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)
BALANCED SALT SOLN NO.2 IRRIG. INTRAOCULAR SOLN [35037] Inpatient	0250 RC	$25.54	$15.33	$8.83 – $24.03	—
CALCIUM GLUCONATE 0.465 MEQ/ML (10%) INTRAVENOUS SOLN [300372] Inpatient	J0612 HCPCS	$45.68	$27.41	$15.80 – $42.98	—
HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML INTRAMUSC SYRG [89696] Inpatient	90371 CPT	$318	$191	$110 – $300	—
HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML (5 ML) INTRAMUSC SOLN [89694] Inpatient	90371 CPT	$528	$317	$183 – $497	—
HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML INTRAMUSC SOLN [89626] Inpatient	90371 CPT	$300	$180	$104 – $283	—
HEPATITIS B IMMUNE GLOBULIN 220 UNIT/ML INTRAMUSC SYRG [89625] Inpatient	90371 CPT	$300	$180	$104 – $283	—
HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML INTRAMUSC SOLN [90841] Inpatient	90371 CPT	$482	$289	$167 – $454	—
HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML INTRAMUSC SOLN [90837] Inpatient	90371 CPT	$300	$180	$104 – $283	—
MAGNESIUM SULFATE 50 % (500 MG/ML) INJECTION SOLN [300377] Inpatient	J3475 HCPCS	$15.00	$9.00	$5.19 – $14.12	—