Froedtert West Bend Hospital — price list

← Hospital overviewVerified from Froedtert West Bend 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)
0.45% NaCl with KCl 20 mEq solution 1000 mL 20-0.45 MEQ/L-% Solution 1,000 mL Flex Cont Inpatient	0250 RC	$148	$81.40	$88.80 – $141	—
0.9% NaCl 0.9 % Solution 50 mL Vial Inpatient	0250 RC	$16.43	$9.04	$9.86 – $15.61	—
abatacept 25 mg/mL Recon Soln 1 Each Vial Inpatient	J0129 HCPCS	$8,340	$4,587	$4,170 – $7,923	—
abobotulinumtoxinA 300 units Recon Soln 1 Each Vial Inpatient	J0586 HCPCS	$2,922	$1,607	$1,461 – $2,776	—
acetaminophen 160 MG/5ML Solution 5 mL Cup Inpatient	0250 RC	$8.67	$4.77	$5.20 – $8.24	—
acetaminophen 325 MG Suppos 1 Each Inpatient	0250 RC	$5.45	$3.00	$3.27 – $5.18	—
acetaminophen 325 MG/10.15ML Solution 10.15 mL Oral Syringe Inpatient	0250 RC	$4.32	$2.38	$2.59 – $4.10	—
acetaminophen 500 MG Tab 100 Each Box Inpatient	0250 RC	$4.17	$2.30	$2.50 – $3.96	—
acetaminophen 500 mg/15.6 mL Solution 15.6 mL Oral Syringe Inpatient	0250 RC	$4.49	$2.47	$2.69 – $4.27	—
acetaminophen/codeine 120-12 mg/5 mL Solution 5 mL Oral Syringe Inpatient	0250 RC	$11.46	$6.31	$6.88 – $10.89	—
acetaZOLAMIDE 250 MG Tab 100 Each Bottle Inpatient	0250 RC	$9.16	$5.04	$5.50 – $8.70	—
acetylcysteine 20 % Solution 30 mL Vial Inpatient	0250 RC	$95.92	$52.76	$57.55 – $91.12	—
activated charcoal AQ 50 g Liquid 240 mL Bottle Inpatient	0250 RC	$70.57	$38.82	$42.34 – $67.04	—
ADAMTS13 recombinant-krhn 1500 units Kit 1 Each Vial Inpatient	J7171 HCPCS	$51.24	$28.19	$25.62 – $48.68	—
ado-trastuzumab emtansine 20 mg/mL Recon Soln 1 Each Vial Inpatient	J9354 HCPCS	$17,175	$9,446	$8,588 – $16,317	—
Agalsidase beta 35 MG Recon Soln 1 Each Vial Inpatient	J0180 HCPCS	$33,277	$18,302	$16,638 – $31,613	—
albumin human 25 % Solution 50 mL Flex Cont Inpatient	P9047 HCPCS	$435	$239	$261 – $413	$588
albumin human 5 % Solution 50 mL Vial Inpatient	P9045 HCPCS	$258	$142	$155 – $245	—
albuterol 0.5% Nebu Soln 1 Each Box Inpatient	0250 RC	$9.65	$5.31	$5.79 – $9.17	—
albuterol HFA 108 (90 Base) MCG/ACT Aero Soln 6.7 g Inhaler Inpatient	0250 RC	$146	$80.27	$87.56 – $139	—
alemtuzumab 12 MG/1.2ML Solution 1.2 mL Vial Inpatient	J0202 HCPCS	$125,171	$68,844	$62,586 – $118,913	—
allopurinol 300 MG Tab 100 Each Box Inpatient	0250 RC	$9.02	$4.97	$5.41 – $8.57	—
allopurinol 50 mg half tablet Tab 0.5 tablet Packet Inpatient	0250 RC	$8.68	$4.78	$5.21 – $8.25	—
alpha-1-proteinase inhibitor (human) 1000 MG Solution 1,000 mg Vial Inpatient	J0256 HCPCS	$3,260	$1,793	$1,630 – $3,097	—
ALPRAZolam 0.125 mg half tablet Tab 0.5 tablet Packet Inpatient	0250 RC	$8.11	$4.47	$4.87 – $7.70	—
alteplase 0.5 mg/2 mL Solution 0.01 Each Syringe Inpatient	J2997 HCPCS	$18,711	$10,291	$9,355 – $17,775	—
alteplase 1 mg/mL Recon Soln 1 Each Vial Inpatient	J2997 HCPCS	$18,711	$10,291	$9,355 – $17,775	—
aluminum & magnesium hydroxide/simethicone 200-200-20 mg/ 5 ml Suspension 30 mL Cup Inpatient	0250 RC	$6.70	$3.69	$4.02 – $6.37	—
aluminum & magnesium hydroxide/simethicone 400-400-40 MG/5ML Suspension 355 mL Bottle Inpatient	0250 RC	$32.43	$17.84	$19.46 – $30.81	—
aminocaproic acid 500 MG Tab 30 Each Bottle Inpatient	0250 RC	$35.25	$19.39	$21.15 – $33.49	—