Ascension Calumet Hospital, Inc.
614 Memorial Dr, Chilton, WI · Ascension · · NPI 1376541748
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 |
|---|---|---|---|---|
| Ana ds-dna CPT 86226 | $43.32 | $76.00 | $12.72 – $46.74 | 11 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | not published | not published | $31.67 – $37.58 | 3 |
| Anal pressure record CPT 91122 | not published | not published | $92.79 – $299.33 | 7 |
| Anal/urinary muscle study CPT 51784 | $666.33 | $1,169.00 | $38.46 – $165.21 | 7 |
| Anal/urinary muscle study CPT 51785 | not published | not published | $89.37 – $314.85 | 7 |
| Analysis complx cranial nerve pulse gen prgrmg 95977 CPT 95977 | not published | not published | $53.81 – $177.42 | 6 |
| Analysis gene f2 20210g>a variant CPT 81240 | $203.49 | $357.00 | $68.97 – $253.56 | 10 |
| Analysis gene f5 leiden variant CPT 81241 | $164.73 | $289.00 | $77.04 – $283.21 | 10 |
| Analysis nerve CPT 88356 | not published | not published | $76.99 – $303.63 | 8 |
| Analysis; simple cranial nerv pulse gen prgrmg 95976 CPT 95976 | $82.65 | $145.00 | $40.57 – $135.03 | 6 |
| Analysis tumor CPT 88358 | not published | not published | $49.79 – $89.35 | 8 |
| Analyze neurostimulator simple w/reprogramming 95971 CPT 95971 | $197.79 | $347.00 | $40.65 – $165.42 | 7 |
| Anaplsma phgcytophlm amp prb CPT 87468 | not published | not published | $36.84 – $135.45 | 7 |
| Anastamo/extrahep bil duct/gi trac 47760 CPT 47760 | $3,885.69 | $6,817.00 | $2,245.30 – $4,772.88 | 7 |
| Anastamo/roux-en-y/extrahep bil/gi 47780 CPT 47780 | not published | not published | $2,459.69 – $8,711.74 | 7 |
| Anastomosis of facial/other nerve 64868 CPT 64868 | not published | not published | $1,040.04 – $3,612.34 | 7 |
| Anca screen with reflex to titer -quest CPT 86021 | $26.22 | $46.00 | $15.80 – $58.09 | 11 |
| An cholangiogram percutaneous compl CPT 47531 | $2,161.44 | $3,792.00 | $72.55 – $1,411.13 | 6 |
| Androstanediol CPT 82154 | not published | not published | $30.27 – $111.28 | 11 |
| An fluoro guide for cvp CPT 77001 | $372.21 | $653.00 | $18.59 – $45.06 | 7 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | not published | not published | $145.94 – $2,510.93 | 6 |
| Angioplasty fem/pop unilat 37224 CPT 37224 | not published | not published | $429.27 – $12,444.11 | 7 |
| Angioplasty/iliac/init ves/unilat 37220 CPT 37220 | not published | not published | $387.36 – $10,454.70 | 7 |
| Angioplasty tib/pero/unilat/ea add 37232 CPT 37232 | not published | not published | $193.86 – $3,694.16 | 7 |
| Angiotensin ii CPT 82163 | not published | not published | $21.55 – $79.21 | 11 |
| Angio tib/peroneal/init ves/unila 37228 CPT 37228 | not published | not published | $522.92 – $17,932.95 | 7 |
| Angio trnslmnl balloon same artery ea addl CPT 37247 | not published | not published | $169.92 – $2,612.55 | 6 |
| Angio trnslmnl balloon same artery ini CPT 37246 | not published | not published | $342.43 – $7,444.84 | 6 |
| Angio trnslmnl balloon same vein ea addl CPT 37249 | not published | not published | $143.67 – $1,995.71 | 6 |
| Angio trnslmnl balloon same vein ini CPT 37248 | not published | not published | $297.00 – $5,485.50 | 6 |
| Anidulafungin injection HCPCS J0348 | $3.76 | $6.60 | $0.68 – $6.60 | 6 |
