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 |
|---|---|---|---|---|
| Excimer lsr psriasis>500sqcm CPT 96922 | not published | not published | $123.64 – $803.76 | 7 |
| Exc im tumor/back/flank/ < 5 cm 21932 CPT 21932 | not published | not published | $678.94 – $2,347.01 | 7 |
| Exc im tumor/foot/toe < 1.5 cm 28045 CPT 28045 | not published | not published | $371.23 – $1,798.84 | 7 |
| Exc im tumor/shoulder area 5cm/> 23073 CPT 23073 | $1,039.68 | $1,824.00 | $716.09 – $1,485.02 | 7 |
| Exc intracard tumor/resect/bypass 33120 CPT 33120 | not published | not published | $2,039.28 – $7,320.53 | 7 |
| Exc ischial pr ulcer w/ostc musc/myoq flap/skin 15946 CPT 15946 | not published | not published | $1,650.89 – $5,825.78 | 7 |
| Exc ischial pr ulc prim sutr CPT 15940 | not published | not published | $727.35 – $2,493.04 | 7 |
| Exc isch pr ulc prm sut ostc CPT 15941 | not published | not published | $960.52 – $3,275.66 | 7 |
| Exc isch pr ulc skn flp clsr CPT 15944 | not published | not published | $969.79 – $3,260.40 | 7 |
| Exc isch pr ulc skn flp ostc CPT 15945 | not published | not published | $1,058.10 – $3,652.65 | 7 |
| Excise anal ext tag/papilla CPT 46220 | $549.48 | $964.00 | $126.88 – $827.33 | 7 |
| Excise epiphyseal bar CPT 20150 | not published | not published | $1,033.05 – $3,585.45 | 7 |
| Excise foot tendon sheath CPT 28086 | not published | not published | $371.86 – $1,966.95 | 7 |
| Excise foot tendon sheath CPT 28088 | not published | not published | $313.79 – $1,595.55 | 7 |
| Excise ileoanal reservior CPT 45136 | not published | not published | $1,843.31 – $6,537.23 | 7 |
| Excise inferior turbinate CPT 30130 | not published | not published | $443.68 – $1,432.80 | 7 |
| Excise intestine lesion(s) 44110 CPT 44110 | not published | not published | $862.21 – $3,007.69 | 7 |
| Excise intraspinl lesion crv CPT 63265 | not published | not published | $1,639.27 – $5,669.36 | 7 |
| Excise intrspinl lesion crvl CPT 63270 | not published | not published | $2,016.38 – $6,976.20 | 7 |
| Excise intrspinl lesion lmbr CPT 63267 | not published | not published | $1,362.42 – $4,707.79 | 7 |
| Excise intrspinl lesion lmbr CPT 63272 | not published | not published | $1,844.69 – $6,425.44 | 7 |
| Excise intrspinl lesion scrl CPT 63268 | not published | not published | $1,433.96 – $4,836.64 | 7 |
| Excise intrspinl lesion scrl CPT 63273 | not published | not published | $1,818.47 – $6,273.68 | 7 |
| Excise intrspinl lesion thrc CPT 63271 | not published | not published | $2,014.70 – $6,978.94 | 7 |
| Excise lesion testis CPT 54512 | not published | not published | $562.92 – $1,968.64 | 7 |
| Excise lip or cheek fold CPT 40819 | not published | not published | $212.85 – $1,033.84 | 7 |
| Excise lwr jaw cyst w/repair CPT 21047 | not published | not published | $1,270.55 – $4,670.10 | 7 |
| Excise mandible lesion CPT 21040 | not published | not published | $384.86 – $1,816.05 | 7 |
| Excise max/zygoma b9 tumor CPT 21030 | not published | not published | $383.43 – $1,801.91 | 7 |
| Excise max/zygoma mal tumor CPT 21034 | not published | not published | $1,176.97 – $4,702.13 | 7 |
| Excise oral mucosa for graft 40818 CPT 40818 | not published | not published | $281.44 – $1,340.06 | 7 |
| Excise parotid gland/lesion CPT 42410 | not published | not published | $659.55 – $2,244.98 | 7 |
