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
Goniotomy CPT 65820 not published not published $873.51 – $2,859.71 7
Graft hand or finger tendon CPT 26416 not published not published $966.34 – $3,217.91 7
Graft repair of spine defect 63710 CPT 63710 not published not published $1,092.46 – $3,771.68 7
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 $384.75 $675.00 $197.15 – $219.10 3
Great toe-hand transfer CPT 26551 not published not published $3,369.31 – $11,741.78 7
Great toe with reduction 28495 CPT 28495 not published not published $163.10 – $650.48 7
Grfg autol fat lipo 25 cc/< CPT 15773 not published not published $522.75 – $2,094.41 6
Grfg autol fat lipo 50 cc/< CPT 15771 not published not published $532.50 – $2,074.46 6
Grfg autol fat lipo ea addl CPT 15772 not published not published $150.62 – $651.19 6
Grfg autol soft tiss dir exc CPT 15769 not published not published $497.93 – $1,729.46 6
Ground mileage HCPCS A0425 $11.40 $20.00 $7.62 – $7.62 2
Group behave couns 2-10 HCPCS G0473 $30.78 $54.00 $12.59 – $42.35 6
Growth hormone antibody CPT 86277 not published not published $16.53 – $60.76 11
Growth hormone panel CPT 80428 not published not published $70.04 – $257.46 11
Growth hormone panel CPT 80430 not published not published $112.26 – $499.21 11
Growth stimulation gene 2 CPT 83006 not published not published $31.46 – $291.82 10
Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 not published not published $1,915.00 – $6,769.91 7
Gstr rstcv oth/thn v-band CPT 43843 not published not published $1,283.42 – $4,515.38 7
Gstr rstcv px shrt roux-en-y CPT 43846 not published not published $1,648.25 – $5,728.35 7
Gstr rstcv px sm int rcnstj CPT 43847 not published not published $1,801.72 – $6,353.78 7
Gstr rstcv px v-banded gstp CPT 43842 not published not published $1,214.22 – $4,293.56 6
Gstrst open wo constj tube CPT 43830 not published not published $711.12 – $2,484.53 7
G-tube reposition CPT 43761 not published not published $105.07 – $440.48 7
Gu dilat ureter/urethra s&i CPT 74485 not published not published $41.66 – $98.93 7
Guided cath fluid drainage 10030 CPT 10030 not published not published $138.82 – $2,248.35 6
Guide endoanchr sg-64 aaa 62cm HCPCS L8670 $1,152.59 $2,022.08 $555.54 – $555.54 2
Guid loc target vol rad tx CPT 77387 not published not published $232.43 – $232.43 2
Gum graft CPT 41870 not published not published $1,082.36 – $1,082.36 2
Gynecomastia (males) 19300 CPT 19300 not published not published $445.90 – $1,969.61 7
Hair removal by electrolysis 17380 CPT 17380 not published not published $268.05 – $268.05 2
Hair trnspl 1-15 punch grfts CPT 15775 not published not published $260.81 – $1,331.81 7
Hair trnspl >15 punch grafts CPT 15776 not published not published $356.72 – $1,824.15 7
Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 $21.09 $37.00 $10.12 – $37.00 6
Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 $2.21 $3.87 $1.74 – $3.87 6
Handle/convey/speciman/office-lab 99000 CPT 99000 not published not published $7.38 – $9.28 3
Hand tendon/muscle transfer CPT 26494 not published not published $885.72 – $2,919.60 7
Hand tendon reconstruction CPT 26500 not published not published $727.89 – $2,295.86 7
Hand tendon reconstruction CPT 26502 not published not published $796.86 – $2,607.38 7
Hand X-ray CPT 73130 $176.70 $310.00 $8.96 – $21.45 7
Haptoglobin quantitative CPT 83010 $46.17 $81.00 $13.21 – $48.56 11
Harvest allogeneic stem cell CPT 38205 not published not published $88.91 – $316.09 7
Harvest auto stem cells CPT 38206 not published not published $87.13 – $314.81 7
Harvest cultured skin graft 15040 CPT 15040 not published not published $127.54 – $939.26 7
Harvest eye tissue alograft CPT 68371 not published not published $436.60 – $1,501.73 7
Harvest femoropopliteal vein 35572 CPT 35572 not published not published $329.09 – $1,202.40 7
Harvest stem cell concentrte CPT 38215 not published not published $49.12 – $177.38 6
Harvest vein for bypass 35500 CPT 35500 not published not published $304.55 – $1,108.61 7
Hast w/i&r phys/qhp CPT 94452 $147.63 $259.00 $14.89 – $48.64 7
Hast w/oxygen titrate CPT 94453 $147.63 $259.00 $19.44 – $63.48 7
Hba1/hba2 full gene sequence CPT 81259 not published not published $630.00 – $2,316.00 7
Hba1/hba2 gene dup/del vrnts CPT 81269 not published not published $212.52 – $781.26 7
