Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J7294. 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
27
Median % of Medicare
--
Rate range
$339.96 - $2,585.14
J7294 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $2,382.60* | -- | -- | 2026 |
| Arizona | $2,420.54 | -- | -- | 2026 |
| California | $2,317.31 | -- | -- | 2026 |
| Connecticut | $1,248.90 | -- | -- | 2026 |
| District of Columbia | $2,090.00 | -- | Not required | 2021 |
| Iowa | $2,334.79 | -- | -- | 2024 |
| Illinois | $2,251.56 | -- | -- | 2026 |
| Indiana | $2,541.57 | -- | -- | 2024 |
| Kansas | $2,420.54 | -- | -- | 2024 |
| Kentucky | $339.96 | -- | -- | 2026 |
| Louisiana | $2,420.54 | -- | -- | 2026 |
| Maine | $501.36 | -- | -- | 2026 |
| Michigan | $2,565.77 | -- | -- | 2026 |
| Minnesota | $2,305.28 | -- | Required | 2024 |
| Mississippi | $2,420.54 | -- | -- | 2025 |
| Montana | $2,420.54 | -- | -- | 2026 |
| Nebraska | $2,585.14 | -- | -- | 2026 |
| New Hampshire | $2,420.54 | -- | Not required | 2026 |
| New Jersey | $2,069.10 | -- | Not required | 2026 |
| New Mexico | $2,243.32 | -- | -- | 2025 |
| Oklahoma | $2,090.00 | -- | -- | 2026 |
| South Carolina | $2,381.82 | -- | -- | 2024 |
| Texas | $2,468.96* | -- | -- | 2026 |
| Utah | $2,316.42* | -- | Not required | 2026 |
| Virginia | $2,090.00 | -- | -- | 2021 |
| Washington | $2,420.54 | -- | -- | 2026 |
| Wisconsin | $2,090.00 | -- | -- | 2021 |
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 J7294?
27 state Medicaid programs publish a fee-for-service rate for J7294 (segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each), ranging from $339.96 in Kentucky to $2,585.14 in Nebraska. The full table on this page lists every publishing state's current rate.
Which state pays the most for J7294?
Nebraska publishes the highest Medicaid rate for J7294 at $2,585.14. Kentucky publishes the lowest at $339.96.
Does J7294 require prior authorization under Medicaid?
1 of the 27 publishing states flag J7294 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".