| Ankle arthroscopy/surgery CPT 29891 | not published | not published | $707.90 – $2,420.81 | 7 |
| Ankle arthroscopy/surgery CPT 29892 | not published | not published | $679.82 – $2,376.79 | 7 |
| Ankle arthroscopy/surgery CPT 29894 | not published | not published | $529.66 – $1,803.86 | 7 |
| Ankle arthroscopy/surgery CPT 29895 | $859.56 | $1,508.00 | $488.20 – $1,048.82 | 7 |
| Ankle arthroscopy/surgery CPT 29897 | $878.94 | $1,542.00 | $520.33 – $1,117.70 | 7 |
| Ankle arthroscopy/surgery CPT 29898 | $996.36 | $1,748.00 | $589.78 – $1,233.70 | 7 |
| Ankle arthroscopy/surgery CPT 29899 | not published | not published | $1,042.31 – $3,696.49 | 7 |
| Ankle X-ray CPT 73610 | $165.30 | $290.00 | $8.96 – $21.45 | 7 |
| Anl sp inf pmp w/mdreprg&fil CPT 62370 | not published | not published | $47.63 – $362.03 | 7 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | $189.81 | $333.00 | $90.86 – $158.84 | 6 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | $197.22 | $346.00 | $98.72 – $169.07 | 6 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | $212.61 | $373.00 | $99.46 – $176.03 | 6 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | $240.54 | $422.00 | $120.71 – $203.54 | 6 |
| Anodyne therapy charges pt CPT 97026 | not published | not published | $7.50 – $12.29 | 7 |
| Anogenital exam child w imag CPT 99170 | not published | not published | $89.56 – $521.09 | 7 |
| Anora (draw only) CPT 99001 | $12.54 | $22.00 | $7.85 – $10.66 | 3 |
| Anorectal myomectomy CPT 45108 | not published | not published | $382.95 – $1,312.50 | 7 |
| Anoscopy CPT 46611 | not published | not published | $83.40 – $735.19 | 7 |
| Anoscopy ablation lesion 46615 CPT 46615 | not published | not published | $94.19 – $583.31 | 7 |
| Anoscopy and biopsy CPT 46606 | not published | not published | $77.66 – $931.01 | 7 |
| Anoscopy and dilation 46604 CPT 46604 | not published | not published | $68.09 – $2,433.34 | 7 |
| Anoscopy control bleeding 46614 CPT 46614 | not published | not published | $66.73 – $534.86 | 7 |
| Anoscopy remove fb 46608 CPT 46608 | not published | not published | $84.77 – $968.18 | 7 |
| Anoscopy remove lesion 46610 CPT 46610 | not published | not published | $82.08 – $925.20 | 7 |
| Anoscopy remove lesions w/cautery/snare 46612 CPT 46612 | not published | not published | $95.34 – $1,122.00 | 7 |
| Ans parasymp & symp w/tilt CPT 95924 | not published | not published | $91.65 – $201.08 | 7 |
| Ant colporrhaphy/rpr cyctocele 57240 CPT 57240 | not published | not published | $639.93 – $2,192.85 | 7 |
| Antibody CPT 86744 | not published | not published | $8.32 – $61.72 | 11 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $45.03 | $79.00 | $8.32 – $49.72 | 11 |
| Antibody elution rbc reference CPT 86860 | $98.61 | $173.00 | $34.23 – $43.01 | 3 |
| Antibody htlv/hiv confirm test CPT 86689 | not published | not published | $20.32 – $74.69 | 11 |
| Antibody htlv-i CPT 86687 | $15.39 | $27.00 | $9.54 – $35.09 | 11 |
| Antibody htlv-ii CPT 86688 | $23.94 | $42.00 | $14.70 – $54.04 | 11 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $164.73 | $289.00 | $19.29 – $70.91 | 11 |
| Antibody id rbc panel CPT 86870 | $205.77 | $361.00 | $34.23 – $59.08 | 3 |
