BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH — price list

← Hospital overviewVerified from BAYLOR SCOTT & WHITE ALL SAINTS MEDICAL CENTER - FORT WORTH’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.

490 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
acamprosate 333 mg tablet,delayed release Outpatient	63700001 CDM	$1.64	$0.98	$0.26 – $1.23	—
acarbose 50 mg tablet Outpatient	63700001 CDM	$1.02	$0.61	$0.16 – $0.77	—
acetaminophen 120 mg rectal suppository Outpatient	63700001 CDM	$0.62	$0.37	$0.10 – $0.47	—
acetaminophen 120 mg-codeine 12 mg/5 mL (5 mL) oral solution,acetaminophen 120 mg-codeine 12 mg/5 mL oral solution Outpatient	63700001 CDM	$3.17	$1.90	$0.51 – $2.38	—
acetaminophen 120 mg-codeine 12 mg/5 mL oral solution Outpatient	63700001 CDM	$3.09	$1.85	$0.49 – $2.32	—
acetaminophen 160 mg/5 mL (5 mL) oral solution Outpatient	63700001 CDM	$3.24	$1.94	$0.52 – $2.43	—
acetaminophen 160 mg/5 mL oral liquid Outpatient	63700001 CDM	$8.51	$5.11	$1.36 – $6.38	—
acetaminophen 300 mg-codeine 30 mg tablet Outpatient	63700001 CDM	$3.36	$2.02	$0.54 – $2.52	—
acetaminophen 300 mg-codeine 60 mg tablet Outpatient	63700001 CDM	$4.16	$2.50	$0.67 – $3.12	—
acetaminophen 32 mg/mL oral syringe (FOR ORAL USE ONLY) Outpatient	63700001 CDM	$0.09	$0.05	$0.01 – $0.07	—
acetaminophen 325 mg rectal suppository Outpatient	63700001 CDM	$1.40	$0.84	$0.22 – $1.05	—
acetaminophen 325 mg tablet Outpatient	63700001 CDM	$0.03	$0.02	$0.00 – $0.02	—
acetaminophen 325 mg/10.15 mL oral suspension Outpatient	63700001 CDM	$1.97	$1.18	$0.32 – $1.48	—
acetaminophen 500 mg tablet Outpatient	63700001 CDM	$0.06	$0.04	$0.01 – $0.05	—
acetaminophen 650 mg rectal suppository Outpatient	63700001 CDM	$0.56	$0.34	$0.09 – $0.42	—
acetaminophen 650 mg/20.3 mL oral solution Outpatient	63700001 CDM	$0.28	$0.17	$0.04 – $0.21	—
acetaminophen 80 mg chewable tablet Outpatient	63700001 CDM	$0.13	$0.08	$0.02 – $0.10	—
acetaZOLAMIDE 250 mg tablet Outpatient	63700001 CDM	$0.70	$0.42	$0.11 – $0.53	—
acetaZOLAMIDE ER 500 mg capsule,extended release Outpatient	63700001 CDM	$2.50	$1.50	$0.40 – $1.88	—
activated charcoaL 25 gram oral suspension Outpatient	63700001 CDM	$28.24	$16.94	$4.52 – $21.18	—
activated charcoaL 25 gram/120 mL oral suspension,activated charcol 15 g/72 ml oral suspension,activated charcoal 50 gram/240 ml oral suspension Outpatient	63700001 CDM	$26.64	$15.98	$4.26 – $19.98	—
activated charcoal-sorbitoL 50 gram/240 mL oral suspension Outpatient	63700001 CDM	$60.00	$36.00	$9.60 – $45.00	—
activated charcoal-sorbitoL 50 gram/240 mL oral suspension,activated charcoal-sorbitoL 25 gram/120 mL oral suspension Outpatient	63700001 CDM	$60.00	$36.00	$9.60 – $45.00	—
albuterol sulfate 2.5 mg/3 mL (0.083 %) solution for nebulization Outpatient	63700001 CDM	$1.40	$0.84	$0.22 – $1.05	—
albuterol sulfate 90 mcg/actuation breath activated powder inhaler Outpatient	63700001 CDM	$137	$82.44	$21.98 – $103	—
albuterol sulfate concentrate 5 mg/mL(0.5 %) solution for nebulization Outpatient	63700001 CDM	$97.60	$58.56	$15.62 – $73.20	—
albuterol sulfate HFA 90 mcg/actuation aerosol inhaler Outpatient	63700001 CDM	$46.44	$27.86	$7.43 – $34.83	—
albuterol sulfate HFA 90 mcg/actuation aerosol inhaler,albuterol sulfate 90 mcg/actuation breath activated power inhaler Outpatient	63700001 CDM	$160	$96.28	$25.67 – $120	—
alfuzosin ER 10 mg tablet,extended release 24 hr Outpatient	63700001 CDM	$1.70	$1.02	$0.27 – $1.27	—
ALPRAZolam 0.25 mg tablet Outpatient	63700001 CDM	$0.10	$0.06	$0.02 – $0.08	—