Hydroxyzine is one of those prescriptions where the drug itself is almost free and everything you pay is the machinery around it. A 25 mg tablet costs a pharmacy about three and a half cents. Medicare Part D covered 4.7 million hydroxyzine HCl claims in 2024 at an average of $15.71 each.
The wrinkle that sends people looking for a price is that hydroxyzine comes as two different salts with two different brand histories, and pharmacies file them as separate drugs. Hydroxyzine hydrochloride is the tablet, sold for decades as Atarax. Hydroxyzine pamoate is the capsule, sold as Vistaril. Every figure below was researched on September 4, 2026.
What Does Hydroxyzine Cost Without Insurance?
Acquisition costs come from the CMS National Average Drug Acquisition Cost survey, all rows effective August 19, 2026. Cash prices come from SingleCare (prices updated September 4, 2026) and Cost Plus Drugs, both read September 4, 2026. Medicare figures are 2024 claims from the CMS Part D Spending by Drug file.
| Option | Low | Average | High |
|---|---|---|---|
| CMS NADAC acquisition cost, one HCl tablet | $0.02856 (10 mg) | $0.03417 (25 mg) | $0.05831 (50 mg) |
| CMS NADAC acquisition cost, one pamoate capsule | $0.06269 (25 mg) | $0.08201 (50 mg) | $0.44458 (100 mg) |
| Discount card, 30 tablets or capsules of 25 mg | $4.95 (HCl) | $5.21 | $5.47 (pamoate) |
| Cost Plus Drugs, 30 HCl tablets | $5.59 (10 mg) | $6.38 (50 mg) | $6.52 (25 mg) |
| Cost Plus Drugs, 30 pamoate capsules | $6.59 (25 mg) | $6.93 (50 mg) | $15.94 (100 mg) |
| Average retail, no card, 30 of the 25 mg | $23.36 (pamoate) | $33.01 (HCl) | $40.00 (HCl) |
| CMS NADAC acquisition cost, oral solution 10 mg/5 mL | $13.07 (120 mL) | $26.14 (240 mL) | $51.51 (473 mL) |
| Medicare Part D 2024, average spend per claim | $12.08 (pamoate) | $15.71 (HCl oral) | $293.57 (HCl injection) |
Two things in that table do the most work. The first is that the card price and the Cost Plus price land within about two dollars of each other on the same 30 pills, which tells you the competitive floor for this drug is roughly $5 to $7 and there is not much room below it.
The second is the gap between that floor and the unhelped counter price. SingleCare’s own pages do not agree with each other on what retail is: the live hydroxyzine HCl page states a $33.01 average retail price for 30 of the 25 mg tablets, while its explainer articles put the same fill at “around $39” and “$40.” Take $33 to $40 as the honest cross-source range for paying with nothing, and treat any of those numbers as a reason to pull out a card rather than a market rate.
What Drives the Price
Which salt you were prescribed, at the wholesale level. In the August 2026 CMS file a 25 mg pamoate capsule costs a pharmacy $0.06269 against $0.03417 for a 25 mg HCl tablet, so the pamoate is about 1.8 times the acquisition cost. At 50 mg the gap narrows to 1.4 times ($0.08201 against $0.05831). These are the raw ingredient costs, and they are the reason a plan’s formulary may treat the two differently.
Which salt you were prescribed, at the counter. Here the effect nearly disappears, and it is worth understanding why. Cost Plus Drugs publishes its arithmetic: for 30 of the 25 mg HCl tablets it pays $1.32 for the drug, adds a 15% markup of $0.20 and a flat $5.00 pharmacy labor fee, for $6.52. For the pamoate capsules the drug costs $1.38, the markup is $0.21, and the same $5.00 labor fee applies, for $6.59. The dispensing work costs seventy-seven cents on the dollar. Salt chemistry costs six cents.
The 100 mg capsule is the real outlier. FDA lists marketed hydroxyzine HCl tablets only at 10, 25 and 50 mg, so if you need 100 mg in one pill it has to be a pamoate capsule. That capsule costs a pharmacy $0.44458, which is 5.4 times the 50 mg capsule and 13 times the 50 mg HCl tablet. Cost Plus charges $15.94 for 30 of them against $6.59 for the 25 mg. This is the one strength where the presentation genuinely moves your bill.
Liquid and injectable cost several times more than pills. The oral solution runs $0.10891 per mL of acquisition cost, so a 473 mL bottle is about $51.51 wholesale before any pharmacy markup. The injectable is a different market entirely: it does not appear in the retail NADAC survey at all, and in 2024 Part D data the one injectable labeler, American Regent, averaged $293.57 per claim and $25.48 per mL against $0.21 per oral dosage unit for everything else.
