BAYLOR SCOTT & WHITE PAVILION - TEMPLE — price list

← Hospital overviewVerified from BAYLOR SCOTT & WHITE PAVILION - TEMPLE’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.

202 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
acamprosate 333 mg tablet,delayed release Inpatient	63700001 CDM	$1.64	$0.98	$0.90 – $1.15	—
acamprosate 333 mg tablet,delayed release Outpatient	63700001 CDM	$1.64	$0.98	$0.90 – $1.15	—
acarbose 50 mg tablet Inpatient	63700001 CDM	$1.02	$0.61	$0.56 – $0.71	—
acarbose 50 mg tablet Outpatient	63700001 CDM	$1.02	$0.61	$0.56 – $0.71	—
acetaminophen 120 mg rectal suppository Inpatient	63700001 CDM	$0.62	$0.37	$0.34 – $0.43	—
acetaminophen 120 mg rectal suppository Outpatient	63700001 CDM	$0.62	$0.37	$0.34 – $0.43	—
acetaminophen 120 mg-codeine 12 mg/5 mL (5 mL) oral solution,acetaminophen 120 mg-codeine 12 mg/5 mL oral solution Inpatient	63700001 CDM	$3.17	$1.90	$1.74 – $2.22	—
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	$1.74 – $2.22	—
acetaminophen 120 mg-codeine 12 mg/5 mL oral solution Inpatient	63700001 CDM	$3.09	$1.85	$1.70 – $2.16	—
acetaminophen 120 mg-codeine 12 mg/5 mL oral solution Outpatient	63700001 CDM	$3.09	$1.85	$1.70 – $2.16	—
acetaminophen 160 mg/5 mL (5 mL) oral solution Inpatient	63700001 CDM	$3.24	$1.94	$1.78 – $2.27	—
acetaminophen 160 mg/5 mL (5 mL) oral solution Outpatient	63700001 CDM	$3.24	$1.94	$1.78 – $2.27	—
acetaminophen 160 mg/5 mL oral liquid Inpatient	63700001 CDM	$8.51	$5.11	$4.68 – $5.96	—
acetaminophen 160 mg/5 mL oral liquid Outpatient	63700001 CDM	$8.51	$5.11	$4.68 – $5.96	—
acetaminophen 300 mg-codeine 30 mg tablet Inpatient	63700001 CDM	$3.36	$2.02	$1.85 – $2.35	—
acetaminophen 300 mg-codeine 30 mg tablet Outpatient	63700001 CDM	$3.36	$2.02	$1.85 – $2.35	—
acetaminophen 32 mg/mL oral syringe (FOR ORAL USE ONLY) Inpatient	63700001 CDM	$0.09	$0.05	$0.05 – $0.06	—
acetaminophen 32 mg/mL oral syringe (FOR ORAL USE ONLY) Outpatient	63700001 CDM	$0.09	$0.05	$0.05 – $0.06	—
acetaminophen 325 mg rectal suppository Inpatient	63700001 CDM	$1.40	$0.84	$0.77 – $0.98	—
acetaminophen 325 mg rectal suppository Outpatient	63700001 CDM	$1.40	$0.84	$0.77 – $0.98	—
acetaminophen 325 mg/10.15 mL oral suspension Inpatient	63700001 CDM	$1.97	$1.18	$1.08 – $1.38	—
acetaminophen 325 mg/10.15 mL oral suspension Outpatient	63700001 CDM	$1.97	$1.18	$1.08 – $1.38	—
acetaminophen 650 mg rectal suppository Inpatient	63700001 CDM	$0.56	$0.34	$0.31 – $0.39	—
acetaminophen 650 mg rectal suppository Outpatient	63700001 CDM	$0.56	$0.34	$0.31 – $0.39	—
acetaminophen 650 mg/20.3 mL oral solution Inpatient	63700001 CDM	$0.28	$0.17	$0.15 – $0.20	—
acetaminophen 650 mg/20.3 mL oral solution Outpatient	63700001 CDM	$0.28	$0.17	$0.15 – $0.20	—
acetaminophen 80 mg chewable tablet Inpatient	63700001 CDM	$0.13	$0.08	$0.07 – $0.09	—
acetaminophen 80 mg chewable tablet Outpatient	63700001 CDM	$0.13	$0.08	$0.07 – $0.09	—
acetaZOLAMIDE ER 500 mg capsule,extended release Inpatient	63700001 CDM	$2.50	$1.50	$1.38 – $1.75	—
acetaZOLAMIDE ER 500 mg capsule,extended release Outpatient	63700001 CDM	$2.50	$1.50	$1.38 – $1.75	—