Cost of Botox injections for migraine headaches

October 2, 2013

Botox injections is the only FDA-approved treatment for chronic migraine headaches. This is a very effective (works in 70% of chronic migraine patients) and very safe treatment. The only major drawback is its cost. However, there is a great variation in the cost from doctor to doctor and hospital to hospital. This post was prompted by an email I received from a former patient. Here are some excerpts from our exchange (with her permission):

“You’ve been my doctor now for many years, and I was just in your office over the summer for Botox treatment, but I live now in Charlottesville, VA and UVA’s hospital down here charges around $6000 for the same procedure that your office can do for $2250. With my insurance, I’m still responsible for 20% of the bill, and I can’t afford to have the procedure done here in Charlottesville.

They tell me it’s because they’re paying for facilities and staff, but even the drug is more than twice as much…THAT doesn’t make sense at all! This treatment has changed my life quite dramatically for the better. I’m so much healthier, more productive, creative, and all around a better citizen and human being as a result of not having constant headaches.”

Part of my response to her: “I am not surprised about the $6,000 price tag – I recently gave a lecture at Harvard and they also charge $6,000 and so do Mayo and Cleveland Clinics. They all also charge $2,000 for IV magnesium, while we charge $250.”

Our out-of-pocket fee for Botox injections is often only $1,700 and sometimes less, depending on the amount of Botox injected. However, the majority of our patients are covered by insurance and they have to pay only their usual copay. Almost all insurance plans now pay for Botox injections for chronic migraines, although they often require trials of prophylactic medications before they approve Botox.

Written by
Alexander Mauskop, MD
Continue reading
March 26, 2026
Alternative Therapies
Lidocaine-Based Treatments Offer Another Option for Severe Migraines
This post explains how lidocaine, beyond its traditional use as a local anesthetic, can be given by IV or directly into the middle meningeal artery to help break severe, treatment-resistant migraines, with early studies showing promising relief and generally mild, manageable side effects.
Read article
February 16, 2026
News
Potential big news for the 40 million Americans with migraine.
It is long overue to make triptans available without a prescription, like in the rest of the world.
Read article