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 |
|---|---|---|---|---|
| East Setauket, NY | $231.96 | $0.00 – $949.73 | 449 | 8 |
| Rosedale, MD | $8.32 | $1.46 – $14.35 | 449 | 2 |
| Landover Hills, MD | $4.86 | $4.86 – $4.86 | 449 | 1 |
| Lombard, IL | $1,467 | $839.52 – $1,702 | 448 | 3 |
| Dillon, MT | $1.51 | $1.51 – $1.51 | 447 | 1 |
| Centennial, CO | $21.22 | $0.00 – $327.54 | 447 | 5 |
| Jonesborough, TN | $0.32 | $0.28 – $0.86 | 447 | 4 |
| Tamarac, FL | $1.24 | $0.13 – $2.47 | 446 | 3 |
| Susanville, CA | $15.72 | $15.72 – $15.72 | 446 | 1 |
| Rowland Heights, CA | $20.68 | $6.00 – $22.28 | 446 | 2 |
| Vestavia Hls, AL | $1.19 | $1.19 – $1.19 | 446 | 1 |
| Walled Lake, MI | $0.88 | $0.88 – $0.88 | 445 | 1 |
| Palmetto Bay, FL | $0.00 | $0.00 – $0.00 | 445 | 1 |
| Carteret, NJ | $14.49 | $14.11 – $16.77 | 444 | 3 |
| Star City, AR | $0.56 | $0.27 – $0.68 | 444 | 2 |
| Redmond, OR | $42.88 | $0.00 – $676.24 | 443 | 13 |
| Camden On Gauley, WV | $25.88 | $25.88 – $25.88 | 443 | 1 |
| Jupiter, FL | $0.42 | $0.00 – $1.74 | 442 | 4 |
| Eatonton, GA | $1.19 | $1.19 – $1.19 | 442 | 1 |
| Ponca City, OK | $3.22 | $0.00 – $56.27 | 442 | 9 |
| Liberty, KY | $4.17 | $1.69 – $10.91 | 442 | 4 |
| Salem, NH | $457.84 | $7.58 – $471.49 | 442 | 2 |
| Walton, KY | $11.85 | $11.18 – $17.36 | 441 | 3 |
| Springfield, TN | $6.74 | $0.00 – $44.82 | 440 | 4 |
| Smithfield, RI | $22.86 | $22.86 – $22.86 | 440 | 1 |
| Arvada, CO | $49.23 | $0.00 – $78.30 | 440 | 4 |
| Century, FL | $0.26 | $0.26 – $0.26 | 440 | 1 |
| Manchester, MO | $40.61 | $40.61 – $40.61 | 439 | 1 |
| Broomfield, CO | $4.58 | $0.00 – $11.75 | 438 | 4 |
| Elkhorn, NE | $1.44 | $0.85 – $9.51 | 438 | 5 |
| New Johnsonville, TN | $1.74 | $1.74 – $1.74 | 438 | 1 |
| Kearneysville, WV | $0.26 | $0.26 – $0.26 | 437 | 1 |
| Center, TX | $0.86 | $0.73 – $0.87 | 437 | 2 |
| Hempstead, NY | $38.87 | $38.87 – $38.87 | 436 | 1 |
| Newton, NC | $5.59 | $5.48 – $5.60 | 436 | 2 |
| Uniontown, OH | $6.51 | $3.55 – $98.91 | 436 | 3 |
| Waycross, GA | $162.79 | $0.21 – $194.58 | 435 | 3 |
| Bay City, TX | $36.49 | $14.31 – $60.11 | 435 | 3 |
| Amelia Court House, VA | $0.35 | $0.35 – $0.35 | 433 | 1 |
| Mooresburg, TN | $0.33 | $0.33 – $0.33 | 432 | 1 |
| Mesquite, NV | $0.71 | $0.15 – $0.74 | 431 | 2 |
| Olathe, KS | $15.52 | $0.45 – $22.97 | 430 | 4 |
| Seymour, TN | $4.01 | $0.59 – $70.71 | 429 | 6 |
| Prospect Park, NJ | $9.41 | $9.41 – $9.41 | 429 | 1 |
| Saint Petersburg, FL | $4.11 | $2.76 – $21.95 | 428 | 2 |
| Burleson, TX | $3.64 | $1.20 – $56.94 | 427 | 3 |
| La Grande, OR | $44.78 | $5.75 – $72.83 | 426 | 7 |
| Aberdeen, MD | $0.05 | $0.05 – $0.05 | 426 | 1 |
| Mayaguez, PR | $3.43 | $0.00 – $7.77 | 426 | 5 |
| Stanton, KY | $13.84 | $0.39 – $14.33 | 426 | 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.