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 |
|---|---|---|---|---|
| Impres&prep oral surg splint CPT 21085 | not published | not published | $509.32 – $2,567.59 | 7 |
| Impres&prep orbital prosth CPT 21077 | not published | not published | $1,827.53 – $8,211.83 | 7 |
| Impres&prep paltl aug prosth CPT 21082 | not published | not published | $1,174.37 – $5,439.68 | 7 |
| Impres&prep paltl lft prosth CPT 21083 | not published | not published | $1,085.91 – $5,185.13 | 7 |
| Impres&prep sp aid prosth CPT 21084 | not published | not published | $1,255.92 – $5,935.73 | 7 |
| Impres&prep surg obt prosth CPT 21076 | not published | not published | $742.20 – $3,317.51 | 7 |
| Inactivated je vacc im CPT 90738 | $422.94 | $742.00 | $504.42 – $504.42 | 2 |
| Inc deep opng b1 crtx thorax CPT 21510 | not published | not published | $462.32 – $1,581.68 | 7 |
| Inc dp bone crtx f/arm&/wrst CPT 25035 | not published | not published | $618.68 – $2,090.85 | 7 |
| Inc dp opn b1 crtx hum/elbw CPT 23935 | $713.64 | $1,252.00 | $542.17 – $1,100.01 | 7 |
| Incis 1 vertebral seg cerv CPT 22210 | not published | not published | $1,790.02 – $6,192.86 | 7 |
| Incis 1 vertebral seg lumbar CPT 22214 | not published | not published | $1,526.21 – $5,242.24 | 7 |
| Incis 1 vertebral seg thorac CPT 22212 | not published | not published | $1,526.97 – $5,229.53 | 7 |
| Incis addl spine segment CPT 22216 | not published | not published | $354.28 – $1,261.28 | 7 |
| Incise bile duct sphincter CPT 47460 | not published | not published | $1,269.39 – $4,478.40 | 7 |
| Incise diaphragm nerve CPT 64746 | not published | not published | $435.82 – $1,516.99 | 7 |
| Incise/drain eyelid lining CPT 68020 | not published | not published | $116.97 – $440.14 | 7 |
| Incise flexor carpi radialis CPT 25001 | not published | not published | $372.11 – $1,239.08 | 7 |
| Incise hand/finger tendon CPT 26460 | not published | not published | $482.11 – $1,494.04 | 7 |
| Incise hip/thigh nerve CPT 64763 | not published | not published | $523.67 – $1,805.85 | 7 |
| Incise hip/thigh nerve CPT 64766 | not published | not published | $644.93 – $2,226.98 | 7 |
| Incise inner ear CPT 69801 | $1,226.07 | $2,151.00 | $129.38 – $767.48 | 7 |
| Incise inner ear nerve CPT 69915 | not published | not published | $1,570.40 – $5,447.59 | 7 |
| Incise inner ear nerve CPT 69950 | not published | not published | $1,819.81 – $6,322.46 | 7 |
| Incise inner eye adhesions CPT 65860 | not published | not published | $262.30 – $1,128.23 | 7 |
| Incise inner eye adhesions CPT 65865 | not published | not published | $507.17 – $1,730.78 | 7 |
| Incise inner eye adhesions CPT 65870 | not published | not published | $629.70 – $2,159.03 | 7 |
| Incise inner eye adhesions CPT 65875 | not published | not published | $672.26 – $2,300.66 | 7 |
| Incise inner eye adhesions CPT 65880 | not published | not published | $705.87 – $2,420.93 | 7 |
| Incise inner eye strands CPT 67030 | not published | not published | $592.17 – $1,978.46 | 7 |
| Incise nerve back of head CPT 64744 | not published | not published | $509.38 – $1,695.34 | 7 |
| Incise perq finger tendon 26060 CPT 26060 | not published | not published | $274.02 – $932.74 | 7 |
| Incise skull/brain surgery CPT 61720 | not published | not published | $1,244.49 – $4,278.00 | 7 |
| Incise skull/brain surgery CPT 61735 | not published | not published | $1,556.95 – $5,357.44 | 7 |
| Incise skull for treatment CPT 61770 | not published | not published | $1,576.05 – $5,451.23 | 7 |
| Incise skull repair CPT 62121 | not published | not published | $1,580.63 – $5,502.38 | 7 |
| Incise skull/sutures CPT 61556 | not published | not published | $1,664.24 – $5,738.14 | 7 |
| Incise skull/sutures CPT 61557 | not published | not published | $1,649.64 – $5,665.76 | 7 |
| Incise sperm duct pouch CPT 55600 | not published | not published | $444.29 – $1,541.81 | 7 |
| Incise spinal cord tract(s) CPT 63170 | not published | not published | $1,557.52 – $5,359.88 | 7 |
| Incise spine accessory nerve CPT 63191 | not published | not published | $1,354.80 – $4,646.96 | 7 |
| Incise spine nrv >2 segmnts CPT 63190 | not published | not published | $1,272.23 – $4,439.66 | 7 |
| Incise spine nrv half segmnt CPT 63185 | not published | not published | $1,210.11 – $3,991.24 | 7 |
| Incise tear duct opening 68440 CPT 68440 | not published | not published | $106.76 – $374.21 | 7 |
| Incise tendon(s) & muscle(s) CPT 23406 | not published | not published | $768.02 – $2,760.08 | 7 |
| Incise thigh tendon & fascia CPT 27305 | not published | not published | $508.30 – $1,721.36 | 7 |
| Incise & treat bladder CPT 51030 | not published | not published | $498.90 – $1,726.39 | 7 |
| Incise wrist/forearm tendon CPT 25290 | not published | not published | $462.76 – $1,567.43 | 7 |
