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
Drainage of prostate abscess CPT 55720 not published not published $474.74 – $1,654.73 7
Drainage of prostate abscess CPT 55725 not published not published $625.70 – $2,173.13 7
Drainage of rectal abscess CPT 45005 not published not published $169.73 – $1,052.89 7
Drainage of rectal abscess 45020 CPT 45020 not published not published $587.09 – $2,040.86 7
Drainage of salivary gland CPT 42305 not published not published $457.11 – $1,544.74 7
Drainage of salivary gland CPT 42320 not published not published $189.42 – $928.28 7
Drainage of spinal cyst CPT 63172 not published not published $1,380.45 – $4,711.58 7
Drainage of spinal cyst CPT 63173 not published not published $1,682.72 – $5,801.36 7
Drainage of throat abscess CPT 42725 not published not published $834.93 – $2,904.79 7
Drainage of urethra abscess CPT 53040 not published not published $412.72 – $1,434.60 7
Drainage of urethra abscess 53060 CPT 53060 not published not published $172.19 – $672.98 7
Drainage of urinary leakage CPT 53080 not published not published $442.95 – $1,536.08 7
Drainage of urinary leakage CPT 53085 not published not published $678.71 – $2,374.95 7
Drain bladder by trocar/cath CPT 51101 not published not published $52.48 – $518.29 7
Drain blood from under nail 11740 CPT 11740 $128.25 $225.00 $34.50 – $150.50 7
Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 not published not published $210.04 – $2,646.71 6
Drain cath image guided visceral pq CPT 49405 not published not published $199.38 – $3,226.73 6
Drain cerebro spinal fluid 62272 CPT 62272 not published not published $89.91 – $654.19 7
Drain chest lesion CPT 21502 not published not published $515.17 – $1,784.29 7
Drain finger abscess;simple 26010 CPT 26010 $305.52 $536.00 $149.67 – $593.58 7
Drain lower leg bursa CPT 27604 not published not published $340.44 – $1,728.38 7
Drain lower leg lesion 27603 CPT 27603 $547.77 $961.00 $407.94 – $1,189.63 7
Drain neck/chest lesion 21501 CPT 21501 not published not published $352.95 – $1,686.15 7
Drain open lung lesion 32200 CPT 32200 not published not published $1,131.75 – $3,979.65 7
Drain ovarn cyst abd CPT 58805 not published not published $447.73 – $1,513.95 7
Drain ovary abscess open CPT 58820 not published not published $356.23 – $1,185.90 7
Drain pancreatic pseudocyst 48510 CPT 48510 not published not published $1,101.32 – $3,875.96 7
Drain penis lesion CPT 54015 not published not published $318.58 – $1,118.44 7
Drain shoulder bone lesion CPT 23035 not published not published $706.62 – $2,432.93 7
Drain shoulder bursa 23031 CPT 23031 not published not published $232.72 – $1,462.80 7
Drain shoulder lesion CPT 23030 not published not published $265.02 – $1,568.21 7
Drain thigh/knee lesion 27301 CPT 27301 $526.68 $924.00 $529.69 – $1,476.77 7
Drain thyroid/tongue cyst CPT 60000 not published not published $168.09 – $631.31 7
Drain to peritoneal cavity CPT 49062 not published not published $773.11 – $2,705.81 7
Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 $343.14 $602.00 $115.19 – $552.08 7
Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 $305.52 $536.00 $58.28 – $297.38 7
Dress/debrid prtl-thick burn l 16030 CPT 16030 not published not published $134.46 – $694.50 7
Dressing change not for burn w/anes 15852 CPT 15852 not published not published $45.56 – $166.99 7
Drill hole evac+/drg subdural hematoma 61108 CPT 61108 not published not published $900.34 – $3,054.11 7
Drill hole implt ventricular cath/device 61107 CPT 61107 not published not published $296.13 – $1,047.86 7
Drm agrft f/s/n/h/f/g/m ea CPT 15136 not published not published $90.65 – $350.93 7
Drm agrft t/a/l ea addl CPT 15131 not published not published $90.65 – $354.75 7
Drng appendix abscess open 44900 CPT 44900 not published not published $787.15 – $2,758.39 7
Drng hand tendon sheath 26020 CPT 26020 not published not published $587.29 – $1,990.95 7
Drng of eyelid abscess 67700 CPT 67700 not published not published $123.48 – $1,017.53 7
Drng of finger abscess comp 26011 CPT 26011 not published not published $194.89 – $1,582.24 7
Drng of hydrocele 55000 CPT 55000 not published not published $88.36 – $429.98 7
Drng of mouth lesion 40801 CPT 40801 not published not published $211.27 – $1,099.35 7
Drng of ovarian cyst(s) 58800 CPT 58800 not published not published $330.65 – $1,249.16 7
