Xarelto is the brand name for rivaroxaban, an oral anticoagulant sold by Johnson & Johnson. Unlike its main competitor, it is usually taken once a day at the 20 mg maintenance strength, so a 30-tablet bottle is a 30-day supply and a 90-tablet bottle covers a quarter. That makes the pricing unusually easy to compare.
The 2026 picture is genuinely good news for cash payers. Johnson & Johnson publishes a flat self-pay price of $197 for a 30-day supply, the federal TrumpRx site lists the same number, and Medicare’s negotiated price landed at exactly $197 as well. Meanwhile a generic has arrived, but only in one strength. This guide prices all of it as verified on September 1, 2026.
What Does Xarelto Cost Without Insurance?
Manufacturer figures come from the J&J Direct price list on Johnson & Johnson’s own site. Federal figures come from TrumpRx and the CMS Maximum Fair Price data file. Counter prices come from SingleCare’s live Xarelto page, updated September 2, 2026.
| Option | Low | Average | High |
|---|---|---|---|
| Xarelto 10, 15, or 20 mg, 30 tablets, J&J Direct self-pay | $197.00 | $197.00 | $197.00 |
| Xarelto 10, 15, or 20 mg, 90 tablets, J&J Direct self-pay | $591.00 | $591.00 | $591.00 |
| Xarelto 30-day supply, TrumpRx original price before discount | $611.82 | $611.82 | $611.82 |
| Xarelto 30-day supply, Medicare negotiated price (Part D only) | $197.00 | $197.00 | $197.00 |
| Brand Xarelto 2.5 mg, 60 tablets, retail counter | $703.80 (Walgreens) | $710.70 (CVS) | $733.80 (Kroger) |
| Generic rivaroxaban 2.5 mg, 30 tablets, Cost Plus Drugs | $13.91 | $13.91 | $13.91 |
| Generic rivaroxaban 2.5 mg, 30 tablets, TrumpRx | $19.16 | $19.16 | $19.16 |
| Xarelto savings card, commercial insurance only | $10 | $10 | $10 |
Two numbers deserve a second look. The $197 self-pay price applies identically at 10 mg, 15 mg, and 20 mg, which is unusual and means dose changes will not change your bill. And the $611.82 figure on TrumpRx is the pre-discount reference price, so the site describes the offer as 68% off.
How the J&J Direct price works
J&J Direct is Johnson & Johnson’s direct-to-patient, self-pay program. Its published page describes it as serving patients who are uninsured, who face coverage and affordability gaps through their health plan, or who simply choose to pay out of pocket. That last clause matters: you do not have to be uninsured to use it.
The price list is specific down to the national drug code. Xarelto 10 mg, 15 mg, and 20 mg in 30-tablet bottles are all $197.00. The 90-tablet bottles of 10 mg, 15 mg, and 20 mg are all $591.00, which is exactly three times the monthly price with no bulk discount. You call J&J Direct at 1-855-522-3241 to transfer a valid prescription, and the medicine ships to your home.
TrumpRx, the federal drug pricing site, lists Xarelto at the same $197.00 and routes orders to J&J Direct. As of September 2026 TrumpRx carries a Xarelto page and a generic rivaroxaban page but does not list Eliquis or Entresto, so it is worth checking the site each time rather than assuming what is on it.
The generic exists, but only at 2.5 mg
Generic rivaroxaban is now on the U.S. market at the 2.5 mg strength, and it is cheap. Cost Plus Drugs sells 30 tablets for $13.91 against a stated retail comparison of $231.30. TrumpRx starts generic rivaroxaban at $19.16 for 30 tablets, $28.07 for 60, and $36.99 for 90.
But SingleCare’s page is blunt about the limit: Xarelto is available as a generic only in the 2.5 mg dose, and anyone who needs a higher strength is still buying brand. TrumpRx’s rivaroxaban page confirms it, offering only the 2.5 mg tablet. So the generic price is real but does not apply to the common 20 mg maintenance strength.
That single approval still had a large consequence. CMS’s Maximum Fair Price data file shows every Xarelto national drug code deselected from the Medicare Drug Price Negotiation Program with an end date of December 31, 2026, because a drug stops being a selected drug once a generic is approved and marketed. The 2027 inflation-adjusted price of $202.33 is on file but end-dated.
