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
Dx gastr intub w/asp spec CPT 43754 not published not published $39.06 – $660.75 7
Dx gastr intub w/asp specs CPT 43755 not published not published $62.45 – $626.89 7
Dx intraop epcar Ultrasound chd i&r CPT 76989 not published not published $36.02 – $36.02 4
Dx intraop epicar car Ultrasound chd CPT 76987 not published not published $97.24 – $97.24 4
Dx intraop thoracic aorta Ultrasound CPT 76984 not published not published $31.22 – $31.22 4
Dx laryngoscopy newborn CPT 31520 not published not published $162.21 – $558.23 7
Dx laryngoscopy w/oper scope CPT 31526 not published not published $162.59 – $560.85 7
Dx ntrop epcr Ultrasound chd img acq CPT 76988 not published not published $61.59 – $61.59 4
Dynamic cavernosometry CPT 54231 not published not published $120.76 – $516.45 7
Dynamic fine wire emg CPT 96003 not published not published $17.84 – $58.27 7
Dynamic surface emg CPT 96002 not published not published $22.43 – $73.18 7
Ear and throat examination CPT 92502 not published not published $101.77 – $313.90 7
Ear canal biopsy 69105 CPT 69105 not published not published $67.07 – $510.26 7
Ear cartilage graft CPT 21235 not published not published $602.39 – $2,628.90 7
Ear irrigation 69209 CPT 69209 $124.26 $218.00 $16.89 – $50.51 6
Ear protector evaluation CPT 92596 not published not published $82.18 – $212.23 7
Ecg 12 lead tracing only CPT 93005 $177.27 $311.00 $6.55 – $27.01 7
Ecg/1-3 leads/interp & report only 93042 CPT 93042 not published not published $7.14 – $23.32 7
Ecg/1-3 leads/tracing only 93041 CPT 93041 $117.99 $207.00 $6.55 – $17.75 7
Ecg < 30 days transmission & analysis CPT 93271 not published not published $152.83 – $539.85 7
Ecg external < 48 hours recording CPT 93225 $204.06 $358.00 $19.39 – $82.57 7
Ecg external < 48 hours scanning analysis w/report CPT 93226 $507.30 $890.00 $37.94 – $117.32 7
Ecg external > 48 hours up to 7 days recording CPT 93242 not published not published $12.61 – $51.34 6
Ecg external >7 days up to 15 days recording CPT 93246 not published not published $12.61 – $51.34 6
Ecg record/review CPT 93268 not published not published $187.21 – $653.08 7
Ecg/review interpret only CPT 93272 $62.70 $110.00 $25.70 – $85.04 7
Echocardiogram (Heart Ultrasound) CPT 93306 $1,877.01 $3,293.00 $73.25 – $246.30 7
Echocardiography doppler color flow mapping CPT 93325 $290.70 $510.00 $3.32 – $10.85 7
Echocardiography transthoracic 2d followup/limited CPT 93308 $844.17 $1,481.00 $26.43 – $86.26 7
Echocardiograpy doppler follow up/limited study CPT 93321 $349.41 $613.00 $7.50 – $24.47 7
Echo exam of eye CPT 76516 not published not published $23.96 – $72.88 7
Echo exam of eye CPT 76519 not published not published $32.39 – $76.66 7
Echo exam of eye CPT 76529 not published not published $34.58 – $81.02 7
Echo exam of eye thickness CPT 76514 not published not published $8.20 – $13.15 7
Echo exam of fetal heart CPT 76825 not published not published $85.23 – $202.72 7
Echo exam of fetal heart CPT 76826 not published not published $42.25 – $100.64 7
Echo exam of fetal heart CPT 76827 not published not published $29.72 – $70.33 7
Echo exam of fetal heart CPT 76828 not published not published $28.49 – $57.21 7
Echo exam uterus 76831- CPT 76831 not published not published $37.08 – $88.24 7
Echograp trans r pros study CPT 76873 not published not published $81.72 – $192.82 7
Echo guidance radiotherapy CPT 76965 not published not published $56.81 – $72.34 7
Echo guide cardiocentesis CPT 76930 not published not published $74.89 – $145.82 3
Echo guide for amniocentesis CPT 76946 not published not published $19.64 – $32.20 7
Echo guide for artery repair CPT 76936 not published not published $96.76 – $232.57 7
Echo guide for heart biopsy CPT 76932 not published not published $36.79 – $83.50 7
Echo guide for transfusion CPT 76941 not published not published $68.88 – $161.01 7
Echo guide ova aspiration CPT 76948 not published not published $33.00 – $81.77 7
Echo guide villus sampling CPT 76945 not published not published $34.38 – $81.77 7
Echo stress CPT 93350 not published not published $73.25 – $239.10 7
Echo tee cngntl wo ctrst probe plcmnt CPT 93316 not published not published $26.91 – $90.21 7
Echo tee guidance CPT 93355 not published not published $234.54 – $766.21 6
Echo tee probe placement image acquisition interpretation & report CPT 93312 not published not published $112.78 – $368.59 7
Echo transesophageal CPT 93313 not published not published $11.72 – $84.10 7
