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.

25 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
HC AUTOIMMUNE MYELOPATHY, MOG-IGG1 AB, FLOW CYTOMETRY, EA Inpatient	86363 CPT	$135	$74.25	$81.00 – $119	—
HC AUTOIMMUNE MYOPATHY GAD CSF, ISLET CELL ANTIBODY Inpatient	86341 CPT	$242	$133	$145 – $213	—
HC AUTOIMMUNE MYOPATHY GAD, ISLET CELL ANTIBODY Inpatient	86341 CPT	$270	$149	$162 – $238	—
HC B CELLS TOTAL COUNT CD20+ FOR RITUXIMAB MONITORING Inpatient	86355 CPT	$137	$75.35	$82.20 – $121	—
HC CANCER ANTIGEN 15-3 IMMUNOASSAY Inpatient	86300 CPT	$118	$64.90	$70.80 – $104	—
HC CANCER ANTIGEN 19-9 FLUID IMMUNOASSAY Inpatient	86301 CPT	$125	$68.75	$75.00 – $110	—
HC CANCER ANTIGEN 19-9 IMMUNOASSAY Inpatient	86301 CPT	$118	$64.90	$70.80 – $104	—
HC DIPHTHERIA TOXOID ANTIBODY IMMUNOASSAY Inpatient	86317 CPT	$134	$73.70	$80.40 – $118	—
HC ENCEPHALOPATHY GAD AB, ISLET CELL ANTIBODY Inpatient	86341 CPT	$172	$94.60	$103 – $151	—
HC H INFLUENZA TYPE B ANTIBODY IGG, IMMUNOASSAY INFECTIOUS AGENT ANTIBODY Inpatient	86317 CPT	$134	$73.70	$80.40 – $118	—
HC IA2 (ICA), ISLET CELL ANTIBODY Inpatient	86341 CPT	$172	$94.60	$103 – $151	—
HC IMMNFIXTN ELCTRPH BETA-2 TRANSFERIN BOD FLD Inpatient	86335 CPT	$207	$114	$124 – $182	—
HC IMMUNOASSAY TUMOR CA 125 Inpatient	86304 CPT	$118	$64.90	$70.80 – $104	—
HC ISLET CELL ANTIBODY Inpatient	86341 CPT	$53.00	$29.15	$31.80 – $46.64	—
HC MDS1, ISLET CELL ANTIBODY Inpatient	86341 CPT	$244	$134	$146 – $215	—
HC MITOCHONDRIAL AB IGG, EA Inpatient	86381 CPT	$66.00	$36.30	$39.60 – $58.08	—
HC MONONUCL CELL ANTG QUANT % TOTAL CD20 (B-CELLS) Inpatient	86356 CPT	$213	$117	$128 – $187	—
HC MONONUCLEAR CELL ANTIG QUANT T-REG CD3+CD4+CD25+CD127- Inpatient	86356 CPT	$197	$108	$118 – $173	—
HC ROMA HUMAN EPIDIDYMIS PROTEIN 4 Inpatient	86305 CPT	$143	$78.38	$85.50 – $125	—
HC STIFF PERSON ISLET CELL ANTIBODY Inpatient	86341 CPT	$586	$322	$351 – $515	—
HC STREP PNEUMONIAE IGG AB (14) EA, IMMUNOASSAY INFC AGNT AB, QUANT, NOS Inpatient	86317 CPT	$43.00	$23.65	$25.80 – $37.84	—
HC T CELLS TOTAL COUNT Inpatient	86359 CPT	$177	$97.35	$106 – $156	—
HC TETANUS, IA INFC AGNT AB, QUANT, NOS Inpatient	86317 CPT	$58.00	$31.90	$34.80 – $51.04	—
HC THYROID PEROXIDASE (TPO) MICROSOMAL ANTIBODIES Inpatient	86376 CPT	$82.00	$45.10	$49.20 – $72.16	—
HC TITER, MOG-IGG1 AB, FLOW CYTOMETRY, EA Inpatient	86363 CPT	$205	$113	$123 – $180	—