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.

136 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
0.45% NaCl 0.45 % Solution 1,000 mL Flex Cont Inpatient	0258 RC	$134	$73.70	$80.40 – $118	—
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 – $130	—
acetaminophen 160 MG/5ML Solution 15.6 mL Oral Syringe Inpatient	0250 RC	$4.49	$2.47	$2.69 – $3.95	—
acetaminophen 325 MG Suppos 12 Each Box Inpatient	0250 RC	$4.83	$2.66	$2.90 – $4.25	—
albendazole 200 MG Tab 2 Each Bottle Inpatient	0250 RC	$77.00	$42.35	$46.20 – $67.76	—
albuterol (2.5 mg/3mL) 0.083% Nebu Soln 3 mL Plas Cont Inpatient	0250 RC	$8.99	$4.95	$5.39 – $7.91	—
albuterol HFA 108 (90 Base) MCG/ACT Aero Soln 8 g Inhaler Inpatient	0250 RC	$99.52	$54.74	$59.71 – $87.58	—
allopurinol 150 mg half tablet Tab 0.5 tablet Packet Inpatient	0250 RC	$8.10	$4.46	$4.86 – $7.13	—
aminocaproic acid 500 MG Tab 30 Each Bottle Inpatient	0250 RC	$35.25	$19.39	$21.15 – $31.02	—
amoxicillin 400 MG/5ML Recon Susp 100 mL Bottle Inpatient	0250 RC	$29.45	$16.20	$17.67 – $25.92	—
amoxicillin/clavulanate 250-62.5 mg/5 mL Recon Susp 100 mL Bottle Inpatient	0250 RC	$370	$204	$222 – $326	—
amphetamine/dextroamphetamine 10 MG CAPSULE SR 24 HR 100 Each Bottle Inpatient	0250 RC	$11.31	$6.23	$6.79 – $9.95	—
amphetamine/dextroamphetamine 5 MG Tab 100 Each Bottle Inpatient	0250 RC	$11.95	$6.58	$7.17 – $10.52	—
apixaban 2.5 MG Tab 60 Each Bottle Inpatient	0250 RC	$33.28	$18.31	$19.97 – $29.29	—
ARIPiprazole 5 MG Tab 30 Each Bottle Inpatient	0250 RC	$8.78	$4.83	$5.27 – $7.73	—
aspirin 325 MG Tab 500 Each Box Inpatient	0250 RC	$4.21	$2.32	$2.53 – $3.70	—
aspirin 81 MG Chew Tab 500 Each Disp Pack Inpatient	0250 RC	$4.23	$2.33	$2.54 – $3.72	—
aspirin 81 MG Tablet Delayed Response 180 Each Bottle Inpatient	0250 RC	$4.09	$2.25	$2.45 – $3.60	—
atenolol 50 MG Tab 100 Each Box Inpatient	0250 RC	$8.30	$4.57	$4.98 – $7.30	—
azaCITIDine 100 MG Recon Susp 1 Each Vial Inpatient	J9025 HCPCS	$876	$482	$438 – $771	—
bacitracin 500 UNIT/GM Ointment 3.5 g Tube Inpatient	0250 RC	$203	$112	$122 – $178	—
bacitracin/polymyxin B 500-10000 UNIT/GM Ointment 3.5 g Tube Inpatient	0250 RC	$100	$55.13	$60.14 – $88.20	—
Bacteriostatic Water(Benz Alc) Solution 30 mL Vial Inpatient	0250 RC	$72.03	$39.62	$43.22 – $63.39	—
baricitinib 1 MG Tab 30 Each Bottle Inpatient	0250 RC	$226	$125	$136 – $199	—
Barium Sulfate Cap 10 Each Box Inpatient	0255 RC	$68.00	$37.40	$40.80 – $59.84	—
benzonatate 100 MG Cap 100 Each Box Inpatient	0250 RC	$9.53	$5.25	$5.72 – $8.39	—
benztropine 1 MG Tab 100 Each Bottle Inpatient	0250 RC	$8.53	$4.70	$5.12 – $7.51	—
bethanechol 25 MG Tab 100 Each Bottle Inpatient	0250 RC	$9.51	$5.24	$5.71 – $8.37	—
bismuth subsalicylate 262 MG Chew Tab 30 Each Box Inpatient	0250 RC	$4.26	$2.35	$2.56 – $3.75	—
bisoprolol fumarate 2.5 mg half tablet Tab 0.5 tablet Package Inpatient	0250 RC	$8.33	$4.59	$5.00 – $7.33	—