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.

28 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
HC ANTIBODY, ENCEPHALITIS, EASTERN EQUINE, EACH Inpatient	86652 CPT	$176	$96.80	$106 – $155	—
HC ANTIBODY, ENCEPHALITIS, ST. LOUIS, EACH Inpatient	86653 CPT	$133	$73.15	$79.80 – $117	—
HC BORDETELLA PERTUSSIS AB IGM Inpatient	86615 CPT	$114	$62.70	$68.40 – $100	—
HC BORDETELLA PERTUSSIS IGG ANTIBODY Inpatient	86615 CPT	$151	$83.05	$90.60 – $133	—
HC BORRELIA BURGDORFERI CONFIRMATORY TEST ANTIBODY, IGG BY IMMUNOBLOT CSF Inpatient	86617 CPT	$94.00	$51.70	$56.40 – $82.72	—
HC BORRELIA BURGDORFERI CONFIRMATORY TEST ANTIBODY, IGM BY IMMUNOBLOT CSF Inpatient	86617 CPT	$94.00	$51.70	$56.40 – $82.72	—
HC CANDIDA ANTIBODY EACH Inpatient	86628 CPT	$40.00	$22.00	$24.00 – $35.20	—
HC CLSD TX INTERPHALANGEAL JT DISLOC WO ANES Inpatient	28660 CPT	$1,207	$664	$724 – $1,062	—
HC COCCIDIOIDES ANTIBODY PANEL Inpatient	86635 CPT	$43.00	$23.65	$25.80 – $37.84	—
HC CONFIRMATORY B. BURGDORFERI TEST SYS ANTIBODIES, IGG Inpatient	86617 CPT	$88.00	$48.40	$52.80 – $77.44	—
HC CONFIRMATORY B. BURGDORFERI TEST SYS ANTIBODIES, IGM Inpatient	86617 CPT	$88.00	$48.40	$52.80 – $77.44	—
HC COXSACKIE, ENTEROVIRUS ANTIBODY Inpatient	86658 CPT	$33.00	$18.15	$19.80 – $29.04	—
HC CYTOMEGALOVIRUS (CMV) IGG ANTIBODY Inpatient	86644 CPT	$123	$67.65	$73.80 – $108	—
HC ECHINOCOCCUS HELMINTH ANTIBODY Inpatient	86682 CPT	$66.00	$36.30	$39.60 – $58.08	—
HC EPSTEIN-BARR VIRAL CAPSID (VCA) IGA ANTIBODY Inpatient	86665 CPT	$136	$74.80	$81.60 – $120	—
HC EPSTEIN-BARR VIRAL CAPSID (VCA) IGG ANTIBODY Inpatient	86665 CPT	$102	$56.10	$61.20 – $89.76	—
HC EPSTEIN-BARR VIRUS ANTIBD NUCLEAR ANTIG (EBNA) Inpatient	86664 CPT	$84.00	$46.20	$50.40 – $73.92	—
HC FUNGAL ANTIBODIES, BLASOMYCES Inpatient	86612 CPT	$34.00	$18.70	$20.40 – $29.92	—
HC FUNGAL ANTIBODIES, COCCIDIOIDES Inpatient	86635 CPT	$34.00	$18.70	$20.40 – $29.92	—
HC FUNGAL ANTIBODIES, HISTOPLASMA Inpatient	86698 CPT	$34.00	$18.70	$20.40 – $29.92	—
HC HELICOBACTER PYLORI IGG ANTIBODY Inpatient	86677 CPT	$175	$96.25	$105 – $154	—
HC HERPES TYPE 2 IGG ANTIBODY SIMPLEX TEST Inpatient	86696 CPT	$165	$90.75	$99.00 – $145	—
HC HERPES TYPE NOS ANTIBODY SIMPLEX TEST Inpatient	86694 CPT	$185	$102	$111 – $163	—
HC IGG ANTIBODY, LYME DISEASE, CONFIRM TEST, IMMUNOBLOT Inpatient	86617 CPT	$88.00	$48.40	$52.80 – $77.44	—
HC IGG, ANTIBODY, BORRELIA BURGDORFERI (LYME DISEASE) Inpatient	86618 CPT	$97.00	$53.35	$58.20 – $85.36	—
HC IGM ANTIBODY, LYME DISEASE, CONFIRM TEST, IMMUNOBLOT Inpatient	86617 CPT	$88.00	$48.40	$52.80 – $77.44	—
HC LYME ANTIBODY REFLECTIVE PANEL, CSF Inpatient	86618 CPT	$97.00	$53.35	$58.20 – $85.36	—
HC LYME DISEASE (BORRELIA BURGDORFERI) ANTIBODIES Inpatient	86618 CPT	$86.50	$47.58	$51.90 – $76.12	—