| Incision anal septum infant CPT 46070 | not published | not published | $280.95 – $945.79 | 7 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $2,641.95 | $4,635.00 | $125.01 – $360.43 | 7 |
| Incision & drainage open of deep abscess (subfascial) pos CPT 22010 | not published | not published | $981.86 – $3,344.40 | 7 |
| Incision/fixation of femur CPT 27165 | not published | not published | $1,410.39 – $4,900.28 | 7 |
| Incision of achilles tendon CPT 27605 | not published | not published | $194.86 – $1,257.19 | 7 |
| Incision of achilles tendon CPT 27606 | not published | not published | $282.42 – $1,000.73 | 7 |
| Incision of anal sphincter CPT 46080 | $231.42 | $406.00 | $162.08 – $553.18 | 7 |
| Incision of ankle bone CPT 28302 | not published | not published | $745.79 – $2,556.90 | 7 |
| Incision of bile duct CPT 47425 | not published | not published | $1,365.35 – $4,820.70 | 7 |
| Incision of bile duct 47420 CPT 47420 | not published | not published | $1,341.11 – $4,734.26 | 7 |
| Incision of brain tissue CPT 61541 | not published | not published | $2,084.31 – $7,216.84 | 7 |
| Incision of brain tissue CPT 61567 | not published | not published | $2,469.78 – $8,582.48 | 7 |
| Incision of breast lesion CPT 19020 | $954.75 | $1,675.00 | $324.10 – $1,051.27 | 7 |
| Incision of brow nerve CPT 64732 | not published | not published | $459.97 – $1,519.84 | 7 |
| Incision of burn scab initi CPT 16035 | not published | not published | $200.00 – $711.64 | 7 |
| Incision of cheek nerve CPT 64734 | not published | not published | $518.94 – $1,716.79 | 7 |
| Incision of chin nerve CPT 64736 | not published | not published | $352.43 – $1,284.38 | 7 |
| Incision of eardrum CPT 69420 | not published | not published | $128.13 – $675.38 | 7 |
| Incision of eardrum CPT 69421 | not published | not published | $160.78 – $531.79 | 7 |
| Incision of esophagus CPT 43020 | not published | not published | $574.18 – $1,978.43 | 7 |
| Incision of eye CPT 65850 | not published | not published | $890.65 – $3,070.91 | 7 |
| Incision of eye CPT 66172 | not published | not published | $1,264.28 – $4,338.15 | 7 |
| Incision of eyelid CPT 67710 | not published | not published | $104.15 – $857.70 | 7 |
| Incision of facial nerve CPT 64742 | not published | not published | $527.73 – $1,808.51 | 7 |
| Incision of fibula CPT 27707 | not published | not published | $429.54 – $1,436.59 | 7 |
| Incision of finger tendon CPT 26455 | not published | not published | $491.58 – $1,529.55 | 7 |
| Incision of foot fascia CPT 28008 | $485.07 | $851.00 | $315.69 – $967.70 | 7 |
| Incision of foot tendon 28234 CPT 28234 | not published | not published | $289.84 – $1,511.55 | 7 |
| Incision of gallbladder 47480 CPT 47480 | not published | not published | $887.75 – $3,118.88 | 7 |
| Incision of heel bone CPT 28300 | $1,146.84 | $2,012.00 | $682.06 – $1,429.39 | 7 |
| Incision of hip bone CPT 27146 | not published | not published | $1,314.73 – $4,555.01 | 7 |
| Incision of hip bones CPT 27151 | not published | not published | $1,617.78 – $5,652.56 | 7 |
| Incision of hip tendon CPT 27000 | not published | not published | $418.94 – $1,479.04 | 7 |
| Incision of hip tendon CPT 27001 | not published | not published | $564.77 – $1,934.93 | 7 |
| Incision of hip tendon CPT 27003 | not published | not published | $628.23 – $2,135.29 | 7 |
| Incision of hip tendons CPT 27006 | not published | not published | $753.44 – $2,590.05 | 7 |
| Incision of iris CPT 66500 | not published | not published | $419.79 – $1,358.93 | 7 |
| Incision of iris CPT 66505 | not published | not published | $456.47 – $1,482.83 | 7 |
| Incision of jaw joint CPT 21010 | not published | not published | $783.29 – $2,749.69 | 7 |
| Incision of jaw nerve CPT 64738 | not published | not published | $476.46 – $1,664.33 | 7 |
| Incision of knee joint CPT 27435 | not published | not published | $841.42 – $2,891.18 | 7 |
| Incision of liver duct CPT 47400 | not published | not published | $2,134.01 – $7,579.76 | 7 |
| Incision of lymph channels CPT 38308 | not published | not published | $479.75 – $1,611.19 | 7 |
| Incision of metatarsal CPT 28306 | $677.73 | $1,189.00 | $431.71 – $1,384.98 | 7 |
| Incision of metatarsal CPT 28307 | not published | not published | $542.52 – $2,286.98 | 7 |
| Incision of metatarsal CPT 28308 | $595.65 | $1,045.00 | $413.45 – $1,266.78 | 7 |
| Incision of metatarsals CPT 28309 | not published | not published | $946.58 – $3,202.20 | 7 |
| Incision of midfoot bones CPT 28304 | $930.81 | $1,633.00 | $645.79 – $1,808.22 | 7 |
| Incision of neck of femur CPT 27161 | not published | not published | $1,255.31 – $4,351.65 | 7 |
| Incision of palm tendon CPT 26450 | not published | not published | $494.84 – $1,541.33 | 7 |
| Incision of prostate CPT 52450 | not published | not published | $499.80 – $1,723.58 | 7 |
| Incision of pyloric muscle 43520 CPT 43520 | not published | not published | $699.31 – $2,428.01 | 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.