Drng of palm multi bursas 26030 CPT 26030 not published not published $518.39 – $1,761.19 7
Drng of palm single bursa 26025 CPT 26025 not published not published $442.69 – $1,511.06 7
Drng of pelvic abscess transrectal 45000 CPT 45000 not published not published $444.83 – $1,533.75 7
Drng of salivary cyst 42409 CPT 42409 not published not published $246.76 – $1,321.84 7
Drng of scrotum abscess 55100 CPT 55100 not published not published $176.42 – $813.04 7
Drng open retroperitoneal abscess 49060 CPT 49060 not published not published $1,102.54 – $3,898.39 7
Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 not published not published $1,008.35 – $3,542.63 7
Drng ovary abscess perqt 58822 CPT 58822 not published not published $742.21 – $2,566.84 7
Drng peritoneal abscess open 49020 CPT 49020 not published not published $1,600.82 – $5,633.40 7
Drng salivary gland simple 42300 CPT 42300 not published not published $165.52 – $773.36 7
Drng salivary gland submax/subling 42310 CPT 42310 not published not published $143.83 – $640.95 7
Drug admin & hemodynmic meas CPT 93463 not published not published $101.51 – $328.94 7
Drug assay caffeine CPT 80155 not published not published $20.23 – $148.88 10
Drug assay posaconazole CPT 80187 $135.66 $238.00 $28.47 – $104.64 7
Drug assay rufinamide CPT 80210 not published not published $28.47 – $104.64 7
Drug assay vedolizumab CPT 80280 not published not published $40.50 – $148.88 7
Drug assay voriconazole CPT 80285 $241.68 $424.00 $28.47 – $104.64 7
Drug asy hydroxychloroquine CPT 80220 not published not published $19.57 – $71.95 7
Drug of abuse screen urine CPT 80305 $78.66 $138.00 $13.23 – $48.64 8
Drug screening tapentadol CPT 80372 not published not published $29.42 – $31.67 3
Drug screen quant tiagabine CPT 80199 not published not published $25.83 – $104.64 10
Drug/substance nos 4-6 CPT 80376 not published not published $31.67 – $33.73 3
Drug test def 1-7 classes HCPCS G0480 $243.96 $428.00 $83.94 – $157.91 9
Drug test def 8-14 classes HCPCS G0481 $267.90 $470.00 $129.14 – $216.09 9
Drug test prsmv instrmnt CPT 80306 $52.44 $92.00 $18.00 – $66.16 8
Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 $262.20 $460.00 $65.25 – $239.86 8
Drvvt confirm - quest CPT 85597 not published not published $18.88 – $69.40 11
Dstrj extensive retinopathy CPT 67227 not published not published $268.69 – $1,344.49 7
Dstrj nulyt agt gnclr nrv CPT 64624 $3,439.95 $6,035.00 $154.20 – $1,482.86 6
Dstr mal les s/n/h/f/g >4.0 CPT 17276 not published not published $212.19 – $1,032.60 7
Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 $586.53 $1,029.00 $179.51 – $537.22 7
Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 not published not published $208.77 – $1,010.40 7
Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 not published not published $283.43 – $1,298.51 7
Ductogram sgl duct CPT 77053 not published not published $18.31 – $43.85 7
Duodenal exclusion CPT 48547 not published not published $1,780.72 – $6,307.39 7
Duodenal motility study CPT 91022 not published not published $77.14 – $250.56 7
Duplex scan bilateral study 93985 CPT 93985 not published not published $38.09 – $125.43 6
Duplex scan unilateral study 93986 CPT 93986 not published not published $23.79 – $79.20 6
Dup scan/hemodialysis access 93990 CPT 93990 not published not published $23.55 – $78.42 7
Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 $799.71 $1,403.00 $24.38 – $80.31 7
Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 $1,584.60 $2,780.00 $39.38 – $130.06 7
Durvalumab 50 mg/ml intravenous solution HCPCS J9173 $137.19 $240.68 $111.64 – $240.68 6
Dxa bone density axl vrt fx CPT 77085 not published not published $15.23 – $36.49 6
Dx aly aud oi snd prcsr 1st CPT 92622 not published not published $71.23 – $71.23 4
Dx aly aud oi snd prcsr each CPT 92623 not published not published $18.85 – $18.85 4
Dx bronchoscope/brush 31623 CPT 31623 $2,910.42 $5,106.00 $136.93 – $983.29 7
Dx bronchoscope/lavage 31624 CPT 31624 $2,910.42 $5,106.00 $138.48 – $918.23 7
Dx bronchoscope/wash 31622 CPT 31622 $1,988.16 $3,488.00 $135.97 – $879.45 7
Dx dark adaptation exam i&r CPT 92284 not published not published $25.21 – $42.42 7
Dx duod intub w/asp spec 43756 CPT 43756 not published not published $53.37 – $910.84 7
Dx duod intub w/asp specs CPT 43757 not published not published $80.22 – $1,251.19 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.