Xolair (omalizumab) cost per injection and what the patient owes

$9.1374 per mg ($45.687 per 5 mg billing unit) is Part B's ASP+6% rate for Q4 2026. Once the $283 Part B deductible is met, the patient owes the remaining 20% coinsurance on the drug and its administration, with no annual out-of-pocket maximum to cap it. Full explanation: How Medicare Part B drug cost sharing works →

Medicare pays J2357 per 5 mg billing unit, not per syringe or per dose. The chronic urticaria dose and a mid-table asthma dose both land on 300 mg (60 units, $2,741.22), but the label's IgE-and-weight table moves the asthma, nasal polyps and food-allergy doses anywhere from 75 mg to 600 mg, so the allowed drug amount for those three indications is not a single number the way it is for chronic urticaria.

375 mg falls between the 300 mg and 600 mg syringe sizes, so it is built from a 300 mg syringe and a 75 mg syringe rather than dispensed as one unit: 75 units of J2357 total, with no waste. Each syringe is its own subcutaneous injection, so the claim carries two 96372 lines, the second with modifier 59 or XS on most payers' edits, not one line at double the administration fee.

The per-unit rate is the same $45.687 whichever syringe combination fills the dose, so the drug line prices the same way as the 300 mg example above. This page does not total a 375 mg claim on its own; use the estimator, which builds the syringe combination and both injection lines for any dose entered.

For the reference patient (300 mg, 60 units, drug + the 96372 administration code), Medicare allows $2,756.58, and the Part B coinsurance on that is $551.31. Plans A, B, C, D, F, G, M and N cover that coinsurance in full, so those patients owe nothing per dose once the $283 deductible is met. Plans K and L do not, and on the every-4-week chronic urticaria schedule, most of a year's roughly 13 doses land after the deductible is already met. The first dose of the year, before the deductible is met, costs a Plan K patient $530.36; every dose after it costs $275.66. One larger charge early in the year, then a smaller recurring one. See what each Medigap plan (A–N) owes on this claim →

Only the letters that leave this patient a balance are listed. The full A–N grid, the high-deductible variants, Plan N’s office-visit carve-out and the MACRA restriction on Plans C and F are at Medigap Plans A–N.

At every-4-week dosing, 13 doses a year at $2,756.58 comes to $35,835.54 before the 2% sequester. That figure is the chronic urticaria regimen, and also a mid-table asthma year that happens to land on the same 300 mg dose. An asthma or nasal-polyps regimen dosed every 2 weeks doubles the number of doses, not the figure above; price that regimen dose by dose rather than assuming one fixed annual total.

Commercial payers negotiate their own rate for J2357, not ASP+6%; our corpus holds published rates from 37 payers, including Aetna, UnitedHealthcare, Cigna, Anthem, Regence, Premera and Kaiser. Aetna’s median is $46.73 per 5 mg unit against Medicare’s $45.687, putting a 300 mg dose at $2,803.80 before benefits. Rates move by state as well as by payer, which is why the estimator above takes one. What the patient owes then depends on their specific benefits. Full explanation: How commercial drug reimbursement works →

Medicare pays the same ASP+6% rate for the Xolair drug itself no matter where it's given. Xolair is a short in-office subcutaneous injection, not an infusion, so most buy-and-bill claims are under the physician fee schedule's injection code (96372) rather than a hospital-outpatient facility fee. Our coverage corpus shows 14 of 28 omalizumab policy sets carry a site-of-care rule, most of them requiring the first several doses in a clinical setting before self-administration is allowed. Our data doesn't carry a Xolair-specific hospital-outpatient facility rate, so this estimator only prices the office/physician-fee-schedule path.

Place of service (POS) is what drives that rate split. POS 11 (office) prices the admin code at the non-facility physician fee schedule rate, which is the path this estimator prices. A site-of-care rule that sends the same claim to POS 19 (off-campus hospital outpatient), POS 22 (hospital outpatient) or POS 24 (ambulatory surgical center) moves the admin code to the facility rate instead, a different number for the same CPT code. Confirm the POS on the claim before comparing an admin-fee estimate against what a payer actually paid.

Xolair's label has allowed self-administration since 2021, once a patient has taken at least three doses under supervision with no hypersensitivity reaction and can recognize and treat anaphylaxis. A self-injected dose moves off the medical benefit entirely: no J2357 claim, no 96372 line, and no ASP-based reimbursement to estimate here. The drug is dispensed through the pharmacy benefit instead, and what the patient owes is set by that plan's specialty-tier copay or coinsurance, not by this page's numbers.

The Q2 2026 rate ($41.82) applied to a 300 mg dose is $2,509.20 — a figure that still shows up on outdated pages. The current Q4 2026 rate applied to the same 300 mg dose is $2,741.22. Use the quarter that is actually in effect for the claim's date of service.

On a commercial plan, the Xolair Copay Card can take the drug copay down to $5 per dose, up to $15,000 a year — on the 300 mg example above, that is nearly all of the coinsurance the estimator shows. It does not touch the administration line, and it excludes Medicare, Medicaid and other federal program patients. An uninsured patient at or below 400% of the federal poverty level can instead apply to Genentech Access Solutions for the drug free of charge; that program covers the drug cost only, and administration is still billed separately.

On Medicare, no manufacturer program touches the coinsurance — a diagnosis-matched foundation fund is the only path, when one is open. Right now none is: HealthWell’s Asthma fund ($4,500/year) and Urticaria fund ($4,000/year) both closed June 11, 2026, and PAN Foundation’s Asthma fund ($3,500/year) closed July 30, 2026. No open foundation fund covers Xolair today. See every program for this patient, with current status →

Sources: CMS ASP pricing files (Q4 2026); Medicare physician fee schedule (96372, national non-facility); Medicare Part B deductible (2026); Medicare Rights Center 2026 Medigap plan benefits chart; 37 commercial payer published price files (Q2 2026); Xolair Copay Card and Genentech Access Solutions terms and status (public/programs-bundle.js, generated from the live programs corpus).

Reviewed September 20, 2026 by Erin Rose, CareCost Estimate founder. Methodology →