Not being a controlled substance. Hydroxyzine is not federally scheduled. There is no monitoring-program lookup at pickup, no federal refill cap, and nothing stopping a 90-day script or a mail pharmacy. Compare that with our Xanax cost guide and Klonopin cost guide, where scheduling rules force 30-day fills and local pickup and add real dollars per year.
Cash Price vs. Insurance
This is a textbook drug for skipping the pharmacy benefit. If your plan charges a $10 or $15 generic copay, a $4.95 card price wins outright, and you can decide fill by fill.
The usual tradeoff still applies and is worth saying plainly. Money spent outside your plan does not count toward your deductible or out-of-pocket maximum, and you cannot stack a discount card with insurance on the same prescription. On a five-dollar drug that lost credit almost never matters, though it can if you are also filling something expensive in the same year.
The insurance-side numbers are also unusually low here. Across 2024 Part D claims, hydroxyzine pamoate averaged $12.08 per claim and hydroxyzine HCl $15.71, both of which are close to what a cash payer with a card pays for a 30-day supply plus a dispensing fee. There is no large negotiated discount hiding behind the counter on this molecule, which is exactly why the cash route holds up.
If a pharmacy quotes you a number in the twenties or thirties, that is a contract artifact rather than the price of the drug. Run it through our fair price checker before you pay it.
How to Pay Less
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Price the card before you fill, and price both salts if your prescriber left it open. SingleCare’s hydroxyzine HCl page showed $4.95 for 30 of the 25 mg tablets against a $33.01 stated average retail price on September 4, 2026, and its pamoate page showed $5.47 for 30 of the 25 mg capsules against $23.36. Named-chain prices on those pages move between visits, so treat the per-pharmacy rows as an illustration of spread rather than a quote. Our comparison of GoodRx vs. SingleCare walks through pricing the same script both ways.
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Fill 90 days at once. Nothing about hydroxyzine restricts supply length, and every route charges its dispensing fee per fill. At Cost Plus that fee is an explicit $5.00 plus $5.25 of shipping, so one 90-day order instead of three 30-day orders saves roughly $20 a year on a drug that only costs about $60 a year in the first place.
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Use a transparent mail pharmacy if you want a published number instead of a quote. Cost Plus Drugs lists $6.52 for 30 of the 25 mg HCl tablets and $6.59 for 30 of the 25 mg pamoate capsules, plus $5.25 standard shipping, with the manufacturing cost, the 15% markup and the labor fee itemized on the page. That is about $11.80 delivered either way.
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Do not count on a $4 generic program. Walmart’s Prescription Program list, effective March 24, 2025 and read September 4, 2026, does not include hydroxyzine at any strength or in any of its three tiers ($4/$10, $9/$24, $15/$38). Ask the pharmacy to check your exact drug against the current list rather than assuming it qualifies.
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Ask about the pill strength if you take more than 25 mg at a time. Two 25 mg HCl tablets cost about seven cents of acquisition against six cents for one 50 mg tablet, so the strengths are close and it rarely matters. It matters at 100 mg, where the only single-pill option is the pamoate capsule at more than five times the per-unit cost of the 50 mg. Strength is a prescriber decision, not a pharmacy one, but it is a fair question to raise.
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Budget for the visit, not just the pills. The prescription is the cheap part; the appointment that produces it is not. A free or sliding-scale clinic can handle refills at little or no cost, and our psychiatrist cost guide and therapy cost guide cover what the visits themselves run. If a clinic bills you more than you expected, our guide to negotiating medical bills covers the next step.
Bottom Line
Budget about $5 to $7 for 30 of the 25 mg pills in either salt, or roughly $12 delivered from a transparent mail pharmacy, and treat anything above $20 as a reason to shop rather than a fact about the drug. The salt on your bottle is not the lever people expect it to be: at $0.03 and $0.06 a pill, the dispensing fee swamps the chemistry.
The genuinely expensive versions are the 100 mg pamoate capsule at $15.94 for 30, the oral liquid at roughly $51 wholesale for a 473 mL bottle, and the injectable at $293.57 per Part D claim. There is no brand tier to worry about, because FDA lists Vistaril and Atarax as discontinued in every form. If you also fill a second anxiety or sleep prescription, our buspirone cost guide, trazodone cost guide and gabapentin cost guide run the same arithmetic on those.