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 |
|---|---|---|---|---|
| Hemagglutination inhibition CPT 86280 | not published | not published | $8.60 – $31.61 | 11 |
| Hematocrit CPT 85014 | $10.26 | $18.00 | $2.49 – $9.15 | 11 |
| Hematopoietic nuclear tx CPT 79403 | not published | not published | $117.34 – $193.66 | 7 |
| Hemicrt intrclry algrft prtl CPT 20933 | not published | not published | $695.64 – $2,358.00 | 6 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $703.38 – $2,399.21 | 7 |
| Hemodialysis access study CPT 90940 | not published | not published | $190.94 – $190.94 | 2 |
| Hemodialysis one evaluation CPT 90935 | not published | not published | $75.20 – $243.12 | 7 |
| Hemodialysis repeated eval CPT 90937 | not published | not published | $108.10 – $347.77 | 7 |
| Hemoglobin CPT 85018 | $14.25 | $25.00 | $2.49 – $9.15 | 11 |
| Hemoglobin copper sulfate CPT 83026 | not published | not published | $3.38 – $15.48 | 11 |
| Hemoglobin fetal qualitative CPT 83033 | $17.10 | $30.00 | $8.40 – $30.88 | 11 |
| Hemoglobin f (fetal) chemical CPT 83030 | not published | not published | $11.28 – $41.46 | 11 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $7.98 | $14.00 | $4.19 – $31.65 | 11 |
| Hemoglobin-oxygen affinity CPT 82820 | not published | not published | $14.01 – $51.49 | 11 |
| Hemoglobin plasma CPT 83051 | not published | not published | $4.98 – $28.22 | 11 |
| Hemoglobin thermolabile CPT 83065 | not published | not published | $9.45 – $34.74 | 11 |
| Hemoglobin urine CPT 83069 | not published | not published | $4.15 – $15.25 | 11 |
| Hemolysin acid CPT 85475 | not published | not published | $9.31 – $34.24 | 11 |
| Hemolysins/agglutinins auto CPT 86940 | not published | not published | $9.21 – $33.85 | 11 |
| Hemolysins and agglutinins incubated CPT 86941 | not published | not published | $12.72 – $46.74 | 11 |
| Hemoperfusion CPT 90997 | not published | not published | $93.15 – $299.40 | 7 |
| Hemophilus influenza antibdy CPT 86684 | not published | not published | $16.63 – $61.14 | 11 |
| Hemorrhoidectomy intern transanal deater 2+ 46948 CPT 46948 | not published | not published | $461.35 – $1,578.34 | 6 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $193.80 | $340.00 | $202.55 – $996.08 | 7 |
| Hemorrhoidopexy stapling 46947 CPT 46947 | $565.44 | $992.00 | $400.75 – $829.92 | 7 |
| Heparin assay CPT 85520 | not published | not published | $13.74 – $50.53 | 11 |
| Heparin bolus from bag HCPCS J1644 | $13.78 | $24.18 | $0.36 – $1.85 | 6 |
| Heparin neutralization CPT 85525 | not published | not published | $12.43 – $45.70 | 11 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $0.50 | $0.88 | $0.03 – $0.09 | 6 |
| Heparin-protamine tolerance CPT 85530 | not published | not published | $13.74 – $50.53 | 11 |
| Hepatectomy removal of liver 47120 CPT 47120 | not published | not published | $2,331.16 – $8,225.06 | 7 |
| Hepatitis a antibody igm CPT 86709 | $40.47 | $71.00 | $11.82 – $43.46 | 11 |
| Hepatitis b core antibody igm CPT 86705 | $51.30 | $90.00 | $12.36 – $45.43 | 11 |
| Hepatitis b core antibody total CPT 86704 | $43.32 | $76.00 | $12.65 – $46.51 | 11 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | not published | not published | $192.61 – $1,400.00 | 5 |
| Hepatitis b surface ag quan CPT 87467 | not published | not published | $15.80 – $20.77 | 6 |
| Hepatitis b surface antibody CPT 86706 | $66.69 | $117.00 | $11.28 – $41.46 | 11 |
| Hepatitis b vaccine 40 mcg/ml inj-adult CPT 90747 | not published | not published | $197.05 – $1,400.00 | 5 |
| Hepatitis c antibody CPT 86803 | $24.51 | $43.00 | $14.98 – $55.08 | 11 |
| Hepatitis c rna dir probe CPT 87520 | not published | not published | $28.69 – $120.51 | 11 |
| Hepatitis d quantification CPT 87523 | $146.49 | $257.00 | $165.36 – $188.92 | 5 |
| Hepatitis g dna amp probe CPT 87526 | not published | not published | $41.22 – $151.54 | 11 |
| Hepatitis g dna dir probe CPT 87525 | not published | not published | $28.69 – $115.03 | 11 |
| Hepatitis g dna quant CPT 87527 | not published | not published | $43.85 – $161.19 | 11 |
| Hepatobiliary system imaging CPT 78226 | $1,027.14 | $1,802.00 | $37.00 – $89.18 | 7 |
| Hep b vac 3ag 10mcg 3 dos im CPT 90759 | not published | not published | $103.35 – $1,400.00 | 5 |
| Hepb vacc 3 dose immunsup im CPT 90740 | $145.92 | $256.00 | $107.52 – $1,400.00 | 7 |
| Hereditary colon ca dsordrs CPT 81435 | not published | not published | $614.15 – $2,257.71 | 10 |
| Hereditary colon ca dsordrs CPT 81436 | not published | not published | $614.15 – $2,257.71 | 10 |
| Hered neuroend tum-rlt do 5+ CPT 81437 | not published | not published | $460.88 – $1,694.27 | 7 |
