healthcosts.net

Ascension Calumet Hospital, Inc.

614 Memorial Dr, Chilton, WI · Ascension · · NPI 1376541748

Source: hospital's published price file ↗ · Published Jan 1, 2026 · Ingested Sep 8, 2026

Published prices by procedure

Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.

Procedure Cash price Gross charge Negotiated range Payers
Chromo high res and frag x - sendout CPT 81243 not published not published $59.89 – $220.17 7
Chromosome analys amniotic CPT 88269 not published not published $182.34 – $670.33 11
Chromosome analysis 100 CPT 88249 not published not published $181.83 – $668.44 11
Chromosome analysis 15-20 cell count CPT 88262 not published not published $131.76 – $484.39 11
Chromosome analysis 20-25 CPT 88245 not published not published $181.83 – $668.44 11
Chromosome analysis 45 CPT 88263 not published not published $157.80 – $580.12 11
Chromosome analysis 5 CPT 88261 not published not published $252.80 – $1,020.35 11
Chromosome analysis 50-100 CPT 88248 not published not published $181.83 – $668.44 11
Chromosome analys placenta CPT 88267 not published not published $198.00 – $727.88 11
Chromosome banding study CPT 88283 not published not published $72.03 – $264.80 11
Chromosome count additional CPT 88285 not published not published $27.17 – $103.87 11
Chromosome karyotype study CPT 88280 $90.06 $158.00 $35.14 – $129.19 11
Chromosome study additional CPT 88289 not published not published $36.15 – $132.90 11
Chronic urticaria - sendout CPT 86343 not published not published $13.08 – $48.10 11
Chylomicron screen, bf - sendout CPT 82664 not published not published $49.14 – $237.39 11
Ciliary transsleral therapy CPT 66710 not published not published $414.21 – $1,615.50 7
Cine/video x-rays CPT 76120 not published not published $20.25 – $45.93 7
Cine/video x-rays add-on CPT 76125 not published not published $13.88 – $32.96 7
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 $6.44 $11.30 $2.21 – $3.00 6
Circum 28 days or older CPT 54161 $403.56 $708.00 $207.21 – $422.77 7
Circumcise/surg/28 days or < 54160 CPT 54160 not published not published $152.38 – $801.56 7
Circumcision (newborn) CPT 54150 not published not published $99.13 – $557.03 7
Cisplatin 1 mg/ml desensitization HCPCS J9060 $7.49 $13.14 $2.79 – $7.00 6
C-kit mutation liquid tumor - sendout CPT 81272 $701.67 $1,231.00 $345.99 – $1,271.91 10
Claviculectomy partial CPT 23120 not published not published $618.83 – $2,095.05 7
Claviculectomy total CPT 23125 not published not published $740.51 – $2,534.78 7
Clean out mastoid cavity CPT 69222 $542.07 $951.00 $145.13 – $765.38 7
Clearance of airways CPT 31720 $291.27 $511.00 $50.85 – $202.20 7
Clearance of tear duct CPT 68530 not published not published $267.59 – $1,578.94 7
C-lens fitg corneosclrl lens CPT 92313 not published not published $46.20 – $325.63 7
C-lens fitg tech aphakia 1 CPT 92315 not published not published $22.25 – $259.01 7
C-lens fitg tech aphakia ou CPT 92316 not published not published $33.68 – $322.96 7
C-lens fitg tech corneosclrl CPT 92317 not published not published $22.25 – $270.60 7
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 $10.70 $18.77 $1.85 – $18.77 6
Clitoroplasty intersex state CPT 56805 not published not published $1,205.90 – $4,192.54 7
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 $27.59 $48.41 $26.92 – $48.41 6
Close bronchial fistula 32815 CPT 32815 not published not published $2,741.75 – $9,768.71 7
Closed carpo/metacarpal disl thumb w/manip CPT 26641 not published not published $411.84 – $1,374.23 7
Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 not published not published $423.66 – $1,545.26 7
Closed treatment of femoral fracture proximal end neck; wi CPT 27232 not published not published $746.52 – $2,659.91 7
Closed tx/acetabululm without manip 27220 CPT 27220 not published not published $432.84 – $1,539.75 7
Closed tx humerus fx with manip 23605 CPT 23605 $3,024.99 $5,307.00 $456.71 – $1,677.49 7
Closed tx humerus fx without manip 23600 CPT 23600 $473.67 $831.00 $344.62 – $722.02 7
Closed tx humerus fx w/manip 24505 CPT 24505 not published not published $482.84 – $1,789.84 7
Closed tx metatarsophalangeal jnt disl without anes CPT 28630 not published not published $116.74 – $565.84 7
Closed tx nose/jaw fx CPT 21345 not published not published $675.89 – $2,829.53 7
Closed tx orbit without manipulj CPT 21400 not published not published $180.92 – $728.51 7
Closed tx orbit w/manipulj CPT 21401 not published not published $347.53 – $1,870.20 7
Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 $880.65 $1,545.00 $610.09 – $1,254.53 7
Closed tx septal&nose fx CPT 21337 not published not published $319.40 – $1,484.51 7