| Antibody influenza virus CPT 86710 | not published | not published | $14.23 – $52.30 | 11 |
| Antibody lymphocytic choriomeningitis CPT 86727 | not published | not published | $8.32 – $49.68 | 11 |
| Antibody screen rbc CPT 86850 | $86.64 | $152.00 | $5.47 – $37.71 | 10 |
| Antibody tetanus CPT 86774 | not published | not published | $15.54 – $57.13 | 11 |
| Antidepressant not specified CPT 80338 | not published | not published | $73.23 – $73.23 | 2 |
| Antigen therapy services CPT 95145 | not published | not published | $3.07 – $100.32 | 7 |
| Antigen therapy services CPT 95146 | not published | not published | $3.07 – $184.82 | 7 |
| Antigen therapy services CPT 95147 | not published | not published | $3.07 – $186.00 | 7 |
| Antigen therapy services CPT 95148 | not published | not published | $3.07 – $271.65 | 7 |
| Antigen therapy services CPT 95149 | not published | not published | $3.07 – $360.78 | 7 |
| Antigen therapy services CPT 95165 | not published | not published | $3.43 – $47.08 | 7 |
| Antigen therapy services CPT 95170 | not published | not published | $3.07 – $35.49 | 7 |
| Anti mog serum - sendout CPT 86362 | $559.17 | $981.00 | $12.65 – $46.51 | 7 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $43.32 | $76.00 | $12.65 – $46.51 | 7 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $18.24 | $32.00 | $12.65 – $46.51 | 7 |
| Ant instr 2-3 vert segm 22845 CPT 22845 | not published | not published | $703.53 – $2,499.26 | 7 |
| Ant instrumentation/4-7 vert seg 22846 CPT 22846 | not published | not published | $731.59 – $2,597.59 | 7 |
| Antinuclear antibodies CPT 86038 | $66.69 | $117.00 | $12.69 – $46.67 | 11 |
| Antinuclear antibodies titer CPT 86039 | $40.47 | $71.00 | $11.72 – $43.08 | 11 |
| Antiphosphatidylserine antibody CPT 86148 | $27.93 | $49.00 | $8.32 – $62.03 | 11 |
| Antistreptolysin o screen CPT 86063 | not published | not published | $6.06 – $22.27 | 11 |
| Antistreptolysin o titer CPT 86060 | $25.65 | $45.00 | $7.67 – $28.18 | 11 |
| Antithrombin iii activity CPT 85300 | $37.62 | $66.00 | $12.44 – $45.74 | 11 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | not published | not published | $903.08 – $3,140.63 | 7 |
| Ant sgm img ir flrscn angrph CPT 92287 | not published | not published | $31.45 – $157.07 | 7 |
| Ant sgm img i&r speclr mic CPT 92286 | not published | not published | $22.89 – $53.64 | 7 |
| Aortic circulation assist 33971 CPT 33971 | not published | not published | $701.22 – $2,470.69 | 7 |
| Aortic dysfunction/dilation CPT 81410 | not published | not published | $529.20 – $1,945.44 | 7 |
| Aortic dysfunction/dilation CPT 81411 | not published | not published | $1,417.70 – $5,211.73 | 7 |
| Aortic hemiarch graft 33866 CPT 33866 | not published | not published | $888.31 – $3,228.94 | 6 |
| Apc gene dup/delet variants CPT 81203 | not published | not published | $210.00 – $772.00 | 7 |
| Apc gene full sequence CPT 81201 | not published | not published | $819.00 – $3,010.80 | 7 |
| Apc gene known fam variants CPT 81202 | not published | not published | $294.00 – $1,080.80 | 7 |
| Aphakia prosth service temp CPT 92358 | not published | not published | $35.12 – $35.12 | 2 |
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.