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
Cryopreservation embryo(s) CPT 89258 not published not published $76.99 – $697.65 3
Cryopreservation oocyte(s) CPT 89337 not published not published $180.91 – $250.57 3
Cryopreservation sperm CPT 89259 not published not published $49.79 – $180.91 3
Cryopreserve stem cells CPT 38207 not published not published $46.78 – $167.59 6
Cryopreserve testicular tiss CPT 89335 not published not published $63.73 – $76.99 3
Cryosurg ablate fa each CPT 19105 not published not published $207.45 – $9,921.56 7
Cryosurgery penis lesion(s) 54056 CPT 54056 not published not published $119.40 – $511.16 7
Cryotherapy of acne 17340 CPT 17340 not published not published $51.58 – $190.31 7
Cryptococcus abs qn - sendout CPT 86641 not published not published $8.32 – $55.62 11
Cryptosporidium antigen CPT 87272 $43.32 $76.00 $12.58 – $46.24 11
Crystal identification light microscopy CPT 89060 $27.36 $48.00 $7.70 – $28.29 11
C-Section Delivery (full care) CPT 59510 not published not published $2,670.36 – $6,132.40 7
C-section delivery incl p/p care 59515 CPT 59515 not published not published $1,316.09 – $3,290.00 7
Csf leakage imaging CPT 78650 not published not published $26.43 – $68.11 7
Csf shunt reprogram 62252 CPT 62252 not published not published $43.77 – $124.98 7
Csf ventriculography CPT 78635 not published not published $30.96 – $75.00 7
CT 3d report other modality w/workstation CPT 76377 not published not published $40.06 – $90.13 7
Cta abdomen without & /or w/contrast CPT 74175 $1,143.42 $2,006.00 $91.21 – $221.54 7
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 $1,257.99 $2,207.00 $119.27 – $289.32 7
Cta lower extremity without & w/contrast (both sides) CPT 73706 $916.56 $1,608.00 $94.90 – $229.55 7
Cta neck without &/or w/contrast CPT 70498 $1,309.29 $2,297.00 $88.12 – $213.58 7
CT Angiogram of Abdomen and Pelvis CPT 74174 $1,820.01 $3,193.00 $110.26 – $267.17 7
CT Angiogram of the Chest (for blood clot) CPT 71275 $1,371.99 $2,407.00 $91.56 – $222.41 7
CT Angiogram of the Head CPT 70496 $1,374.84 $2,412.00 $88.12 – $213.58 7
CT angio hrt w/3d image CPT 75574 not published not published $120.45 – $290.46 7
CT angio pelvis CPT 72191 not published not published $90.12 – $218.96 7
Cta upper extremity w &/or without contrast left CPT 73206 $917.13 $1,609.00 $90.12 – $218.96 7
CT bone density axial CPT 77078 not published not published $12.99 – $30.31 7
CT colonography dx CPT 74261 $1,063.62 $1,866.00 $120.93 – $293.56 7
CT colonography dx w/dye CPT 74262 not published not published $126.21 – $305.91 7
CT colonography screening CPT 74263 $1,719.69 $3,017.00 $117.02 – $281.41 6
CT guidance for needle placement CPT 77012 not published not published $73.45 – $180.17 7
CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 not published not published $58.20 – $141.93 7
CT guid parench tis ablat CPT 77013 not published not published $192.16 – $466.79 7
CT heart w/evaluation of calcium without contrast CPT 75571 not published not published $29.13 – $70.61 7
CT hrt c+ strux cgen hrt ds CPT 75573 not published not published $127.95 – $310.40 7
CT hrt w/3d image CPT 75572 not published not published $87.64 – $212.44 7
CT limited or localized follow-up study CPT 76380 not published not published $47.98 – $118.02 7
CT lower extremity w/contrast (both sides) CPT 73701 $651.51 $1,143.00 $58.62 – $141.79 7
CT lower extremity without contrast (both sides) CPT 73700 $519.84 $912.00 $50.39 – $122.36 7
CT lwr extremity w/o&w/dye CPT 73702 $862.41 $1,513.00 $61.21 – $148.30 7
CT neck soft tissue w/contrast CPT 70491 $731.88 $1,284.00 $69.80 – $169.41 7
CT neck soft tissue without contrast CPT 70490 $516.42 $906.00 $64.64 – $157.06 7
CT neck soft tissue without & w/contrast CPT 70492 $803.13 $1,409.00 $81.36 – $198.55 7
CT orbit/sella/fossa w/wo contrast CPT 70482 $907.44 $1,592.00 $63.91 – $164.78 7
CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 $791.73 $1,389.00 $57.14 – $157.39 7
CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 $669.18 $1,174.00 $65.00 – $156.22 7
Ctrl nosebld postir subsq 30906 CPT 30906 not published not published $135.88 – $1,275.00 7
CT scan for therapy guide CPT 77014 not published not published $47.88 – $110.91 7
CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 $1,644.45 $2,885.00 $101.15 – $245.35 7
CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 $1,553.25 $2,725.00 $91.80 – $223.25 7
CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 $1,371.99 $2,407.00 $87.75 – $212.68 7
CT thoracic spine w/contrast CPT 72129 not published not published $61.69 – $149.15 7
CT thoracic spine without contrast CPT 72128 $548.91 $963.00 $50.39 – $122.37 7
CT thorax low dose for lung screening without contrast CPT 71271 $72.96 $128.00 $54.56 – $71.43 6
CT t-spine w /wo contrast CPT 72130 $869.82 $1,526.00 $64.27 – $155.32 7
CT upper extremity w/contrast (both sides) CPT 73201 $644.10 $1,130.00 $58.62 – $141.79 7
CT upper extremity without contrast (both sides) CPT 73200 $518.70 $910.00 $50.39 – $122.36 7
CT uppr extremity w/o&w/dye CPT 73202 $859.56 $1,508.00 $61.21 – $149.15 7
Cultr oocyte/embryo <4 days CPT 89250 not published not published $76.99 – $1,294.55 3
Cultr oocyte/embryo <4 days CPT 89251 not published not published $76.99 – $1,346.54 3
Cult skin graft fnhfg 15155 CPT 15155 not published not published $752.79 – $2,878.95 7
Cult skin grft t/arm/leg CPT 15150 not published not published $645.63 – $2,478.56 7
Culture aerobic additional method definitive id each CPT 87077 $29.64 $52.00 $8.48 – $31.19 11
Culture afb any source CPT 87116 $41.04 $72.00 $11.34 – $41.69 11
Culture anaerobic additional method definitive id each CPT 87076 $58.14 $102.00 $8.48 – $31.19 11
Culture anaerobic except blood CPT 87075 $95.19 $167.00 $9.94 – $36.55 11
Culture bact stool aero addl path ea CPT 87046 $29.07 $51.00 $9.91 – $36.44 11
Culture body fluid CPT 87070 $70.68 $124.00 $9.05 – $33.27 11
Culture fungi definitive id mold CPT 87107 $38.19 $67.00 $10.84 – $39.84 11
Culture fungi definitive id yeast CPT 87106 $38.19 $67.00 $10.84 – $39.84 11
Culture fungi other (except blood) CPT 87102 $28.50 $50.00 $8.83 – $32.46 11
Culture fungi skin/hair/nail CPT 87101 $29.07 $51.00 $8.10 – $29.76 11
Culture mycobacteria definitive id each isolate CPT 87118 $95.76 $168.00 $15.34 – $56.39 11
Culture mycoplasma any source CPT 87109 $92.91 $163.00 $14.25 – $59.41 11
Culture quantitative aerobic other source CPT 87071 $34.77 $61.00 $10.38 – $38.18 11
Culture screening strep group a CPT 87081 $52.44 $92.00 $6.96 – $25.59 11
Culture typing added method CPT 87158 not published not published $7.49 – $29.88 11
Culture typing immunologic CPT 87147 $24.51 $43.00 $5.44 – $19.99 11
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 not published not published $228.96 – $841.71 7
Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 not published not published $36.84 – $135.45 11
Culture urine each isolate CPT 87088 $30.78 $54.00 $8.49 – $31.23 11
Culture virus isolation CPT 87250 not published not published $20.54 – $75.50 11
Curette/treat cornea CPT 65435 not published not published $73.70 – $298.80 7
Curette/treat cornea CPT 65436 not published not published $391.33 – $1,411.20 7
Cv line/pic reposition CPT 36597 not published not published $61.23 – $484.95 7
Cv stress test i&r only 93018 CPT 93018 $53.01 $93.00 $14.88 – $49.72 7
Cv stress test/supervision only 93016 CPT 93016 $58.71 $103.00 $22.61 – $74.19 7
Cyanocobalamin unsat binding capacity CPT 82608 $24.51 $43.00 $15.04 – $55.28 11
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 $19.12 $33.55 $1.72 – $7.00 6
Cyclic citrullinated peptide antibody CPT 86200 $47.88 $84.00 $13.60 – $49.99 11
Cyclosporine 2 hour CPT 80158 $64.41 $113.00 $18.95 – $69.67 11
Cyp2c19 gene com variants CPT 81225 not published not published $305.93 – $1,124.65 10
Cyp2c9 gene com variants CPT 81227 not published not published $183.55 – $674.77 10
Cyp2d6 gene com variants CPT 81226 not published not published $473.46 – $1,740.51 10
Cyp3a4 gene common variants CPT 81230 not published not published $183.55 – $674.77 7
Cyp3a5 gene common variants CPT 81231 not published not published $183.55 – $674.77 7
Cystatin c CPT 82610 $46.17 $81.00 $19.45 – $71.49 11
Cystic fibrosis cftr CPT 81223 not published not published $523.95 – $1,926.14 7
Cystine urine quantitative CPT 82131 $39.33 $69.00 $24.13 – $88.70 11

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.