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.

13 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
anifrolumab-fnia 300 MG/2ML Solution 2 mL Vial Inpatient	J0491 HCPCS	$22,679	$12,474	$11,340 – $19,958	—
daratumumab-hyaluronidase-fihj 1800-30000 mg-UT/15 mL Solution 15 mL Vial Inpatient	J9144 HCPCS	$43,360	$23,848	$21,680 – $38,156	—
filgrastim (G-CSF) 300 mcg/mL Solution 1 mL Vial Inpatient	J1442 HCPCS	$1,747	$961	$873 – $1,537	—
HC ANTITHROMBIN III ACTIVITY TEST Inpatient	85300 CPT	$112	$61.60	$67.20 – $98.56	—
HC CADMIUM URINE. CADMIUM ASSAY Inpatient	82300 CPT	$134	$73.70	$80.40 – $118	—
HC CANCER ANTIGEN 15-3 IMMUNOASSAY Inpatient	86300 CPT	$118	$64.90	$70.80 – $104	—
HC ELECTRCARDGR, ROUTINE ECG W/AT LST 12 LEADS,TRACING ONLY, W/O INTERP-RPT Inpatient	93005 CPT	$200	$110	$120 – $176	—
HC GONADOTROPIN (FSH) Inpatient	83001 CPT	$106	$58.30	$63.60 – $93.28	—
HC HUMAN GROWTH HORMONE (SOMATOTROPIN) ASSAY Inpatient	83003 CPT	$142	$78.10	$85.20 – $125	—
HC MOL CYTGN INTRPH 5 IN SIT HYBD ANLY 100-300 CEL Inpatient	88275 CPT	$293	$161	$176 – $258	—
HC PROCTOSIGMOIDOSCOPY DX Inpatient	45300 CPT	$1,931	$1,062	$1,159 – $1,699	—
HC URINE SODIUM ASSAY Inpatient	84300 CPT	$29.00	$15.95	$17.40 – $25.52	—
HC X-RAY EXAM, CLAVICLE, COMPLETE Inpatient	73000 CPT	$262	$144	$157 – $231	—