Emergency visit, moderate (level 3) at Froedtert Holy Family Memorial Hospital. CPT 99283.
What Froedtert Holy Family Memorial Hospital publishes for this service, straight from its standard-charges file, last updated December 31, 2025.
Outpatient / ER
$605cash price (self-pay)
$1,100list price
$263–$4,183range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Cross Blue Shield | Medicare Advantage | $263 |
| Community Care Incorporated | Medicare Advantage | $263 |
| Health Partners | Medicare Advantage | $263 |
| Humana | Medicare Advantage | $263 |
| ICare | Medicare Advantage | $263 |
| Molina | Medicare Advantage | $263 |
| Network Health Plan | Medicare Advantage | $263 |
| Security Health Plan | Medicare Advantage | $263 |
| United Healthcare | Medicare Advantage | $263 |
| Allwell | Medicare Advantage | $269 |
| Molina | Marketplace Plans | $284 |
| Medical College of Wisconsin | Employee Plan | $363 |
| Centivo | WI 2 Median | $462 |
| Centivo | WI 1 Broad | $528 |
| Dean Health Plan | All Plans | $550 |
| Health Payment Systems | All Contracted Commercial Plans | $620 |
| Sheboygan Employers Health Network | All Contracted Commercial Plans | $660 |
| Chorus Community Health Plan | Marketplace Plans | $707 |
| Health Partners | All Contracted Commercial Plans | $715 |
| Trilogy | All Contracted Commercial Plans | $726 |
| Cigna | All Contracted Commercial Plans | $792 |
| WPS Health Plan | All Contracted Commercial Plans | $814 |
| Aspirus | Marketplace Plans | $880 |
| HealthEos | All Contracted Commercial Plans | $880 |
| Multiplan/Private Healthcare Systems | All Contracted Commercial Plans | $880 |
| Preferred One | All Contracted Commercial Plans | $880 |
| Security Health Plan | All Contracted Commercial Plans | $880 |
| HealthSmart | All Contracted Commercial Plans | $913 |
| First Health Network | All Contracted Commercial Plans | $968 |
| Network Health Plan | ACA | $1,113 |
Inpatient
$605cash price (self-pay)
$1,100list price
$660–$968range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Sheboygan Employers Health Network | All Contracted Commercial Plans | $660 |
| Trilogy | All Contracted Commercial Plans | $726 |
| Cigna | All Contracted Commercial Plans | $792 |
| Aspirus | Marketplace Plans | $880 |
| HealthEos | All Contracted Commercial Plans | $880 |
| Multiplan/Private Healthcare Systems | All Contracted Commercial Plans | $880 |
| Preferred One | All Contracted Commercial Plans | $880 |
| Security Health Plan | All Contracted Commercial Plans | $880 |
| HealthSmart | All Contracted Commercial Plans | $913 |
| First Health Network | All Contracted Commercial Plans | $968 |
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All common services at Froedtert Holy Family Memorial Hospital