Texas Health Arlington Memorial Hospital — price list

← Hospital overviewVerified from Texas Health Arlington Memorial Hospital’s published price file

Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.

How to read these columns

List: The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
Cash: The discounted self-pay price for paying directly, without insurance.
Negotiated: Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.

These are the hospital’s published reference prices, not a personalized estimate of your bill.

12 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLN [109277] Inpatient	J0131 HCPCS	$185	$111	$63.83 – $174	—
ACETAMINOPHEN 10 MG/ML NEONATAL INTRAVENOUS SOLN [300637] Inpatient	J0131 HCPCS	$130	$78.09	$45.00 – $122	—
ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLN [35253] Inpatient	J0132 HCPCS	$360	$216	$124 – $339	—
ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLN [4257] Inpatient	J0133 HCPCS	$85.73	$51.44	$29.65 – $80.67	—
ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS PNKT [87843] Inpatient	J0135 HCPCS	$11,422	$6,853	$3,950 – $10,748	—
ADALIMUMAB 40 MG/0.8 ML SUBCUTANEOUS SYKT [27477] Inpatient	J0135 HCPCS	$11,422	$6,853	$3,950 – $10,748	—
ALTEPLASE 100 MG INTRAVENOUS SOLR [10139] Inpatient	J2997 HCPCS	$29,041	$17,425	$10,042 – $27,328	—
DARBEPOETIN ALFA IN POLYSORBAT 150 MCG/0.3 ML INJECTION SYRG [88013] Inpatient	J0881 HCPCS	$3,831	$2,299	$1,325 – $3,605	—
Detox Inpatient	0136 RC	—	—	$1,275 – $1,700	—
EVEROLIMUS (ANTINEOPLASTIC) 10 MG ORAL TAB [101377] Inpatient	J7527 HCPCS	$600	$360	$208 – $565	—
EVEROLIMUS (ANTINEOPLASTIC) 5 MG ORAL TAB [101376] Inpatient	J7527 HCPCS	$1,200	$720	$415 – $1,129	—
FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLN [102623] Inpatient	Q0138 HCPCS	$3,939	$2,363	$1,362 – $3,707	—