Echo transesophageal CPT 93314 not published not published $92.00 – $299.87 7
Echo transesophageal CPT 93315 not published not published $133.87 – $434.70 7
Echo transesophageal CPT 93317 not published not published $91.84 – $305.18 7
Echo transesophageal intraop CPT 93318 not published not published $106.61 – $348.01 7
Echo transthoracic CPT 93303 not published not published $65.37 – $213.79 7
Echo transthoracic CPT 93304 not published not published $37.97 – $122.76 7
Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 $1,594.86 $2,798.00 $46.09 – $151.59 7
Ecmo/ecls daily mgmt artery 33949 CPT 33949 not published not published $231.44 – $831.64 6
Ecmo/ecls daily mgmt-venous 33948 CPT 33948 not published not published $237.59 – $859.91 6
Ecmo/ecls initiation artery 33947 CPT 33947 not published not published $335.24 – $1,206.56 6
Ecmo/ecls initiation venous 33946 CPT 33946 not published not published $303.12 – $1,089.90 6
Ecmo/ecls insj cent cannula 0-5yrs 33955 CPT 33955 not published not published $798.44 – $2,895.53 6
Ecmo/ecls insj cent cannula 6yrs&older 33956 CPT 33956 not published not published $808.04 – $2,914.35 6
Ecmo/ecls insj prph cannula 0-5yrs opn 33953 CPT 33953 not published not published $456.18 – $1,652.74 6
Ecmo/ecls insj prph cannula 0-5yrs perq 33951 CPT 33951 not published not published $408.63 – $1,481.14 6
Ecmo/ecls insj prph cannula 6yrs&older opn 33954 CPT 33954 not published not published $460.61 – $1,665.56 6
Ecmo/ecls insj prph cannula 6yrs&older perq 33952 CPT 33952 not published not published $416.11 – $1,501.20 6
Ecmo/ecls remove cent cannula 0-5yrs 33985 CPT 33985 not published not published $494.97 – $1,794.41 6
Ecmo/ecls remove cent cannula 6yrs&older 33986 CPT 33986 not published not published $506.62 – $1,827.30 6
Ecmo/ecls remove perph cannula 0-5yrs opn 33969 CPT 33969 not published not published $263.06 – $952.65 6
Ecmo/ecls remove perph cannula 0-5yrs perq 33965 CPT 33965 not published not published $178.19 – $645.60 6
Ecmo/ecls remove prph cannula 6yrs&older open 33984 CPT 33984 not published not published $274.31 – $991.20 6
Ecmo/ecls remove prph cannula 6yrs&older perq 33966 CPT 33966 not published not published $230.55 – $831.94 6
Ecmo/ecls repos cent cnula 6yrs&older 33964 CPT 33964 not published not published $475.88 – $1,723.99 6
Ecmo/ecls repos cent/perph cnula 0-5yrs 33963 CPT 33963 not published not published $450.76 – $1,633.58 6
Ecmo/ecls repos perph cnula 0-5yrs opn 33959 CPT 33959 not published not published $226.35 – $817.20 6
Ecmo/ecls repos perph cnula 0-5yrs perq 33957 CPT 33957 not published not published $178.19 – $645.60 6
Ecmo/ecls repos perph cnula 6yrs&older opn 33962 CPT 33962 not published not published $226.35 – $817.20 6
Ecmo/ecls repos perph cnula 6yrs&older perq 33958 CPT 33958 not published not published $178.19 – $645.60 6
Ecog impltd brn npgt <30 d CPT 95836 not published not published $111.11 – $354.83 6
E coli 0157 ag ia CPT 87335 not published not published $13.29 – $48.87 11
Ecp ciliary body destruction CPT 66711 not published not published $537.73 – $1,830.75 7
Edu/train/pt/nonmd/in person/30 min98960 CPT 98960 not published not published $87.61 – $87.61 2
Eeg 41-60 minutes 95812-26 CPT 95812 $747.84 $1,312.00 $60.15 – $192.73 7
Eeg/cerebral death evaluation only 95824 -26 CPT 95824 not published not published $41.16 – $131.96 7
Eeg during surgery CPT 95955 not published not published $56.34 – $180.73 7
Eeg monitoring/function test CPT 95958 not published not published $237.13 – $753.20 7
Eeg monitoring/giving drugs CPT 95954 not published not published $119.10 – $381.91 7
Eeg monitor/record/awake/drowsy 95816 CPT 95816 $872.10 $1,530.00 $60.15 – $192.73 7
Eeg over 1 hour 95813 - 26 CPT 95813 $889.20 $1,560.00 $90.89 – $292.27 7
Eeg phy/qhp>36<60 hr without vid CPT 95721 not published not published $216.59 – $701.79 6
Eeg phy/qhp>36<60 hr w/veeg CPT 95722 not published not published $262.46 – $851.02 6
Eeg phy/qhp>60<84 hr without vid CPT 95723 not published not published $263.24 – $868.32 6
Eeg phy/qhp>60<84 hr w/veeg CPT 95724 not published not published $331.29 – $1,087.21 6
Eeg phy/qhp>84 hr without vid CPT 95725 not published not published $303.32 – $991.22 6
Eeg phy/qhp>84 hr w/veeg CPT 95726 not published not published $423.80 – $1,373.80 6
Eeg phy/qhp ea incr w/veeg CPT 95720 not published not published $216.72 – $696.01 6

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.