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 |
|---|---|---|---|---|
| Hartselle, AL | $4.55 | $0.64 – $7.32 | 657 | 3 |
| Boca Raton, FL | $3.37 | $0.00 – $4.29 | 656 | 3 |
| Augusta, AR | $0.00 | $0.00 – $0.00 | 656 | 2 |
| Grapevine, TX | $0.76 | $0.76 – $0.76 | 653 | 1 |
| Sunny Isles Beach, FL | $6.36 | $1.15 – $30.98 | 653 | 2 |
| Wilmington, CA | $12.58 | $2.25 – $16.21 | 651 | 2 |
| Stonewall, LA | $0.85 | $0.00 – $1.00 | 650 | 3 |
| Astoria, OR | $16.40 | $16.40 – $16.40 | 649 | 1 |
| Olive Hill, KY | $1.00 | $0.93 – $1.27 | 649 | 2 |
| Livingston, MT | $0.79 | $0.79 – $0.79 | 647 | 1 |
| Lockesburg, AR | $13.02 | $2.86 – $13.25 | 647 | 2 |
| Mansfield, TX | $6.92 | $0.00 – $41.43 | 646 | 7 |
| Campbell, CA | $693.57 | $330.07 – $807.35 | 646 | 2 |
| Kingsville, TX | $16.18 | $0.00 – $74.74 | 645 | 8 |
| Pekin, IL | $5.79 | $1.00 – $10.91 | 644 | 3 |
| Wynne, AR | $0.62 | $0.00 – $0.95 | 643 | 2 |
| Auburn, ME | $3.52 | $1.59 – $3.61 | 640 | 4 |
| Stuart, FL | $239.61 | $0.00 – $647.36 | 640 | 6 |
| Rochester, IN | $7.38 | $7.38 – $7.38 | 640 | 1 |
| Bloomfield Township, MI | $58.96 | $58.96 – $58.96 | 640 | 1 |
| Carver, MA | $0.95 | $0.95 – $0.95 | 639 | 1 |
| South Jordan, UT | $0.35 | $0.00 – $0.43 | 638 | 2 |
| Lancaster, WI | $0.00 | $0.00 – $0.00 | 637 | 1 |
| Geneva, AL | $1.58 | $0.00 – $1.91 | 637 | 3 |
| Coalgate, OK | $1.16 | $1.16 – $1.19 | 636 | 2 |
| Kenton, OH | $0.14 | $0.00 – $0.73 | 635 | 5 |
| Claremont, CA | $0.91 | $0.00 – $1.01 | 635 | 3 |
| Willcox, AZ | $0.79 | $0.00 – $0.81 | 635 | 2 |
| Newport, KY | $1.04 | $0.22 – $11.98 | 633 | 5 |
| Decatur, TN | $1.20 | $1.10 – $1.29 | 632 | 4 |
| Salida, CA | $4.56 | $4.56 – $4.58 | 632 | 2 |
| Rockwell, NC | $11.81 | $11.81 – $11.81 | 631 | 1 |
| Southampton, NY | $0.24 | $0.24 – $0.24 | 630 | 1 |
| Caledonia, MI | $9.88 | $1.19 – $23.54 | 630 | 2 |
| Palatka, FL | $26.94 | $5.67 – $38.36 | 629 | 3 |
| Lavonia, GA | $0.68 | $0.68 – $0.68 | 628 | 1 |
| Hermiston, OR | $14.84 | $3.75 – $41.15 | 626 | 9 |
| Pawtucket, RI | $9.47 | $9.47 – $9.47 | 626 | 1 |
| Maywood, IL | $7.43 | $1.07 – $19.35 | 625 | 4 |
| Hewlett, NY | $2.73 | $1.51 – $11.07 | 622 | 3 |
| Pine Ridge, SD | $260.63 | $260.63 – $260.63 | 620 | 1 |
| Kerrville, TX | $13.07 | $11.56 – $13.26 | 619 | 2 |
| Thomson, GA | $2.90 | $0.25 – $4.08 | 619 | 4 |
| Bisbee, AZ | $7.89 | $7.89 – $7.89 | 619 | 1 |
| Richland, MS | $0.18 | $0.00 – $1.55 | 618 | 2 |
| Sheridan, AR | $11.70 | $3.24 – $14.71 | 616 | 2 |
| Lake City, FL | $26.07 | $0.00 – $63.84 | 615 | 6 |
| Conneaut, OH | $0.24 | $0.24 – $0.24 | 614 | 1 |
| Colchester, VT | $34.06 | $0.96 – $61.82 | 612 | 3 |
| Bowie, MD | $72.96 | $0.00 – $1,450 | 609 | 3 |
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.