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.
28 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| HC ANTIBODY, WEST NILE VIRUS, EACH Inpatient | 86789 CPT | $105 | $57.75 | $63.00 – $92.40 | — | |
| HC BABESIA MICROTI PROTOZOA ANTIBODY Inpatient | 86753 CPT | $66.00 | $36.30 | $39.60 – $58.08 | — | |
| HC E HISTOLYTICA PROTOZOA ANTIBODY NOS Inpatient | 86753 CPT | $71.00 | $39.05 | $42.60 – $62.48 | — | |
| HC FTA TREPONEMA PALLIDUM ANTIBODY Inpatient | 86780 CPT | $59.00 | $32.45 | $35.40 – $51.92 | — | |
| HC HEP B CORE ANTIBODY IGM Inpatient | 86705 CPT | $99.00 | $54.45 | $59.40 – $87.12 | — | |
| HC HEPATITIS A ANTIBODY (HAAB) Inpatient | 86708 CPT | $71.00 | $39.05 | $42.60 – $62.48 | — | |
| HC HEPATITIS A ANTIBODY (HAAB), IGM ANTIBODY Inpatient | 86709 CPT | $64.00 | $35.20 | $38.40 – $56.32 | — | |
| HC HEPATITIS B CORE ANTIBODY TOTAL Inpatient | 86704 CPT | $69.00 | $37.95 | $41.40 – $60.72 | — | |
| HC HEPATITIS E (HEV) EACH, ANTIBODY, VIRUS, NES Inpatient | 86790 CPT | $157 | $86.35 | $94.20 – $138 | — | |
| HC HIV-1 & HIV-2 SINGLE ASSAY Inpatient | 86703 CPT | $85.00 | $46.75 | $51.00 – $74.80 | — | |
| HC HIV-2 ANTIBODY DIFFERENTIATION (MULTISPOT) Inpatient | 86702 CPT | $52.00 | $28.60 | $31.20 – $45.76 | — | |
| HC HUMAN HERPES 6 AB IGM, AB, VIRUS, NES Inpatient | 86790 CPT | $520 | $286 | $312 – $458 | — | |
| HC LEGIONELLA PNEUMOPHILIA AB 1-6 IGM Inpatient | 86713 CPT | $315 | $173 | $189 – $277 | — | |
| HC PARVOVIRUS IGG ANTIBODY Inpatient | 86747 CPT | $123 | $67.65 | $73.80 – $108 | — | |
| HC POWASSAN, ANTIBODY, VIRUS, NOS, EACH Inpatient | 86790 CPT | $411 | $226 | $247 – $362 | — | |
| HC RABIES, ANTIBODY, VIRUS, NES Inpatient | 86790 CPT | $305 | $168 | $183 – $268 | — | |
| HC RICKETTSIA ANTIBODY (1) Inpatient | 86757 CPT | $62.00 | $34.10 | $37.20 – $54.56 | — | |
| HC RUBELLA ANTIBODY Inpatient | 86762 CPT | $123 | $67.65 | $73.80 – $108 | — | |
| HC RUBEOLA (MEASLES) IGM ANTIBODY (1) Inpatient | 86765 CPT | $22.00 | $12.10 | $13.20 – $19.36 | — | |
| HC TOTAL QUANT SPIKE, ANTIBODY, SARS-COV-2 Inpatient | 86769 CPT | $118 | $64.90 | $70.80 – $104 | — | |
| HC TOXOPLASMA ANTIBODY Inpatient | 86777 CPT | $68.00 | $37.40 | $40.80 – $59.84 | — | |
| HC TOXOPLASMA CSF IGM ANTIBODY Inpatient | 86778 CPT | $151 | $83.05 | $90.60 – $133 | — | |
| HC TOXOPLASMA GONDII IGG ANTIBODY Inpatient | 86777 CPT | $52.00 | $28.60 | $31.20 – $45.76 | — | |
| HC TOXOPLASMA IGM ANTIBODY (1) Inpatient | 86778 CPT | $123 | $67.65 | $73.80 – $108 | — | |
| HC VARICELLA-ZOSTER ANTIBODY Inpatient | 86787 CPT | $109 | $59.95 | $65.40 – $95.92 | — | |
| HC VARICELLA-ZOSTER IGM ANTIBODY Inpatient | 86787 CPT | $109 | $59.95 | $65.40 – $95.92 | — | |
| HC WEST NILE VIRUS IGG ANTIBODY Inpatient | 86789 CPT | $117 | $64.35 | $70.20 – $103 | — | |
| HC WEST NILE VIRUS IGM ANTIBODY Inpatient | 86788 CPT | $130 | $71.50 | $78.00 – $114 | — |