Amiodarone is a rare thing in American pharmacy: a drug where the pills are almost free and the paperwork around them is expensive. A month of 200 mg tablets costs a pharmacy about $3.62. The tests the label attaches to that prescription cost hundreds of dollars a year, every year, for as long as you take it.
That is why this page prices the therapy rather than the tablet. If you are uninsured and about to start amiodarone for atrial fibrillation or a ventricular arrhythmia, the number you need is the annual total, and almost every price guide online gives you only the cheapest tenth of it. Every figure below was researched on September 4, 2026.
What Does Amiodarone Cost Without Insurance?
Drug acquisition costs come from the CMS National Average Drug Acquisition Cost survey, effective August 19, 2026. Lab fee schedule figures come from the CMS Clinical Laboratory Fee Schedule for CY2026 Q3. Billed-charge and allowed-amount figures are 2024 national averages from CMS’s Medicare Physician and Other Practitioners by Geography and Service dataset, released May 21, 2026. Retail prices come from Drugs.com, Cost Plus Drugs and Walmart, all read September 4, 2026.
| Item | Low (allowed amount or acquisition cost) | Typical | High (average billed charge) |
|---|---|---|---|
| Amiodarone 200 mg, 30-day supply | $3.62 (CMS acquisition cost) | $7.90 (Cost Plus Drugs) | $9.25 (Drugs.com retail) |
| Amiodarone 200 mg, one year of drug | $44.01 | $94.80 | $111.00 |
| Thyroid panel, TSH plus free T4, one draw | $25.26 | $25.82 (fee schedule) | $183.09 |
| Hepatic function panel (CPT 80076), one draw | $7.99 | $8.17 (fee schedule) | $44.28 |
| Chest X-ray, 2 views (CPT 71046), one study | $23.13 | $23.13 | $89.42 |
| Comprehensive eye exam (CPT 92014), one visit | $124.79 | $124.79 | $226.69 |
| Follow-up office visit (CPT 99214), one visit | $119.71 | $119.71 | $276.45 |
| Baseline pulmonary function tests (CPT 94010 + 94729) | $76.52 | $76.52 | $247.20 |
| Monitoring bundle, one year | $476.97 (every 6 months) | $829.15 (every 3 months) | $2,599.65 (every 3 months) |
| Total, one year of amiodarone therapy | $521 | $924 | $2,711 |
The monitoring bundle is built directly from the label. Pacerone’s prescribing information instructs prescribers to obtain a baseline chest X-ray and pulmonary function tests including diffusion capacity when therapy starts, then to repeat the history, physical exam and chest X-ray every 3 to 6 months. It also calls for baseline and periodic liver transaminases, thyroid function monitoring before treatment and periodically thereafter, and regular ophthalmic examination including funduscopy and slit-lamp examination.
Two cadences bracket the cost. At the six-month end of the label’s window, the annual bundle is two office visits, two chest X-rays, two thyroid panels, two liver panels and one comprehensive eye exam, which is $476.97 at Medicare-allowed rates and $1,413.17 at average billed charges. At the three-month end it is $829.15 and $2,599.65. The first year adds baseline pulmonary function testing on top.
What Drives the Price
The drug is the rounding error. A year of 200 mg tablets is $44 at wholesale and $111 at the most common retail cash price. Even the most expensive plausible monitoring year is more than twenty times that. Any advice that stops at the pill price has answered the wrong question.
Billed charge versus negotiated rate, which on lab codes is enormous. Providers submit an average of $95.90 for a TSH that Medicare allows $16.44 for, and $87.19 for a free T4 Medicare allows $8.82 for. That is roughly a six-fold and a ten-fold gap. Chest imaging is tighter but still wide: $89.42 submitted against $23.13 allowed for a two-view chest X-ray in an office setting. Those ratios are the whole reason a cash payer who asks for a self-pay rate does so much better than one who does not.
Where the test is done. The same two-view chest X-ray averages $89.42 submitted in an office setting and $55.40 in a facility setting, and the allowed amounts run $23.13 and $10.26. Labs behave the same way. Our guides to X-ray costs without insurance and thyroid test costs cover how to shop each one on its own.
The eye exam, which is the single most expensive recurring line. A comprehensive established-patient eye exam (CPT 92014) allows $124.79 and is billed at an average of $226.69, more than the entire year of tablets either way. Our eye exam cost guide has the cash prices for the routine version, though amiodarone surveillance is a medical exam rather than a vision-plan refraction.
