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 |
|---|---|---|---|---|
| Warrenville, IL | $19.63 | $12.10 – $23.49 | 608 | 8 |
| Oakland Park, FL | $0.08 | $0.00 – $0.12 | 605 | 2 |
| Warsaw, NC | $4.12 | $1.03 – $59.42 | 605 | 2 |
| Alamosa, CO | $4.60 | $0.00 – $22.46 | 604 | 6 |
| Middle Village, NY | $4.15 | $4.15 – $4.15 | 604 | 1 |
| South Portland, ME | $10.29 | $3.02 – $48.55 | 604 | 3 |
| Estero, FL | $10.28 | $5.87 – $10.40 | 598 | 2 |
| Cortez, CO | $85.93 | $0.00 – $95.48 | 596 | 3 |
| Beeville, TX | $29.34 | $0.01 – $76.24 | 596 | 3 |
| Falmouth, MA | $29.43 | $5.85 – $30.12 | 594 | 2 |
| Rockwall, TX | $4.27 | $0.00 – $85.65 | 593 | 4 |
| White Pine, TN | $0.40 | $0.22 – $1.40 | 592 | 4 |
| New Providence, NJ | $5.90 | $5.59 – $11.11 | 591 | 4 |
| Mooresville, IN | $57.78 | $57.78 – $57.78 | 590 | 1 |
| Highland, IN | $0.02 | $0.00 – $1.10 | 588 | 4 |
| Mentor, OH | $14.87 | $0.00 – $99.23 | 586 | 10 |
| Blue Ridge, GA | $1.78 | $0.21 – $14.40 | 586 | 6 |
| Warrior, AL | $0.04 | $0.04 – $0.04 | 586 | 1 |
| Lordsburg, NM | $0.55 | $0.55 – $0.55 | 586 | 1 |
| East Chicago, IN | $0.71 | $0.00 – $4.14 | 586 | 3 |
| Ladysmith, WI | $0.00 | $0.00 – $0.00 | 585 | 1 |
| Spencer, IA | $2.18 | $0.00 – $3.27 | 584 | 4 |
| Martin, KY | $4.47 | $0.37 – $7.25 | 584 | 6 |
| Union, WV | $7.26 | $0.00 – $7.60 | 584 | 2 |
| Zwolle, LA | $0.00 | $0.00 – $0.00 | 583 | 4 |
| Gibson City, IL | $12.39 | $12.39 – $12.39 | 583 | 1 |
| Sulligent, AL | $0.19 | $0.08 – $0.20 | 583 | 2 |
| Pearsall, TX | $0.03 | $0.03 – $0.03 | 582 | 1 |
| Owasso, OK | $1.01 | $0.00 – $10.50 | 581 | 5 |
| Stanton, MI | $5.49 | $5.49 – $5.49 | 581 | 1 |
| Stilwell, OK | $1.53 | $1.43 – $1.83 | 580 | 3 |
| Conyers, GA | $65.43 | $0.00 – $504.88 | 578 | 8 |
| Mt Pleasant, TN | $1.67 | $0.53 – $1.70 | 578 | 2 |
| Baxter, MN | $1,674 | $1,674 – $1,674 | 577 | 1 |
| Inkster, MI | $43.52 | $1.15 – $56.84 | 577 | 2 |
| Shelby, MT | $6.63 | $5.95 – $28.88 | 574 | 2 |
| Lathrup Village, MI | $2.07 | $0.55 – $5.39 | 574 | 3 |
| Springdale, AR | $5.14 | $0.00 – $70.46 | 573 | 9 |
| North Adams, MA | $2.99 | $2.51 – $5.23 | 573 | 2 |
| Pt Pleasant, WV | $15.76 | $15.49 – $27.30 | 572 | 2 |
| Santo Domingo Pueblo, NM | $15.89 | $15.89 – $15.89 | 572 | 1 |
| Mc Farland, CA | $0.08 | $0.08 – $0.08 | 571 | 1 |
| Celina, TN | $4.93 | $0.85 – $6.71 | 570 | 4 |
| Spring Hill, FL | $36.52 | $0.00 – $55.79 | 567 | 7 |
| Parsons, KS | $1.04 | $0.11 – $6.58 | 567 | 3 |
| Metropolis, IL | $1.00 | $0.00 – $2.32 | 563 | 4 |
| Ada, OK | $2.84 | $0.00 – $6.43 | 562 | 7 |
| Riverview, FL | $17.25 | $0.00 – $22.06 | 562 | 5 |
| Scott Depot, WV | $59.48 | $0.00 – $81.63 | 561 | 5 |
| Krotz Springs, LA | $0.00 | $0.00 – $0.00 | 561 | 1 |
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.