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 |
|---|---|---|---|---|
| Douglas, AZ | $35.43 | $0.00 – $92.44 | 527 | 2 |
| Raymondville, TX | $1.63 | $0.02 – $4.55 | 525 | 3 |
| Aventura, FL | $24.47 | $0.00 – $1,027 | 524 | 9 |
| Marana, AZ | $1.10 | $0.37 – $1.21 | 524 | 3 |
| Lawrenceville, IL | $0.00 | $0.00 – $0.00 | 523 | 1 |
| Saint Johns, MI | $8.28 | $0.00 – $9.11 | 522 | 2 |
| Bridgewater, NJ | $56.19 | $0.81 – $625.89 | 521 | 4 |
| West Seneca, NY | $3.97 | $1.29 – $64.60 | 520 | 4 |
| Clinton, MO | $78.54 | $78.54 – $78.54 | 519 | 1 |
| Knightdale, NC | $2.77 | $2.77 – $2.77 | 517 | 1 |
| Springville, NY | $0.04 | $0.04 – $0.04 | 515 | 1 |
| Horizon City, TX | $4.54 | $4.54 – $4.54 | 515 | 1 |
| Ivins, UT | $64.75 | $64.75 – $64.75 | 514 | 1 |
| Delray Beach, FL | $7.60 | $0.00 – $14.41 | 513 | 4 |
| Arlington Hts, IL | $2.93 | $2.93 – $2.93 | 512 | 1 |
| Phila, PA | $0.02 | $0.00 – $0.07 | 511 | 3 |
| Burnsville, MN | $339.45 | $2.06 – $543.21 | 510 | 5 |
| Shawnee, KS | $3.43 | $3.43 – $3.43 | 510 | 1 |
| Blackshear, GA | $40.57 | $40.57 – $40.57 | 510 | 1 |
| Man, WV | $20.03 | $17.57 – $57.75 | 508 | 2 |
| Berlin, VT | $1.08 | $1.08 – $1.08 | 507 | 1 |
| Mound Bayou, MS | $2.14 | $0.00 – $2.47 | 507 | 2 |
| Windham, ME | $47.84 | $8.84 – $74.97 | 507 | 2 |
| Port Jefferson Station, NY | $0.67 | $0.00 – $1.36 | 506 | 5 |
| La Place, LA | $0.40 | $0.05 – $1.32 | 506 | 4 |
| Portland, TN | $1.66 | $0.00 – $1.86 | 506 | 3 |
| Highlands Ranch, CO | $44.56 | $0.00 – $64.81 | 505 | 4 |
| Fultondale, AL | $3.44 | $0.40 – $8.10 | 504 | 2 |
| Bean Station, TN | $0.13 | $0.02 – $0.92 | 504 | 2 |
| Edgefield, SC | $22.51 | $10.82 – $90.43 | 504 | 2 |
| Monsey, NY | $0.28 | $0.28 – $0.28 | 503 | 1 |
| Sullivan, MO | $0.75 | $0.75 – $0.75 | 503 | 1 |
| Fajardo, PR | $3.97 | $0.15 – $47.08 | 502 | 3 |
| Ganado, AZ | $0.00 | $0.00 – $0.00 | 501 | 2 |
| Stillwater, MN | $50.90 | $0.13 – $610.63 | 500 | 4 |
| O Fallon, MO | $1.89 | $1.89 – $1.89 | 500 | 1 |
| Colusa, CA | $4.91 | $4.91 – $4.91 | 499 | 1 |
| Hanover, IN | $43.35 | $5.60 – $49.43 | 497 | 2 |
| Hillsboro, OR | $6.35 | $0.00 – $29.54 | 496 | 10 |
| Scott, LA | $0.65 | $0.51 – $4.17 | 496 | 2 |
| Harts, WV | $0.57 | $0.57 – $0.57 | 496 | 1 |
| Mount Airy, MD | $7.74 | $7.65 – $9.14 | 495 | 2 |
| North Lima, OH | $0.76 | $0.10 – $8.32 | 495 | 2 |
| Brookeland, TX | $2.84 | $2.84 – $2.84 | 495 | 1 |
| Chantilly, VA | $0.06 | $0.06 – $0.06 | 494 | 1 |
| Muscatine, IA | $47.95 | $1.63 – $64.20 | 493 | 2 |
| Columbus, NC | $2.09 | $0.09 – $3.73 | 493 | 2 |
| Elkton, KY | $1.15 | $0.85 – $1.33 | 493 | 3 |
| Chickasha, OK | $14.14 | $14.14 – $14.14 | 492 | 1 |
| Kerman, CA | $9.74 | $0.00 – $10.11 | 492 | 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.