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.

84 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
HC ALKALOIDS, NOS, NICOTINE & METABOLITES, URINE, CONF Inpatient	80323 CPT	$131	$72.05	$78.60 – $115	—
HC ALKALOIDS, NOS, NICOTINE AND METABOLITE QUANT SERUM Inpatient	80323 CPT	$204	$112	$122 – $180	—
HC AMPHETAMINE MDA, METHYLENEDIOXYAMPHETAMINES (MDA, MDEA, MDMA) Inpatient	80359 CPT	$158	$86.90	$94.80 – $139	—
HC AMPHETAMINE UR, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS Inpatient	80307 CPT	$109	$59.95	$65.40 – $95.92	—
HC AMPHETAMINES 3 OR 4, UMBILICAL TISSUE, DRUG SCREEN QUANT Inpatient	80325 CPT	$126	$69.30	$75.60 – $111	—
HC ANTIDEPRESSANTS NOS BUPROPION (WELLBUTRIN) ASSAY Inpatient	80338 CPT	$150	$82.50	$90.00 – $132	—
HC ANTIDEPRESSANTS SEROTONERGIC CLASS 1-2 ESCITALOPRAM (LEXAPRO) ASSAY Inpatient	80332 CPT	$147	$80.85	$88.20 – $129	—
HC ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS, 1 OR 2, AMITRIPTYLINE Inpatient	80335 CPT	$244	$134	$146 – $215	—
HC ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS, 1 OR 2, IMIPRAMINE Inpatient	80335 CPT	$138	$75.90	$82.80 – $121	—
HC ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS, 1 OR 2, NORTRIPTYLINE Inpatient	80335 CPT	$138	$75.90	$82.80 – $121	—
HC BARBITURATES UMBILICAL TISSUE, DRUG SCREENING Inpatient	80345 CPT	$126	$69.30	$75.60 – $111	—
HC BARBITURATES UR, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS Inpatient	80307 CPT	$109	$59.95	$65.40 – $95.92	—
HC BENZODIAZEPINES 1-12 URINE CONFIRMATION ASSAY (2) Inpatient	80346 CPT	$89.00	$48.95	$53.40 – $78.32	—
HC BENZODIAZEPINES UMBILICAL TISSUE, DRUG SCREENING Inpatient	80346 CPT	$126	$69.30	$75.60 – $111	—
HC BENZODIAZEPINES, 1-12 Inpatient	80346 CPT	$283	$156	$170 – $249	—
HC BUPRENORPHINE UR, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ Inpatient	80307 CPT	$97.00	$53.35	$58.20 – $85.36	—
HC CANNABINOID UR, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS Inpatient	80307 CPT	$109	$59.95	$65.40 – $95.92	—
HC CHLORDIAZEPOXIDE, BENZODIAZEPINES, 1-12 Inpatient	80346 CPT	$218	$120	$131 – $192	—
HC CLOMIPRAMINE, ANTIDEPRESSANTS, TRICYCLIC AND OTHER CYCLICALS, 1 OR 2 Inpatient	80335 CPT	$135	$74.25	$81.00 – $119	—
HC COCAINE METABOLITE URINE QUANT, COCAINE, DRUG SCREEN Inpatient	80353 CPT	$154	$84.70	$92.40 – $136	—
HC COCAINE UMBILICAL TISSUE, DRUG SCREENING Inpatient	80353 CPT	$126	$69.30	$75.60 – $111	—
HC COCAINE URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS Inpatient	80307 CPT	$109	$59.95	$65.40 – $95.92	—
HC DRUG SCREEN PNL 9, DRG TST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS Inpatient	80307 CPT	$219	$120	$131 – $193	—
HC DRUG SCREEN, BENZODIAZEPINES, 1-12, CLONAZEPAM Inpatient	80346 CPT	$299	$164	$179 – $263	—
HC DRUG SCREEN, BUPRENORPHINE URINE Inpatient	80348 CPT	$162	$89.10	$97.20 – $143	—
HC DRUG SCREEN, METHADONE SERUM Inpatient	80358 CPT	$130	$71.50	$78.00 – $114	—
HC DRUG SCREEN, OXYCODONE URINE Inpatient	80365 CPT	$203	$112	$122 – $179	—
HC DRUG TEST PANEL, URINE, PRESUM, ANY NUM DRG, CHEM ANLYZ, PER DOS Inpatient	80307 CPT	$335	$184	$201 – $294	—
HC DRUG TEST PANEL, URINE, PRESUM, ANY NUM DRG, CHEM ANLYZ, PER DOS ARUP Inpatient	80307 CPT	$91.50	$50.33	$54.90 – $80.52	—
HC ETHANOL URINE, DRUG TEST, PRESUMP, ANY NUM DRG CL, CHEM ANLYZ, PER DOS Inpatient	80307 CPT	$120	$66.00	$72.00 – $106	—