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.

16 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLN [28521] Inpatient	J0665 HCPCS	$10.00	$6.00	$3.46 – $9.41	—
BUPIVACAINE (PF) 0.5 % INJECTION SOLN NO DISPLAY STRENGTH [300406] Inpatient	J0665 HCPCS	$10.15	$6.09	$3.51 – $9.55	—
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLN [28522] Inpatient	J0665 HCPCS	$10.53	$6.32	$3.64 – $9.91	—
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLN [28523] Inpatient	J0665 HCPCS	$12.08	$7.25	$4.18 – $11.37	—
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLN [3894] Inpatient	J0665 HCPCS	$16.15	$9.69	$5.58 – $15.20	—
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLN [4752] Inpatient	J0665 HCPCS	$13.49	$8.10	$4.66 – $12.69	—
BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJECTION SOLN [28528] Inpatient	J0665 HCPCS	$13.00	$7.80	$4.50 – $12.23	—
COCAINE 4 % NASAL SOLN [140665] Inpatient	C9046 HCPCS	$882	$529	$305 – $830	—
DOCETAXEL 160 MG/8 ML (20 MG/ML) INTRAVENOUS SOLN [117066] Inpatient	J9171 HCPCS	$1,842	$1,105	$637 – $1,734	—
FENTANYL 800 MCG/SPRAY SUBLINGUAL SPRY [115066] Inpatient	0250 RC	$459	$275	$159 – $431	—
FLUZONE HIGHDOSE QUAD 23-24 PF 240 MCG/0.7 ML INTRAMUSC SYRG [157414] Inpatient	90662 CPT	$249	$149	$85.99 – $234	—
GENTAMICIN SULFATE 40 MG/ML INHALATION [300668] Inpatient	J1580 HCPCS	$10.00	$6.00	$3.46 – $9.41	—
HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML INJECTION SOLR [106066] Inpatient	J1720 HCPCS	$147	$88.37	$50.93 – $139	—
MEROPENEM-0.9% SODIUM CHLORIDE 1 GRAM/50 ML INTRAVENOUS PGBK [130661] Inpatient	J2185 HCPCS	$126	$75.38	$43.44 – $118	—
MEROPENEM-0.9% SODIUM CHLORIDE 500 MG/50 ML INTRAVENOUS PGBK [130660] Inpatient	J2185 HCPCS	$93.48	$56.09	$32.33 – $87.96	—
OPT WATER FOR INJECTION STERILE INTRAVENOUS BAG 1000 ML [300661] Inpatient	0250 RC	$50.00	$30.00	$17.29 – $47.05	—