What Drives the Price
Which channel you buy through. J&J Direct at $197 versus a retail counter is the whole ballgame. SingleCare’s September 2026 data shows brand Xarelto at $703.80 to $733.80 for 60 tablets of the 2.5 mg strength at three major chains, with a national average of $805.58.
Brand versus generic, which here means strength. At 2.5 mg you can pay $13.91. At 20 mg you cannot buy a generic at any price in the U.S. as of September 2026.
Quantity. The J&J Direct 90-tablet price of $591 is exactly three months at the 30-tablet price, so there is no volume savings, only fewer transactions. At retail, per-tablet pricing does often improve at 90-day quantities, so check.
Your insurance status. The $10 savings card requires commercial insurance. The $197 Medicare price requires Part D. Cash payers get the $197 self-pay price, which happens to match.
The pharmacy itself. SingleCare’s generic rivaroxaban prices at 2.5 mg ranged from $31.27 at CVS to $493.20 at Albertsons for 60 tablets on the same day. A fifteen-fold spread on an identical generic is not a typo; it is what the U.S. pharmacy market looks like without shopping.
Cash Price vs. Insurance
If you have commercial insurance covering Xarelto, use the savings card. The manufacturer’s savings page says eligible patients may pay as little as $10 for up to a 90-day supply, subject to a limit on savings per fill and a maximum program benefit per calendar year. A free 30-day trial supply is also offered to eligible new patients.
If you are on Medicare, your number is $197 for a 30-day supply, effective January 1, 2026. CMS negotiated it down from a 2023 list price of $517, a 62% discount, and Xarelto was the third-largest drug in the first negotiation cycle at $6.3 billion in Part D gross covered drug costs across 1.3 million users in 2023. Because the drug has been deselected, that price is set to stop applying after 2026, which is a genuine planning point for anyone on Part D. Medicare, Medicaid, TRICARE, and VA beneficiaries cannot use the manufacturer savings card; the manufacturer’s own page points them to Extra Help, state pharmaceutical assistance programs, and independent copay foundations instead.
If you have no coverage at all, the $197 self-pay price is your realistic number, and it is one of the rare cases where the cash price for a brand-name drug matches what Medicare negotiated. Anything a pharmacy quotes you above that is worth challenging. Our fair price checker is a quick sanity check on any number you are given.
Johnson & Johnson also runs a patient assistance program. Its Xarelto cost page states that eligible uninsured patients, or those with coverage gaps, may receive medicine free of charge for up to one year, with enrollment through PatientAssistanceInfo.com or 833-742-0791.
How to Pay Less
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Call J&J Direct first. $197 for 30 tablets, shipped to your home, no insurance required and no membership. Against the $611.82 reference price TrumpRx shows, that is roughly $415 a month.
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Check TrumpRx before every refill. The federal site currently lists both brand Xarelto and generic rivaroxaban with published prices, and the lineup changes. It is free and takes under a minute.
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If you are on the 2.5 mg strength, buy the generic. Cost Plus Drugs lists 30 tablets at $13.91. Our comparison of GoodRx vs. SingleCare explains how to check discount-card prices on the same generic at your local pharmacies before you commit.
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Apply for patient assistance if the price is still out of reach. The Johnson & Johnson Patient Assistance Program can supply the medicine at no cost for up to a year to approved applicants.
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Price the rest of the care, not just the pill. A free or sliding-scale clinic can handle prescribing and follow-up at little or no cost, and a routine cash-pay doctor visit usually runs $100 to $300. Anticoagulant patients often need periodic blood work, so price that separately.
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Push back on a bill that ignores the published price. When a pharmacy or hospital charges far above what the manufacturer itself publishes, say so in writing. Our negotiation script has the wording.
Bottom Line
Budget $197 a month for Xarelto through J&J Direct, or $591 for a 90-day bottle. That is the same number Medicare negotiated, and it is available to anyone paying cash, insured or not. A retail counter without that program can charge three to four times as much for the same medicine.
Generic rivaroxaban is here but only at 2.5 mg, where it costs about $14 for 30 tablets. If you are on 10, 15, or 20 mg, the brand self-pay price is your floor for now. For the other oral anticoagulant that went through the same 2026 Medicare negotiation, see our guide to Eliquis, which currently runs $345 a month direct from its manufacturer. Which drug you take is a decision for you and your prescriber, not a price comparison. For the heart and diabetes drugs in the same negotiation cycle, see Entresto, Jardiance, and Farxiga.