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.
9 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| AMOBARBITAL 500 MG INJECTION SOLR [10098] Inpatient | J0300 HCPCS | $145 | $87.09 | $50.19 – $137 | — | |
| BCG LIVE 50 MG INTRAVESICAL SUSR [12267] Inpatient | J9030 HCPCS | $113 | $67.86 | $39.11 – $106 | — | |
| CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLR [17030] Inpatient | J0697 HCPCS | $15.00 | $9.00 | $5.19 – $14.12 | — | |
| DIPHENHYDRAMINE HCL 50 MG/ML INJECTION SOLN [10307] Inpatient | J1200 HCPCS | $10.00 | $6.00 | $3.46 – $9.41 | — | |
| IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRG [80305] Inpatient | J1740 HCPCS | $1,389 | $834 | $480 – $1,307 | — | |
| PALIPERIDONE PALMITATE 117 MG/0.75 ML INTRAMUSC SYRG [103023] Inpatient | J2426 HCPCS | $5,740 | $3,444 | $1,985 – $5,401 | — | |
| PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSC SYRG [103024] Inpatient | J2426 HCPCS | $7,653 | $4,592 | $2,647 – $7,202 | — | |
| PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSC SYRG [103025] Inpatient | J2426 HCPCS | $11,480 | $6,888 | $3,970 – $10,802 | — | |
| PALIPERIDONE PALMITATE 39 MG/0.25 ML INTRAMUSC SYRG [103021] Inpatient | J2426 HCPCS | $1,913 | $1,148 | $662 – $1,800 | — |