| Code | Description | States | Median rate |
|---|---|---|---|
| J8501 | Aprepitant, oral, 5 mg | 19 | $3.07 |
| J8502 | Injection, aprepitant (aponvie), 1 mg | 18 | $2.00 |
| J8510 | Busulfan; oral, 2 mg | 19 | $23.80 |
| J8515 | Cabergoline, oral, 0.25 mg | 11 | $0.30 |
| J8522 | Capecitabine, oral, 50 mg | 21 | $0.04 |
| J8530 | Cyclophosphamide; oral, 25 mg | 24 | $1.49 |
| J8540 | Dexamethasone, oral, 0.25 mg | 16 | $0.03 |
| J8541 | Dexamethasone (hemady), oral, 0.25 mg | 11 | $0.34 |
| J8560 | Etoposide; oral, 50 mg | 24 | $86.79 |
| J8600 | Melphalan; oral, 2 mg | 15 | $9.90 |
| J8610 | Methotrexate; oral, 2.5 mg | 20 | $0.15 |
| J8611 | Methotrexate (jylamvo), oral, 2.5 mg | 19 | $18.36 |
| J8612 | Methotrexate (xatmep), oral, 2.5 mg | 19 | $22.43 |
| J8655 | Netupitant 300 mg and palonosetron 0.5 mg, oral | 27 | $410.06 |
| J8670 | Rolapitant, oral, 1 mg | 15 | $2.00 |
| J8700 | Temozolomide, oral, 5 mg | 21 | $0.43 |
| J8705 | Topotecan, oral, 0.25 mg | 21 | $125.09 |
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. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.