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.

11 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	—
dextrose 10 % Solution 1,000 mL Flex Cont Inpatient	0258 RC	$162	$89.10	$97.20 – $143	—
dextrose 10 % Solution 250 mL Flex Cont Inpatient	0258 RC	$73.75	$40.57	$44.25 – $64.90	—
dextrose 5 % Solution 100 mL Flex Cont Inpatient	0258 RC	$48.90	$26.90	$29.34 – $43.03	—
dextrose 5 % Solution 50 mL Flex Cont Inpatient	0258 RC	$107	$58.59	$63.91 – $93.73	—
dextrose 5% and 0.2% NaCl with KCl 20 mEq/L 20-5-0.2 MEQ/L-%-% Solution 1,000 mL Flex Cont Inpatient	0258 RC	$176	$96.80	$106 – $155	—
dextrose 5% in lactated ringers Solution 1,000 mL Flex Cont Inpatient	0258 RC	$101	$55.28	$60.30 – $88.44	—
dextrose 5% in lactated ringers with KCl 20 mEq 20 MEQ/L Solution 1,000 mL Flex Cont Inpatient	0258 RC	$147	$80.72	$88.05 – $129	—
dextrose 50 % Solution 50 mL Syringe Inpatient	0258 RC	$162	$88.97	$97.05 – $142	—
dextrose 50 % Solution 50 mL Vial Inpatient	0258 RC	$64.00	$35.20	$38.40 – $56.32	—
fat emulsion (INTRALIPID) 20 % Emulsion 250 mL Flex Cont Inpatient	0258 RC	$359	$197	$215 – $316	—