Closed tx sesamoid fx 28530 CPT 28530 $340.29 $597.00 $111.72 – $256.74 7
Closed tx/talus fracture without manip 28430 CPT 28430 $473.67 $831.00 $228.85 – $525.62 7
Closed tx vert fx w/manj CPT 22315 not published not published $804.62 – $3,122.33 7
Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 not published not published $153.93 – $1,010.33 7
Close mastoid fistula CPT 69700 not published not published $702.57 – $2,413.28 7
Close median sternotomy separation 21750 CPT 21750 not published not published $675.38 – $2,386.46 7
Close tear duct opening CPT 68760 not published not published $154.79 – $780.86 7
Close tear duct opening CPT 68761 not published not published $124.91 – $541.50 7
Close tear system fistula CPT 68770 not published not published $662.34 – $2,285.59 7
Clostridium toxin a w/optic CPT 87803 not published not published $16.80 – $61.76 11
Clos txnose fx without stablz 21315 CPT 21315 $3,025.56 $5,308.00 $61.67 – $990.64 7
Closure enterostomy lg/sm intestine 44620 CPT 44620 not published not published $874.14 – $3,075.56 7
Closure enterostomy lg/sm intestine anast 44626 CPT 44626 $3,246.15 $5,695.00 $1,590.97 – $5,656.09 7
Closure enterostomy lg/sm intestine oth/thn 44625 CPT 44625 $1,997.28 $3,504.00 $1,023.27 – $2,186.64 7
Closure intestinal cutaneous fistula 44640 CPT 44640 not published not published $1,398.33 – $4,950.08 7
Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 not published not published $212.50 – $1,288.73 7
Closure of eyelid by suture CPT 67875 not published not published $100.69 – $643.43 7
Closure of salivary fistula CPT 42600 not published not published $377.16 – $1,850.21 7
Closure of windpipe lesion 31820 CPT 31820 not published not published $349.56 – $1,571.18 7
Clot factor fletcher fact CPT 85292 not published not published $19.88 – $73.07 11
Clot factor viii reltd antgn CPT 85244 not published not published $21.44 – $78.82 11
Clot factor wght kininogen CPT 85293 not published not published $19.88 – $73.07 11
Clot factor xii hageman CPT 85280 $68.97 $121.00 $20.32 – $74.69 11
Clot factor xiii fibrin scrn CPT 85291 not published not published $9.57 – $35.16 11
Clot factor xiii fibrin stab CPT 85290 not published not published $17.16 – $63.07 11
Clotting assay whole blood CPT 85396 not published not published $20.46 – $47.02 8
Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 $731.88 $1,284.00 $324.00 – $1,146.53 7
Clsd tx bimalleol ank fx without manip 27808 CPT 27808 $959.31 $1,683.00 $333.00 – $742.00 7
Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 not published not published $337.82 – $1,233.41 7
Clsd tx clav dislc without manip 23520 CPT 23520 not published not published $260.29 – $850.13 7
Clsd tx clavicle dislocation without manip 23540 CPT 23540 not published not published $257.91 – $833.93 7
Clsd tx clavicle fracture w/manip 23505 CPT 23505 not published not published $360.30 – $1,279.69 7
Clsd tx/clavicular fx without manip 23500 CPT 23500 $473.67 $831.00 $249.45 – $790.46 7
Clsd tx coccygeal fracture 27200 CPT 27200 not published not published $207.57 – $665.14 7
Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 $473.67 $831.00 $208.79 – $666.83 7
Clsd tx dist fib fx w/manip 27788 CPT 27788 $732.45 $1,285.00 $412.56 – $928.27 7
Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 not published not published $330.38 – $1,141.95 7
Clsd tx elbow dislocation child 24640 CPT 24640 $487.92 $856.00 $86.25 – $372.15 7
Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 not published not published $778.86 – $2,707.01 7
Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 $417.24 $732.00 $579.66 – $1,089.40 7
Clsd tx fracture of radius 25500 CPT 25500 $441.18 $774.00 $281.85 – $599.86 7
Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 $387.03 $679.00 $136.22 – $328.62 7
Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 $441.18 $774.00 $157.30 – $595.28 7
Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 $880.08 $1,544.00 $355.06 – $726.21 7
Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 $1,510.50 $2,650.00 $544.59 – $1,198.58 7
Clsd tx fx radius/ulna without manip 25560 CPT 25560 not published not published $283.03 – $1,023.90 7
Clsd tx fx radius/ulna w/manip 25565 CPT 25565 $652.65 $1,145.00 $495.27 – $1,140.57 7
Clsd tx/grt hum tube fx without manip 23620 CPT 23620 $441.18 $774.00 $283.20 – $594.71 7
Clsd tx hip disloc without anes 27265 CPT 27265 $633.27 $1,111.00 $442.75 – $879.14 7
Clsd tx humeral fract without manip 24530 CPT 24530 not published not published $380.76 – $1,366.01 7

A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.