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.
6 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| HC GABITRIL, TIAGABINE DRUG SCREEN, QUANT Inpatient | 80199 CPT | $168 | $92.40 | $101 – $148 | — | |
| HC LEFLUNOMIDE Inpatient | 80193 CPT | $183 | $101 | $110 – $161 | — | |
| HC PROCAINAMIDE ASSAY Inpatient | 80192 CPT | $205 | $113 | $123 – $180 | — | |
| HC TACROLIMUS ASSAY Inpatient | 80197 CPT | $78.00 | $42.90 | $46.80 – $68.64 | — | |
| HC THEOPHYLLINE ASSAY Inpatient | 80198 CPT | $149 | $81.95 | $89.40 – $131 | — | |
| HC X-RAY EXAM, ABDOMEN, 2 VIEWS Inpatient | 74019 CPT | $283 | $156 | $170 – $249 | — |