Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J7172. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
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Publishing states
22
Median % of Medicare
--
Rate range
$43.61 - $55.16
J7172 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $48.54* | -- | -- | 2026 |
| Arizona | $48.17 | -- | -- | 2026 |
| California | $54.65 | -- | -- | 2026 |
| Connecticut | $50.71 | -- | -- | 2025 |
| District of Columbia | $50.47 | -- | Required | 2026 |
| Idaho | $43.61 | -- | Not required | 2026 |
| Illinois | $48.84 | -- | -- | 2026 |
| Indiana | $55.16 | -- | -- | 2026 |
| Kansas | $51.19 | -- | -- | 2026 |
| Michigan | $51.19 | -- | -- | 2026 |
| Minnesota | $51.19 | -- | Required | 2026 |
| Mississippi | $50.19 | -- | -- | 2026 |
| Montana | $50.47 | -- | -- | 2026 |
| Nebraska | $51.19 | -- | -- | 2026 |
| New Hampshire | $52.53 | -- | Not required | 2026 |
| New Jersey | $50.49 | -- | Not required | 2026 |
| Oklahoma | $51.19 | -- | -- | 2026 |
| Texas | $50.71* | -- | -- | 2025 |
| Utah | $51.19* | -- | Required | 2026 |
| Virginia | $51.19* | -- | -- | 2026 |
| Vermont | $48.55 | -- | Required | 2026 |
| Wisconsin | $51.19 | -- | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related drugs codes
- J0013 - Esketamine, nasal spray, 1 mg
- J0120 - Injection, tetracycline, up to 250 mg
- J0121 - Injection, omadacycline, 1 mg
- J0122 - Injection, eravacycline, 1 mg
- J0129 - Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
- J0130 - Injection abciximab, 10 mg
- J0131 - Injection, acetaminophen, not otherwise specified,10 mg
- J0132 - Injection, acetylcysteine, 100 mg
All 137 codes from J7030 to J7686 or every drugs code by number.
Frequently asked questions
How much does Medicaid pay for J7172?
22 state Medicaid programs publish a fee-for-service rate for J7172 (injection, marstacimab-hncq, 0.5 mg), ranging from $43.61 in Idaho to $55.16 in Indiana. The full table on this page lists every publishing state's current rate.
Which state pays the most for J7172?
Indiana publishes the highest Medicaid rate for J7172 at $55.16. Idaho publishes the lowest at $43.61.
Does J7172 require prior authorization under Medicaid?
4 of the 22 publishing states flag J7172 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".