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 |
|---|---|---|---|---|
| Pomona, NJ | $4.28 | $2.74 – $1,119 | 47,073 | 2 |
| Fishersville, VA | $5.58 | $0.00 – $438.38 | 46,791 | 3 |
| Chillicothe, OH | $3.87 | $0.00 – $391.83 | 46,643 | 48 |
| Asheville, NC | $5.62 | $0.00 – $488.12 | 46,487 | 36 |
| Duarte, CA | $127.99 | $0.04 – $154.94 | 46,050 | 5 |
| Portland, OR | $107.82 | $0.00 – $1,156 | 45,604 | 139 |
| Wyoming, MI | $14.01 | $0.00 – $21.05 | 45,583 | 5 |
| Sumter, SC | $6.12 | $0.21 – $81.25 | 45,573 | 34 |
| East Orange, NJ | $11.53 | $0.00 – $29.35 | 45,336 | 7 |
| Voorhees, NJ | $4.32 | $0.00 – $231.78 | 45,304 | 7 |
| Evansville, IN | $85.32 | $0.00 – $914.80 | 45,294 | 55 |
| Goodyear, AZ | $0.78 | $0.00 – $130.29 | 45,201 | 18 |
| Tempe, AZ | $22.00 | $0.00 – $1,315 | 45,129 | 18 |
| Delano, CA | $1.19 | $0.00 – $5.51 | 45,108 | 12 |
| Kosciusko, MS | $0.29 | $0.00 – $6.67 | 45,009 | 8 |
| Newport Beach, CA | $7.26 | $0.00 – $652.16 | 44,962 | 10 |
| Indio, CA | $14.63 | $0.00 – $77.65 | 44,635 | 8 |
| West Allis, WI | $7.86 | $0.00 – $595.50 | 44,516 | 7 |
| Traverse City, MI | $4.74 | $0.00 – $72.71 | 44,410 | 9 |
| Elizabeth, NJ | $34.60 | $0.63 – $110.30 | 44,128 | 14 |
| Salinas, CA | $53.39 | $0.00 – $937.09 | 44,054 | 30 |
| Jackson, MI | $27.25 | $0.00 – $970.09 | 44,037 | 13 |
| West Covina, CA | $11.42 | $0.00 – $18.69 | 44,013 | 14 |
| Greenwood, MS | $1.31 | $0.00 – $2.98 | 43,935 | 14 |
| Union City, NJ | $4.02 | $0.37 – $10.28 | 43,812 | 4 |
| Zanesville, OH | $10.86 | $0.00 – $127.64 | 43,674 | 30 |
| Troy, MI | $0.09 | $0.01 – $25.31 | 43,570 | 4 |
| Kingman, AZ | $3.70 | $0.00 – $13.33 | 43,462 | 11 |
| Sylmar, CA | $17.44 | $0.58 – $315.84 | 43,437 | 4 |
| Springfield, OH | $1.61 | $0.00 – $86.67 | 43,413 | 37 |
| Bridgeport, WV | $26.26 | $0.49 – $42.27 | 43,157 | 19 |
| Sunnyside, WA | $7.19 | $0.20 – $21.42 | 43,119 | 5 |
| Pittsfield, MA | $44.94 | $0.00 – $47.24 | 43,006 | 12 |
| Durham, NC | $24.55 | $0.00 – $1,269 | 42,873 | 61 |
| North Bergen, NJ | $2.56 | $0.00 – $20.61 | 42,855 | 7 |
| Princeton, WV | $13.28 | $0.03 – $76.30 | 42,816 | 29 |
| Covina, CA | $9.04 | $2.38 – $19.88 | 42,780 | 13 |
| Murray, UT | $28.44 | $0.00 – $723.71 | 42,394 | 6 |
| Battle Creek, MI | $6.23 | $0.00 – $44.73 | 42,042 | 5 |
| Casa Grande, AZ | $5.68 | $0.00 – $77.82 | 41,815 | 14 |
| Beaufort, SC | $2.58 | $0.91 – $87.00 | 41,792 | 13 |
| Montebello, CA | $27.98 | $0.00 – $225.85 | 41,750 | 14 |
| Marshfield, WI | $3.61 | $0.00 – $4.59 | 41,707 | 2 |
| Neenah, WI | $97.95 | $0.00 – $849.88 | 41,660 | 13 |
| Ypsilanti, MI | $8.12 | $0.00 – $975.06 | 41,486 | 11 |
| Laurel, MS | $19.21 | $0.00 – $570.83 | 40,943 | 30 |
| Auburn, WA | $70.18 | $0.00 – $1,305 | 40,585 | 10 |
| Sierra Vista, AZ | $0.20 | $0.00 – $3.25 | 40,575 | 5 |
| Stanford, CA | $252.93 | $0.00 – $1,866 | 40,520 | 25 |
| Beloit, WI | $2.95 | $0.01 – $77.23 | 40,282 | 7 |
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.