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.
8 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| CALCIUM CHLORIDE NICU/PEDI INJECTION 100 MG/ML [300659] Inpatient | 0250 RC | $92.19 | $55.32 | $31.88 – $86.75 | — | |
| CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLN [14473] Inpatient | J9065 HCPCS | $1,436 | $861 | $496 – $1,351 | — | |
| LEVOTHYROXINE 100 MCG INTRAVENOUS SOLR [113876] Inpatient | J0650 HCPCS | $95.02 | $57.02 | $32.86 – $89.41 | — | |
| LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLN [143970] Inpatient | J0651 HCPCS | $79.82 | $47.90 | $27.60 – $75.11 | — | |
| LEVOTHYROXINE 200 MCG INTRAVENOUS SOLR [10714] Inpatient | J0650 HCPCS | $95.02 | $57.02 | $32.86 – $89.41 | — | |
| LEVOTHYROXINE 40 MCG/ML INTRAVENOUS SOLN [143971] Inpatient | J0651 HCPCS | $99.78 | $59.87 | $34.50 – $93.89 | — | |
| LEVOTHYROXINE 500 MCG INTRAVENOUS SOLR [11108] Inpatient | J0650 HCPCS | $1,045 | $627 | $361 – $984 | — | |
| LIDOCAINE-DIPHENHYD-AL-MAG-SIM 67-8-133-13 MG/10 ML MUCOUS MEMBR MWSH [300656] Inpatient | 0250 RC | $63.52 | $38.12 | $21.97 – $59.77 | — |