Hba1/hba2 gene fam vrnt CPT 81258 not published not published $394.01 – $1,448.47 7
Hbb full gene sequence CPT 81364 not published not published $340.81 – $1,252.88 7
Hbb gene com variants CPT 81361 not published not published $183.55 – $674.77 7
Hbb gene dup/del variants CPT 81363 not published not published $212.52 – $781.26 7
Hbb gene known fam variant CPT 81362 not published not published $394.01 – $1,448.47 7
Hb glycosylated a1c home dev CPT 83037 $16.53 $29.00 $10.20 – $37.48 11
Hbot, full body chamber, 30m HCPCS G0277 $292.98 $514.00 $194.23 – $441.83 6
Hc ea ha check monaural CPT 92594 not published not published $67.94 – $67.94 2
Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 not published not published $58.99 – $142.98 7
Hcg free betachain test CPT 84704 $26.22 $46.00 $16.05 – $59.02 11
Hcg qualitative CPT 84703 $57.57 $101.00 $7.90 – $29.03 11
Hcg quantitative CPT 84702 $91.20 $160.00 $15.80 – $58.09 11
Hc hearing aid chck binaurl CPT 92593 not published not published $118.23 – $118.23 2
Hc hearing aid chck monarl CPT 92592 not published not published $71.49 – $71.49 2
Hc hearing aid exam both ears CPT 92591 not published not published $229.40 – $229.40 2
Hc hearing aid exam one ear CPT 92590 $103.17 $181.00 $180.32 – $180.32 2
Hc metata joint dislocation anes CPT 28635 not published not published $139.89 – $641.33 7
Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 not published not published $370.34 – $2,414.14 7
Hc mohs micrographic h/n/h/f/g each addl stage CPT 17312 not published not published $196.92 – $1,447.76 7
Hc mohs trunk/arm/leg 1st stage 5 blocks CPT 17313 not published not published $332.19 – $2,262.38 7
Hc mohs trunk/arm/leg ea addl block any stage CPT 17315 not published not published $52.10 – $283.50 7
Hc mohs trunk/arm/leg ea stage after 1st stage CPT 17314 not published not published $182.61 – $1,384.46 7
Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 not published not published $48.80 – $118.02 7
Hc nm fusion spect CT unlisted CPT 78999 not published not published $848.52 – $848.52 2
Hc nm kidney imaging with flow CPT 78701 not published not published $24.58 – $58.88 7
Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 not published not published $45.73 – $111.23 7
Hc pet myocardial imaging metabolic eval single study CPT 78459 not published not published $77.89 – $187.17 7
Hc transcatheter placement and sbsq removal cepd perq CPT 33370 not published not published $129.85 – $475.73 6
Hdr rdncl ntrstl/icav brchtx CPT 77770 not published not published $110.08 – $254.13 6
Hdr rdncl ntrstl/icav brchtx CPT 77771 not published not published $214.29 – $494.19 6
Hdr rdncl ntrstl/icav brchtx CPT 77772 not published not published $302.63 – $698.59 6
Hdr rdncl skn surf brachytx CPT 77767 not published not published $59.26 – $137.04 6
Hdr rdncl skn surf brachytx CPT 77768 not published not published $78.98 – $182.80 6
Head CT scan (with and without contrast) CPT 70470 $845.88 $1,484.00 $64.27 – $155.32 7
Head CT scan (with contrast) CPT 70460 $685.14 $1,202.00 $57.14 – $138.26 7
Head CT scan (without contrast) CPT 70450 $640.68 $1,124.00 $42.89 – $103.84 7
Hearing loss dup/del analys CPT 81431 not published not published $713.55 – $2,623.14 7
Hearing loss sequence analys CPT 81430 not published not published $1,706.25 – $6,272.50 7
Heart first pass add-on CPT 78496 not published not published $24.95 – $50.45 7
Heart first pass multiple CPT 78483 not published not published $73.26 – $176.33 7
Heart image spect CPT 78494 not published not published $59.13 – $142.77 7
Heart infarct image CPT 78466 not published not published $34.18 – $86.40 7
Heart infarct image (ef) CPT 78468 not published not published $39.83 – $95.41 7
Heart revascularize (tmr) CPT 33140 not published not published $1,520.72 – $5,452.58 7
Heart tmr w/other procedure 33141 CPT 33141 not published not published $127.32 – $459.79 7
Heavy metal qual any number CPT 83015 not published not published $21.99 – $80.83 11
Heinz bodies direct CPT 85441 not published not published $4.41 – $16.21 11
Heinz bodies induced CPT 85445 not published not published $7.16 – $26.33 11
Helicobacter pylori antibody igm CPT 86677 $33.63 $59.00 $8.32 – $65.04 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.