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 OCCUPATIONAL THERAPY EVALUATION, HIGH COMPLEXITY Inpatient | 97167 CPT | $535 | $294 | $321 – $471 | — | |
| HC OCCUPATIONAL THERAPY EVALUATION, MODERATE COMPLEXITY Inpatient | 97166 CPT | $361 | $199 | $217 – $318 | — | |
| HC PHYSICAL THERAPY EVALUATION, HIGH COMPLEXITY Inpatient | 97163 CPT | $481 | $265 | $289 – $423 | — | |
| HC PHYSICAL THERAPY EVALUATION, MODERATE COMPLEXITY Inpatient | 97162 CPT | $375 | $206 | $225 – $330 | $97.03 | |
| HC RE-EVALUATION OCCUPATIONAL THERAPY ESTABLISHED PLAN OF CARE Inpatient | 97168 CPT | $206 | $113 | $124 – $181 | — | |
| HC RE-EVALUATION PHYSICAL THERAPY ESTABLISHED PLAN OF CARE Inpatient | 97164 CPT | $173 | $95.15 | $104 – $152 | — |