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.
14 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| alemtuzumab 12 MG/1.2ML Solution 1.2 mL Vial Inpatient | J0202 HCPCS | $125,171 | $68,844 | $62,586 – $110,151 | — | |
| goserelin 3.6 MG Implant 1 Each Syringe Inpatient | J9202 HCPCS | $2,748 | $1,511 | $1,374 – $2,418 | — | |
| HC 0 MIN, ACTH ASSAY Inpatient | 82024 CPT | $60.00 | $33.00 | $36.00 – $52.80 | — | |
| HC 10 MIN, ACTH ASSAY Inpatient | 82024 CPT | $60.00 | $33.00 | $36.00 – $52.80 | — | |
| HC 120 MIN, ACTH ASSAY Inpatient | 82024 CPT | $60.00 | $33.00 | $36.00 – $52.80 | — | |
| HC 20 MIN, ACTH ASSAY Inpatient | 82024 CPT | $60.00 | $33.00 | $36.00 – $52.80 | — | |
| HC 30 MIN, ACTH ASSAY Inpatient | 82024 CPT | $60.00 | $33.00 | $36.00 – $52.80 | — | |
| HC 45 MIN, ACTH ASSAY Inpatient | 82024 CPT | $60.00 | $33.00 | $36.00 – $52.80 | — | |
| HC ACTH ASSAY Inpatient | 82024 CPT | $219 | $120 | $131 – $193 | — | |
| HC BIOPSY, BONE, TROCAR, OR NEEDLE, DEEP Inpatient | 20225 CPT | $4,814 | $2,648 | $2,888 – $4,236 | — | |
| HC DAILY SERVICE MICU Inpatient | 0202 RC | $4,882 | $2,685 | $2,929 – $4,296 | — | |
| HC RESPIRATORY EXTENDED NAAT PANEL, INFC DIS 22 TARGETS SARS-COV-2, RT-PCR Inpatient | 0202U CPT | $930 | $512 | $558 – $818 | — | |
| HC VANCOMYCIN ASSAY Inpatient | 80202 CPT | $97.00 | $53.35 | $58.20 – $85.36 | — | |
| HC VANCOMYCIN ASSAY, RANDOM Inpatient | 80202 CPT | $97.00 | $53.35 | $58.20 – $85.36 | — |