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.

11 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
DOXOrubicin liposome 2 MG/ML Suspension 10 mL Vial Inpatient	Q2050 HCPCS	$2,145	$1,180	$1,073 – $1,888	—
HC INJECTION(S), SINGLE OR MULTIPLE TRIGGER POINT(S), 3 OR MORE MUSCLES Inpatient	20553 CPT	$1,061	$584	$637 – $934	—
HC OT SP ONLY, DRY NEEDLING MAINTENANCE, 1 OR 2 MUSCLES Inpatient	20560 CPT	$50.00	$27.50	$30.00 – $44.00	—
HC OT SP ONLY, DRY NEEDLING MAINTENANCE, 3 OR MORE MUSCLES Inpatient	20561 CPT	$50.00	$27.50	$30.00 – $44.00	—
HC PT NEEDLE INSERTION(S) WITHOUT INJECTION(S) 3 OR MORE MUSCLES Inpatient	20561 CPT	$50.00	$27.50	$30.00 – $44.00	—
HC PT SP ONLY, DRY NEEDLING MAINTENANCE, 1 OR 2 MUSCLES Inpatient	20560 CPT	$50.00	$27.50	$30.00 – $44.00	—
HC PT SP ONLY, DRY NEEDLING MAINTENANCE, 3 OR MORE MUSCLES Inpatient	20561 CPT	$50.00	$27.50	$30.00 – $44.00	—
HC REMOVAL FOREIGN BODY, EXTERNAL EYE, CONJUCTIVAL SUPERFICIAL Inpatient	65205 CPT	$405	$223	$243 – $356	—
HC REPR, INTERM, WND FACE, EARS, EYLDS, NOSE, LIPS/MUC MEMBR, 12.6-20.0 CM Inpatient	12055 CPT	$2,800	$1,540	$1,680 – $2,464	—
HC SMEAR PRIM SRCE INTERP GM STAIN URIN EOSINOPHIL Inpatient	87205 CPT	$192	$106	$115 – $169	—
HC SMEAR PRIMARY SOURCE INTERP GRAM STAIN Inpatient	87205 CPT	$20.00	$11.00	$12.00 – $17.60	—