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.
9 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| diatrizoate meglumine and diatrizoate sodium 66-10 % Solution 30 mL Bottle Inpatient | Q9963 HCPCS | $89.63 | $49.30 | $44.82 – $78.87 | — | |
| HC HYDRATION IV INFUSION, EACH ADDITIONAL HOUR (ADD ON CODE) Inpatient | 96361 CPT | $175 | $96.25 | $105 – $154 | — | |
| HC HYDRATION IV INFUSION, INITIAL, 31-60 MIN Inpatient | 96360 CPT | $648 | $356 | $389 – $570 | — | |
| HC THER/PROPH/DX INJ, EACH ADDL SEQUENTL IV PUSH NEW SUBST/DRUG (ADD) Inpatient | 96375 CPT | $164 | $90.20 | $98.40 – $144 | — | |
| HC THER/PROPH/DX INJ, IV PUSH, SINGLE OR INITIAL SUBSTANCE/DRUG Inpatient | 96374 CPT | $340 | $187 | $204 – $299 | $200 | |
| HC THER/PROPH/DX INJ, SUBCUTANEOUS OR INTRAMUSCULAR Inpatient | 96372 CPT | $202 | $111 | $121 – $178 | — | |
| HC THER/PROPH/DX IV INFUS, ADL SEQUENTL INFUS NEW DRG/SUBST,UP TO 1HR (ADD) Inpatient | 96367 CPT | $230 | $127 | $138 – $202 | — | |
| HC THER/PROPH/DX IV INFUS, EACH ADDITIONAL HOUR (ADD ON CODE) Inpatient | 96366 CPT | $160 | $88.00 | $96.00 – $141 | — | |
| HC THER/PROPH/DX IV INFUS, INITIAL, UP TO 1 HOUR Inpatient | 96365 CPT | $719 | $395 | $431 – $633 | $375 |