| Temperance, MI | $3.82 | $1.00 – $4.39 | 663 | 3 |
| Plain Dealing, LA | $0.00 | $0.00 – $0.00 | 661 | 1 |
| Texas City, TX | $49.54 | $49.54 – $49.54 | 660 | 1 |
| Sterlington, LA | $0.57 | $0.41 – $0.58 | 660 | 2 |
| Warsaw, NY | $15.63 | $0.05 – $55.62 | 659 | 3 |
| Papillion, NE | $2.01 | $0.00 – $15.15 | 659 | 4 |
| Tifton, GA | $0.39 | $0.30 – $0.47 | 659 | 2 |
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.