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.

362 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
AA 3% NO.2 PED-D10-CALCIUM-HEP 3 %-10 %- 2.33 MEQ/250 ML INTRAVENOUS SOLP [137856] Inpatient	0258 RC	$169	$101	$58.40 – $159	—
AA 5%-D15W-ELECTROLYTES 5 % INTRAVENOUS SOLP [17829] Inpatient	0258 RC	$306	$184	$106 – $288	—
ACETAMINOPHEN 32 MG/ML ORAL SYRG [122282] Inpatient	0250 RC	$2.62	$1.58	$0.91 – $2.47	—
ACETIC ACID (BULK) 3 % MISC SUPL LIQD [96293] Inpatient	0250 RC	$218	$131	$75.30 – $205	—
ACETIC ACID 0.25 % IRRIGATION SOLN [14902] Inpatient	0250 RC	$50.00	$30.00	$17.29 – $47.05	—
ACETIC ACID 0.25 % RT IRRIGATION SOLN [300489] Inpatient	0250 RC	$50.00	$30.00	$17.29 – $47.05	—
ACETIC ACID 2 % OTIC SOLN [1301] Inpatient	0250 RC	$70.01	$42.01	$24.21 – $65.88	—
ACETONE MISC SUPL LIQD [12392] Inpatient	0250 RC	$5.00	$3.00	$1.73 – $4.71	—
ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT [14944] Inpatient	0250 RC	$67.54	$40.53	$23.36 – $63.56	—
ACETYLCYSTEINE 100 MG/ML (10 %) MISC SUPL SOLN [14673] Inpatient	0250 RC	$2.00	$1.20	$0.69 – $1.88	—
ACETYLCYSTEINE 200 MG/ML (20 %) MISC SUPL SOLN [1058] Inpatient	0250 RC	$29.45	$17.67	$10.18 – $27.71	—
ACETYLCYSTEINE 200 MG/ML ORAL SOLUTION [300447] Inpatient	0250 RC	$29.45	$17.67	$10.18 – $27.71	—
ACIDOPHILUS-SPOROGENES 35 MILLION- 25 MILLION CELL ORAL TAB [37918] Inpatient	0250 RC	$1.00	$0.60	$0.35 – $0.94	—
ACTIVATED CHARCOAL 50 GRAM/240 ML ORAL SUSP [36414] Inpatient	0250 RC	$20.79	$12.48	$7.19 – $19.56	—
ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML ORAL SUSP [36412] Inpatient	0250 RC	$41.58	$24.95	$14.38 – $39.13	—
ALFENTANIL 500 MCG/ML INJECTION SOLN [9128] Inpatient	0250 RC	$39.98	$23.99	$13.83 – $37.62	—
ALPHA-1 PROTEINASE INHIB.(HUM) 1 GRAM/50 ML (2 %) INTRAVENOUS SOLN [108371] Inpatient	J0257 HCPCS	$56,400	$33,840	$19,503 – $53,072	—
ALPHA-1 PROTEINASE INHIB.(HUM) 1,000 MG (+/-)/20 ML INTRAVENOUS SOLN [139617] Inpatient	J0256 HCPCS	$10,609	$6,365	$3,669 – $9,983	—
ALPROSTADIL 1,000 MCG IURT SUPP [17327] Inpatient	0250 RC	$142	$85.07	$49.02 – $133	—
ALUM, AMMONIUM (BULK) MISC SUPL POWD [4146] Inpatient	0250 RC	$48.65	$29.19	$16.82 – $45.78	—
ALVIMOPAN 12 MG ORAL CAP [98783] Inpatient	0250 RC	$327	$196	$113 – $308	—
AMINO AC 4.25% NO.1-D5W-LYTES 4.25 % INTRAVENOUS SOLP [153554] Inpatient	0258 RC	$312	$187	$108 – $294	—
AMINO ACID 10 % 10 % INTRAVENOUS SOLP [1816] Inpatient	0250 RC	$149	$89.25	$51.44 – $140	—
AMINO ACID 10 % NEONATAL INTRAVENOUS SOLUTION [300819] Inpatient	0258 RC	$708	$425	$245 – $666	—
AMINO ACID 4.25 % IN D5W 4.25 % INTRAVENOUS SOLP [15105] Inpatient	0258 RC	$293	$176	$101 – $275	—
AMINO ACID 4.25%-DEXTROSE 10 % 4.25 % INTRAVENOUS SOLP [5600] Inpatient	0258 RC	$293	$176	$101 – $275	—
AMINO ACID 5 % IN 15% DEXTROSE 5 % INTRAVENOUS SOLP [18889] Inpatient	0258 RC	$312	$187	$108 – $294	—
AMINO ACID 5 %-DEXTROSE 20 % 5 % INTRAVENOUS SOLP [5576] Inpatient	0258 RC	$319	$191	$110 – $300	—
AMINO ACIDS 2.75%-LYTES-CA-D5W 2.75 % INTRAVENOUS SOLP [1617] Inpatient	0258 RC	$172	$103	$59.56 – $162	—
AMINO ACIDS 3%-LYTES-GLYCERIN 3 % INTRAVENOUS SOLP [24144] Inpatient	0250 RC	$50.00	$30.00	$17.29 – $47.05	—