HSHS Holy Family Hospital — price list

← Hospital overviewVerified from HSHS Holy Family 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.

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.

107 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
Automated diff WBC count Inpatient & outpatient	85004 CPT	$75.00	$54.00	$4.38 – $75.00	$75.00
Blood typing serologic abo Inpatient & outpatient	86900 CPT	$198	$143	$3.27 – $356	$198
C diff amplified probe Inpatient & outpatient	87493 CPT	$220	$158	$31.63 – $220	—
Chlmyd trach dna amp probe Inpatient & outpatient	87491 CPT	$321	$231	$31.63 – $321	$321
Compatibility test antiglob Inpatient & outpatient	86922 CPT	$300	$216	$84.00 – $456	—
Detect agent nos dna amp Inpatient & outpatient	87798 CPT	$637	$459	$31.63 – $637	$637
Dna/rna direct probe Inpatient & outpatient	87149 CPT	$135	$97.20	$7.78 – $135	—
Actin smooth musc antibody- 90 Inpatient & outpatient	86015 CPT	$152	$109	$8.50 – $152	$152
Activated protein c resist-90 Inpatient & outpatient	85307 CPT	$143	$103	$4.38 – $143	—
Antineutrophil cyto antb screen- 90 Inpatient & outpatient	86036 CPT	$279	$201	$8.50 – $279	—
Antineutrophil cytoplasmic antibody titer- 90 Inpatient & outpatient	86037 CPT	$71.00	$51.12	$8.50 – $71.00	—
Aspergillus ab-90 Inpatient & outpatient	86606 CPT	$193	$139	$8.50 – $193	—
B cells total count-90 Inpatient & outpatient	86355 CPT	$258	$186	$30.13 – $258	—
Bacteria blood culture t1 Inpatient & outpatient	87040 CPT	$350	$252	$7.78 – $350	$350
Bacterium ab nos-90 Inpatient & outpatient	86609 CPT	$114	$82.08	$8.50 – $114	—
Bartonella screen ab-90 Inpatient & outpatient	86611 CPT	$123	$88.56	$8.50 – $123	—
Beta lactamase Inpatient & outpatient	87185 CPT	$25.00	$18.00	$4.75 – $25.00	—
Blastomyces ab-90 Inpatient & outpatient	86612 CPT	$103	$74.16	$8.50 – $103	$103
Blood count RBC auto-90 Inpatient & outpatient	85041 CPT	$30.00	$21.60	$3.02 – $30.00	—
Blood count reticulocytes auto Inpatient & outpatient	85046 CPT	$170	$122	$4.38 – $170	$154
C-reactive protein (hs) Inpatient & outpatient	86141 CPT	$150	$108	$8.50 – $150	$132
CBC auto withauto diff Inpatient & outpatient	85025 CPT	$155	$112	$4.38 – $155	$136
CBC without diff Inpatient & outpatient	85027 CPT	$117	$84.24	$4.38 – $117	$103
Cd8 total count-90 Inpatient & outpatient	86357 CPT	$252	$181	$30.13 – $252	—
Chlamydia ab-90 Inpatient & outpatient	86631 CPT	$128	$92.16	$8.50 – $128	—
Cmv qn-90 Inpatient & outpatient	87497 CPT	$471	$339	$31.63 – $471	—
Culture aerobic id addl Inpatient & outpatient	87077 CPT	$293	$211	$7.78 – $293	$293
Culture fungus id yeast Inpatient & outpatient	87106 CPT	$205	$148	$7.78 – $205	—
Culture fungus skin/hair/nail Inpatient & outpatient	87101 CPT	$104	$74.88	$7.71 – $104	—
Culture mycoplasma-90 Inpatient & outpatient	87109 CPT	$205	$148	$7.78 – $205	—