Froedtert Holy Family Memorial Hospital — price list
← Hospital overviewVerified from Froedtert Holy Family 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.
6 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| carvedilol 3.125 MG Tab 100 Each Box Inpatient | 0250 RC | $8.27 | $4.55 | $4.96 – $7.28 | — | |
| DOBUTamine 12.5 MG/ML Solution 20 mL Vial Inpatient | J1250 HCPCS | $77.05 | $42.38 | $38.53 – $67.80 | — | |
| filgrastim-ayow 480 mcg/0.8mL Solution Prefilled Syringe 0.8 mL Syringe Inpatient | Q5125 HCPCS | $1,414 | $778 | $707 – $1,245 | — | |
| HC GJB2 SEQUENCE ANALYSIS, COMMON VAR Inpatient | 81254 CPT | $152 | $83.60 | $91.20 – $134 | — | |
| HC HEMOCHROMATOSIS DNA GENE ANALYSIS Inpatient | 81256 CPT | $556 | $306 | $334 – $489 | — | |
| HC IMMUNOASSAY TUMOR CA 125 Inpatient | 86304 CPT | $118 | $64.90 | $70.80 – $104 | — |