Froedtert Menomonee Falls Hospital — price list

← Hospital overviewVerified from Froedtert Menomonee Falls 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.

1,500 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
0.9% NaCl (excel) 0.9 % Solution 250 mL Flex Cont Outpatient	0250 RC	$70.44	$38.75	$21.13 – $63.40	—
0.9% NaCl (excel) 0.9 % Solution 500 mL Flex Cont Outpatient	0250 RC	$77.38	$42.56	$23.21 – $69.64	—
0.9% NaCl (preservative free) 0.9% Solution 10 mL Vial Outpatient	0250 RC	$39.86	$21.93	$11.96 – $35.87	—
0.9% NaCl 0.9 % Solution 10 mL Syringe Outpatient	0250 RC	$6.17	$3.40	$1.85 – $5.55	—
0.9% NaCl 4 L Solution 4,000 mL Bag Outpatient	0250 RC	$119	$65.45	$35.70 – $107	—
0.9% NaCl with KCl 20 mEq solution 1000 mL 20-0.9 MEQ/L-% Solution 1,000 mL Flex Cont Outpatient	0258 RC	$204	$112	$61.20 – $184	—
2.4MM VOLT(TM) LOCKING SCREW 16MM T8 Outpatient	C1713 HCPCS	$800	$440	$240 – $720	$8,788
2.4MM VOLT(TM) LOCKING SCREW 18MM T8 Outpatient	C1713 HCPCS	$800	$440	$240 – $720	$8,788
6.5 X 4.5 SCREW SPINAL ELEMENTS Outpatient	C1713 HCPCS	$2,475	$1,361	$743 – $2,228	$8,788
6.5X50 C2 A0SCREW Outpatient	C1713 HCPCS	$2,475	$1,361	$743 – $2,228	$8,788
abobotulinumtoxinA 500 units Recon Soln 1 Each Vial Outpatient	J0586 HCPCS	$4,858	$2,672	$8.44 – $4,372	—
acebutolol 200 MG Cap 1 Each Blister Outpatient	0250 RC	$11.44	$6.30	$3.43 – $10.30	—
acetaminophen 10 mg/mL Solution 100 mL Vial Outpatient	J0131 HCPCS	$106	$58.08	$0.05 – $95.04	—
acetaminophen 120 MG Suppos 100 Each Box Outpatient	0250 RC	$4.88	$2.69	$1.46 – $4.39	—
acetaminophen 160 MG/5ML Solution 5 mL Cup Outpatient	0250 RC	$8.67	$4.77	$2.60 – $7.80	—
acetaminophen 325 MG Tab 100 Each Box Outpatient	0250 RC	$4.17	$2.30	$1.25 – $3.75	—
acetaminophen 500 MG Tab 100 Each Box Outpatient	0250 RC	$4.17	$2.30	$1.25 – $3.75	—
acetaminophen 650 MG/20.3ML Solution 20.3 mL Cup Outpatient	0250 RC	$12.42	$6.84	$3.73 – $11.18	—
acetaminophen 80 MG Chew Tab 30 Each Bottle Outpatient	0250 RC	$4.30	$2.37	$1.29 – $3.87	—
acetaminophen/codeine 120-12 mg/5 mL Solution 5 mL Cup Outpatient	0250 RC	$25.35	$13.95	$7.61 – $22.82	—
acetaZOLAMIDE 250 MG Tab 100 Each Bottle Outpatient	0250 RC	$9.16	$5.04	$2.75 – $8.24	—
acetaZOLAMIDE 500 MG CAPSULE SR 12 HR 100 Each Bottle Outpatient	0250 RC	$9.65	$5.31	$2.90 – $8.69	—
acetylcysteine 10% 10% Solution 15 mL Bottle Outpatient	0250 RC	$1,825	$1,004	$548 – $1,643	—
acetylcysteine 20 % Solution 3 mL Oral Syringe Outpatient	0250 RC	$14.64	$8.06	$4.39 – $13.18	—
acetylcysteine 20% - 0.5mL Solution 0.5 mL Syringe Outpatient	0250 RC	$8.27	$4.55	$2.48 – $7.44	—
acetylcysteine 5% 5% Solution 15 mL Bottle Outpatient	0250 RC	$161	$88.33	$48.18 – $145	—
acyclovir (neonatal) 5 mg/ml Solution 30 mL Syringe Outpatient	0250 RC	$382	$210	$114 – $343	—
acyclovir 200 MG Cap 100 Each Bottle Outpatient	0250 RC	$8.59	$4.73	$2.58 – $7.73	—
acyclovir 50 mg/mL Solution 20 mL Vial Outpatient	J0133 HCPCS	$167	$91.85	$0.04 – $150	—
ado-trastuzumab emtansine 20 mg/mL Recon Soln 1 Each Vial Outpatient	J9354 HCPCS	$17,175	$9,446	$39.09 – $15,458	—