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) | |
|---|---|---|---|---|---|---|
| BETAMETHASONE ACET,SOD PHOS 6 MG/ML INJECTION SUSP [9519] Inpatient | J0702 HCPCS | $31.42 | $18.86 | $10.87 – $29.57 | — | |
| DIPH,PERTUS(ACEL),TET PED (PF) 15-10-5 LF-MCG-LF/0.5ML INTRAMUSC SUSP [96430] Inpatient | 90700 CPT | $114 | $68.19 | $39.30 – $107 | — | |
| DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML INTRAMUSC SUSP [9189] Inpatient | 90700 CPT | $101 | $60.63 | $34.94 – $95.09 | — | |
| DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML INTRAMUSC SYRG [95610] Inpatient | 90700 CPT | $111 | $66.90 | $38.55 – $105 | — | |
| HYDROMORPHONE IN 0.9 % NACL 30 MG/30 ML INFUSION [300708] Inpatient | J1170 HCPCS | $65.66 | $39.40 | $22.71 – $61.79 | — | |
| HYDROXYZINE PAMOATE 25 MG ORAL CAP [20700] Inpatient | Q0177 HCPCS | $1.00 | $0.60 | $0.35 – $0.94 | — | |
| MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBCUTANEOUS SOLR [96729] Inpatient | 90707 CPT | $325 | $195 | $112 – $306 | — | |
| PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYIN [128070] Inpatient | J2506 HCPCS | $21,179 | $12,708 | $7,324 – $19,930 | — |