| Excise parotid gland/lesion CPT 42415 | not published | not published | $1,105.69 – $3,799.91 | 7 |
| Excise parotid gland/lesion CPT 42420 | not published | not published | $1,236.53 – $4,267.76 | 7 |
| Excise parotid gland/lesion CPT 42425 | not published | not published | $877.17 – $3,010.80 | 7 |
| Excise parotid gland/lesion CPT 42426 | not published | not published | $1,402.00 – $4,859.14 | 7 |
| Excise pharynx lesion CPT 42808 | not published | not published | $175.30 – $827.74 | 7 |
| Excise/repair mouth lesion CPT 40812 | not published | not published | $193.25 – $1,046.18 | 7 |
| Excise sacral spine tumor CPT 49215 | not published | not published | $2,237.29 – $7,864.39 | 7 |
| Excise sublingual gland CPT 42450 | not published | not published | $385.28 – $1,673.29 | 7 |
| Excise submaxillary gland CPT 42440 | not published | not published | $438.28 – $1,485.79 | 7 |
| Excise subq tumor/abd wall <3 cm 22902 CPT 22902 | not published | not published | $344.84 – $1,637.55 | 7 |
| Excise tendon forearm/wrist CPT 25109 | not published | not published | $566.28 – $1,930.84 | 7 |
| Excise wrist tendon sheath CPT 25118 | not published | not published | $408.40 – $1,371.71 | 7 |
| Excision addl breast lesion 19126 CPT 19126 | not published | not published | $157.61 – $563.59 | 7 |
| Excision aural polyp CPT 69540 | not published | not published | $138.50 – $742.13 | 7 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $450.30 | $790.00 | $141.57 – $371.58 | 7 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $463.98 | $814.00 | $144.08 – $386.94 | 7 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $424.65 | $745.00 | $122.41 – $366.14 | 7 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $819.66 | $1,438.00 | $257.47 – $680.05 | 7 |
| Excision breast lesion CPT 19125 | $616.74 | $1,082.00 | $470.79 – $1,186.25 | 7 |
| Excision coa w/graft CPT 33845 | not published | not published | $1,316.24 – $4,667.74 | 7 |
| Excision floor mouth lesion 41116 CPT 41116 | not published | not published | $229.44 – $1,211.21 | 7 |
| Excision graft abdomen CPT 35907 | not published | not published | $1,836.67 – $6,607.01 | 7 |
| Excision graft extremity CPT 35903 | not published | not published | $553.90 – $1,980.75 | 7 |
| Excision graft neck CPT 35901 | not published | not published | $466.89 – $1,643.40 | 7 |
| Excision graft thorax 35905 CPT 35905 | not published | not published | $1,613.90 – $6,177.00 | 7 |
| Excision gum each quadrant CPT 41820 | not published | not published | $864.98 – $864.98 | 2 |
| Excision hand/finger tendon CPT 26415 | not published | not published | $894.39 – $2,969.48 | 7 |
| Excision lesion mouth roof CPT 42106 | not published | not published | $170.17 – $973.99 | 7 |
| Excision lesion mouth roof CPT 42107 | not published | not published | $342.92 – $1,689.98 | 7 |
| Excision nasal polyp(s) simple 30110 CPT 30110 | not published | not published | $140.88 – $867.15 | 7 |
| Excision of anal lesion(s) CPT 46922 | not published | not published | $143.44 – $1,061.03 | 7 |
| Excision of bile duct cyst CPT 47715 | not published | not published | $1,330.75 – $4,694.18 | 7 |
| Excision of bile duct tumor CPT 47711 | not published | not published | $1,558.49 – $5,501.44 | 7 |
| Excision of bile duct tumor CPT 47712 | not published | not published | $1,982.34 – $7,031.89 | 7 |
| Excision of bowel lesion(s) CPT 44111 | not published | not published | $988.21 – $3,488.78 | 7 |