| Hered rta do gen seq 15 CPT 81434 | not published | not published | $627.81 – $2,307.93 | 7 |
| Heredtry nurondcrn tum dsrdr CPT 81438 | not published | not published | $460.88 – $1,694.27 | 7 |
| Hernia Repair (Inguinal) CPT 49505 | $900.60 | $1,580.00 | $530.29 – $1,115.19 | 7 |
| Herpes simplex 1 ag if CPT 87274 | not published | not published | $12.58 – $46.24 | 11 |
| Herpes simplex 2 ag if CPT 87273 | not published | not published | $12.58 – $46.24 | 11 |
| Herpes simplex type 1 antibody igg CPT 86695 | $86.64 | $152.00 | $13.85 – $50.91 | 11 |
| Herpes simplex type 2 antibody igg CPT 86696 | $86.64 | $152.00 | $20.32 – $74.69 | 11 |
| Herpes simplex virus isolation CPT 87255 | not published | not published | $35.55 – $130.70 | 11 |
| Heterophile antibodies screening CPT 86308 | $32.49 | $57.00 | $5.44 – $19.99 | 11 |
| Heterophile antibodies titer CPT 86309 | not published | not published | $6.79 – $24.97 | 11 |
| Heterophile antibody absrbj CPT 86310 | not published | not published | $7.74 – $28.45 | 11 |
| Hexa gene CPT 81255 | not published | not published | $54.02 – $198.60 | 7 |
| Hgb methemoglobin qual CPT 83045 | not published | not published | $6.81 – $25.05 | 11 |
| Hhv-6 dna dir probe CPT 87531 | not published | not published | $28.69 – $223.88 | 11 |
| Hhv-6 dna quant CPT 87533 | not published | not published | $43.85 – $161.19 | 11 |
| Hib-hepb vaccine im CPT 90748 | $72.96 | $128.00 | $79.40 – $79.40 | 2 |
| Hib-mency vacc 6wk-18m0 im CPT 90644 | not published | not published | $38.02 – $38.02 | 2 |
| Hi enrgy eswt plantar fascia CPT 28890 | not published | not published | $239.72 – $1,177.39 | 7 |
| Hinge extension/flex wrist/f HCPCS L3900 | $4,049.85 | $7,105.00 | $1,476.98 – $1,476.98 | 2 |
| Hip arthr0 w/debridement CPT 29862 | not published | not published | $848.43 – $2,908.13 | 7 |
| Hip arthr0 w/synovectomy CPT 29863 | not published | not published | $847.95 – $2,914.58 | 7 |
| Hip arthro acetabuloplasty CPT 29915 | not published | not published | $1,052.08 – $3,656.93 | 7 |
| Hip arthroscopy dx CPT 29860 | not published | not published | $684.31 – $2,380.46 | 7 |
| Hip arthro w/fb removal CPT 29861 | not published | not published | $742.32 – $2,579.93 | 7 |
| Hip arthro w/femoroplasty CPT 29914 | not published | not published | $1,027.36 – $3,557.36 | 7 |
| Hip arthro w/labral repair CPT 29916 | not published | not published | $1,048.14 – $3,659.93 | 7 |
| Hip X-ray CPT 73502 | $193.80 | $340.00 | $11.54 – $27.63 | 6 |
| Histamine CPT 83088 | not published | not published | $31.01 – $113.99 | 11 |
| Histochemical stains add-on CPT 88314 | not published | not published | $21.54 – $53.53 | 8 |
| Histoplasmosis skin test CPT 86510 | not published | not published | $7.60 – $14.75 | 8 |
| Hiv-1 ag ia CPT 87390 | not published | not published | $25.23 – $92.87 | 11 |
| Hiv-1 dna dir probe CPT 87534 | not published | not published | $23.02 – $84.61 | 11 |
| Hiv-2 ag ia CPT 87391 | not published | not published | $23.00 – $84.53 | 11 |
| HIV 2 pcr qual - sendout CPT 87537 | not published | not published | $23.02 – $84.61 | 11 |
| Hiv-2 quant&revrse trnscripj CPT 87539 | not published | not published | $61.27 – $226.27 | 11 |
| Hla class i high defin qual CPT 86832 | not published | not published | $181.47 – $1,249.68 | 11 |
| Hla class ii high defin qual CPT 86833 | not published | not published | $164.98 – $1,257.59 | 11 |
| Hla class i&ii antibody qual CPT 86828 | not published | not published | $56.61 – $247.77 | 11 |
| Hla class i/ii antibody qual CPT 86829 | not published | not published | $42.45 – $247.77 | 11 |
| Hla class ii phenotype qual CPT 86831 | not published | not published | $85.97 – $316.06 | 11 |
| Hla class ii semiquant panel CPT 86835 | not published | not published | $339.11 – $1,246.63 | 11 |
| Hla class i phenotype qual CPT 86830 | not published | not published | $100.30 – $368.71 | 11 |
| Hla class i semiquant panel CPT 86834 | not published | not published | $375.44 – $1,380.18 | 11 |
| Hla i & ii type verify lr CPT 81371 | not published | not published | $344.26 – $1,561.45 | 10 |
| Hla i & ii typing hr CPT 81378 | not published | not published | $362.85 – $1,333.90 | 10 |
| Hla i & ii typing lr CPT 81370 | not published | not published | $422.23 – $1,552.18 | 10 |
| Hla ii typing 1 loc hr CPT 81382 | not published | not published | $129.86 – $477.40 | 10 |
| Hla ii typing ag equiv lr CPT 81375 | not published | not published | $231.78 – $852.06 | 10 |
| Hla i low res one antigen equiv ea CPT 81374 | not published | not published | $78.05 – $286.91 | 10 |
| Hla i typing 1 locus hr CPT 81380 | $517.56 | $908.00 | $186.11 – $684.19 | 10 |
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.