Which amiodarone and which strength. The 200 mg tablet is by far the cheapest per milligram at $0.12058 in CMS data. The 100 mg tablet is $0.38635 and the 400 mg is $0.39377, so the small tablet costs three times as much as the big one. At retail the same inversion shows up: Drugs.com lists 30 of the 100 mg tablets at $56.77 against $9.25 for 30 of the 200 mg.
Brand names, most of which are gone or hospital-only. Drugs@FDA lists Cordarone tablets and Cordarone injection as Discontinued. Pacerone, the Upsher-Smith branded tablet, is live and priced almost identically to the generic at the 200 mg strength ($0.12488 per tablet in CMS data against $0.12058, and $10.29 per 30 on Drugs.com against $9.25). At the 100 mg strength the brand premium is real: $98.09 per 30 against $56.77. Nexterone, Baxter’s premixed intravenous bag, is also live, but intravenous amiodarone reaches you as a line on a hospital bill rather than a prescription you fill. The generic intravenous vial costs $0.52115 per mL in CMS data, about $1.56 for a 150 mg/3 mL vial.
Cash Price vs. Insurance
On the drug itself, paying cash almost always beats running a claim. A $9 Walmart fill or a $7.90 Cost Plus fill is under most copays, and you keep the transaction out of your benefit entirely.
On the monitoring, the calculus flips. Lab and imaging charges are where insurance earns its keep, because the negotiated rate is a fraction of the submitted charge and you cannot get that discount by asking politely at the counter. If you have any coverage at all, use it for the tests even if you pay cash for the pills.
If you are fully self-pay, the thing that matters is asking for the self-pay rate up front, in advance, in writing. Hospitals publish their cash prices in machine-readable files, and our guide to hospital price transparency explains how to read one before you book. Run any quote you get through our fair price checker first.
One warning worth stating plainly: the monitoring is not optional in the sense that skipping it saves money. It exists because amiodarone carries thyroid, liver, lung and eye toxicity risks serious enough to sit in a boxed warning. This page is about what that surveillance costs and how to pay less for it, not about whether to have it.
How to Pay Less
-
Use the Walmart Prescription Program for the tablets. A coordinate-level read of the program drug list effective March 24, 2025 places amiodarone 200 mg in the $9 / $24 tier under Heart Health and Blood Pressure: $9 for 30 tablets and $24 for 90. That $24 works out to about $97 a year, and it requires no card, no coupon and no sign-up.
-
Or price a transparent mail pharmacy. Cost Plus Drugs lists the 200 mg tablet at $7.90 on its standard fill with a flat $5.00 shipping charge added at checkout, and the 400 mg at $19.77. A discount card is worth checking too; our comparison of GoodRx vs. SingleCare covers how to check more than one on the same prescription.
-
Bundle the labs into one draw and ask for the panel code. The hepatic function panel (CPT 80076) is a single $8.17 line on the Medicare fee schedule that covers seven liver analytes. Ordering the components separately costs far more for the same information. Ask whether the thyroid and liver work can be drawn at the same visit rather than on separate days, since each draw carries its own fees.
-
Shop the chest X-ray separately from the clinic that orders it. Imaging is portable. A freestanding imaging center’s cash price is often a fraction of a hospital outpatient department’s, and the order travels with you. Our X-ray cost guide has the current self-pay ranges.
-
Use a sliding-scale clinic for the visits. The follow-up office visit at an average billed charge of $276.45 is the largest single recurring line after the eye exam. A free or sliding-scale clinic can handle the visit, the refill and the lab orders on an income-based fee.
-
Negotiate whatever arrives anyway. With billed-to-allowed ratios of six to one on thyroid labs, there is real room in almost every bill. Our guide to negotiating medical bills has the scripts, and our negotiation script tool will draft one for a specific charge.
Bottom Line
Amiodarone costs about $44 to $111 a year as a drug and about $477 to $2,600 a year as a therapy. The gap between those two numbers is the point of this page, and it is the number that should go into your budget.
The cheapest path is unglamorous and works: take the $9 Walmart or $7.90 mail-order fill for the tablets, ask for a self-pay rate on every lab and X-ray before it is performed, keep the blood draws bundled, and treat the annual eye exam as a scheduled expense rather than a surprise. If you are on an anticoagulant alongside it, our warfarin cost guide tells a similar story about a cheap drug with an expensive monitoring tail, and if a beta blocker was added at the same visit, see our carvedilol cost guide.