| Excision of brain tumor CPT 61545 | not published | not published | $3,077.14 – $10,692.08 | 7 |
| Excision of esophagus lesion CPT 43100 | not published | not published | $669.16 – $2,268.60 | 7 |
| Excision of esophagus lesion CPT 43101 | not published | not published | $996.86 – $3,525.15 | 7 |
| Excision of gum flap CPT 41821 | not published | not published | $195.86 – $195.86 | 2 |
| Excision of gum lesion CPT 41822 | not published | not published | $210.52 – $1,249.09 | 7 |
| Excision of gum lesion CPT 41823 | not published | not published | $386.46 – $1,839.15 | 7 |
| Excision of gum lesion CPT 41826 | not published | not published | $207.34 – $1,146.19 | 7 |
| Excision of gum lesion CPT 41827 | not published | not published | $306.03 – $1,630.46 | 7 |
| Excision of gum lesion CPT 41828 | not published | not published | $230.07 – $1,253.78 | 7 |
| Excision of gum lesion 41825 CPT 41825 | not published | not published | $129.47 – $793.73 | 7 |
| Excision of lesion of mesentery 44820 CPT 44820 | not published | not published | $854.20 – $2,957.74 | 7 |
| Excision of lingual tonsil CPT 42870 | not published | not published | $622.76 – $2,127.86 | 7 |
| Excision of meckels diverticulum 44800 CPT 44800 | $1,361.16 | $2,388.00 | $787.24 – $1,638.07 | 7 |
| Excision of mouth lesion complex 40816 CPT 40816 | not published | not published | $322.25 – $1,459.24 | 7 |
| Excision of neck cyst CPT 42815 | not published | not published | $567.02 – $1,968.34 | 7 |
| Excision of neck cyst confined 42810 CPT 42810 | not published | not published | $300.82 – $1,396.24 | 7 |
| Excision of penis lesion(s) 54060 CPT 54060 | not published | not published | $139.22 – $682.99 | 7 |
| Excision of rectal lesion CPT 45160 | not published | not published | $1,030.87 – $3,608.29 | 7 |
| Excision of rectal prolapse CPT 45135 | not published | not published | $1,344.12 – $4,715.48 | 7 |
| Excision of rectal stricture CPT 45150 | not published | not published | $432.61 – $1,480.35 | 7 |
| Excision of salivary cyst CPT 42408 | not published | not published | $370.77 – $1,925.18 | 7 |
| Excision of skull/sutures CPT 61558 | not published | not published | $1,833.75 – $6,319.28 | 7 |
| Excision of skull/sutures CPT 61559 | not published | not published | $2,331.48 – $8,048.14 | 7 |
| Excision of skull tumor CPT 61563 | not published | not published | $1,923.68 – $6,655.61 | 7 |
| Excision of skull tumor CPT 61564 | not published | not published | $2,330.39 – $8,076.45 | 7 |
| Excision of stomach lesion CPT 43610 | not published | not published | $980.14 – $3,460.99 | 7 |
| Excision of stomach lesion CPT 43611 | not published | not published | $1,231.24 – $4,314.56 | 7 |
| Excision of tongue lesion CPT 41112 | not published | not published | $257.66 – $1,221.49 | 7 |
| Excision of tongue lesion CPT 41114 | not published | not published | $652.53 – $2,245.09 | 7 |
| Excision of tongue lesion w/closure 41113 CPT 41113 | not published | not published | $279.82 – $1,327.01 | 7 |
| Excision of tonsil tags CPT 42860 | not published | not published | $207.33 – $682.28 | 7 |
| Excision of umbilicus 49250 CPT 49250 | not published | not published | $606.46 – $2,088.26 | 7 |
| Excision of uvula CPT 42140 | not published | not published | $173.73 – $1,023.98 | 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.