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 |
|---|---|---|---|---|
| Incision of rectal abscess CPT 46060 | not published | not published | $507.63 – $1,732.91 | 7 |
| Incision of small bowel 44010 CPT 44010 | not published | not published | $871.50 – $3,062.63 | 7 |
| Incision of sperm duct CPT 55200 | not published | not published | $292.73 – $1,501.50 | 7 |
| Incision of spinal nerve 64772 CPT 64772 | not published | not published | $581.14 – $2,016.45 | 7 |
| Incision of stomach nerves CPT 64755 | not published | not published | $922.47 – $3,238.76 | 7 |
| Incision of tendon & muscle CPT 23405 | not published | not published | $645.07 – $2,223.83 | 7 |
| Incision of tendon sheath CPT 25000 | $1,068.75 | $1,875.00 | $370.87 – $734.39 | 7 |
| Incision of thigh CPT 27448 | not published | not published | $859.07 – $2,933.06 | 7 |
| Incision of thigh CPT 27450 | not published | not published | $1,044.07 – $3,625.95 | 7 |
| Incision of thigh tendon CPT 27306 | not published | not published | $370.08 – $1,257.08 | 7 |
| Incision of thigh tendon CPT 27390 | not published | not published | $475.59 – $1,605.04 | 7 |
| Incision of thigh tendons CPT 27307 | not published | not published | $438.27 – $1,716.68 | 7 |
| Incision of thigh tendons CPT 27391 | not published | not published | $607.82 – $2,024.66 | 7 |
| Incision of thigh tendons CPT 27392 | not published | not published | $744.42 – $2,544.98 | 7 |
| Incision of tibia CPT 27705 | not published | not published | $781.11 – $2,716.65 | 7 |
| Incision of tibia & fibula CPT 27709 | not published | not published | $1,182.06 – $4,168.43 | 7 |
| Incision of toe tendons 28011 CPT 28011 | not published | not published | $299.96 – $1,163.06 | 7 |
| Incision of tongue fold CPT 41010 | not published | not published | $116.86 – $761.70 | 7 |
| Incision of tongue nerve CPT 64740 | not published | not published | $486.92 – $1,728.41 | 7 |
| Incision of urethra CPT 53000 | not published | not published | $156.45 – $541.58 | 7 |
| Incision of urethra CPT 53010 | not published | not published | $314.93 – $1,077.83 | 7 |
| Incision of urethra CPT 53020 | not published | not published | $100.10 – $354.00 | 7 |
| Incision of urethra CPT 53025 | not published | not published | $71.69 – $248.06 | 7 |
| Incision of vagus nerve CPT 64760 | not published | not published | $529.31 – $1,824.49 | 7 |
| Incision of windpipe CPT 31601 | not published | not published | $463.74 – $1,622.10 | 7 |
| Incision of windpipe CPT 31610 | not published | not published | $1,004.20 – $3,437.14 | 7 |
| Incision of wrist capsule CPT 25085 | not published | not published | $475.72 – $1,612.16 | 7 |
| Incision secondary cataract CPT 66820 | not published | not published | $499.05 – $1,566.56 | 7 |
| Incision tendon sheath CPT 26055 | $1,745.34 | $3,062.00 | $311.61 – $1,980.08 | 7 |
| Incisn of toe tndn CPT 28010 | not published | not published | $224.42 – $856.80 | 7 |
| Incisn windpipe CPT 31600 | not published | not published | $307.32 – $1,094.44 | 7 |
| Incis spine 3 column adl seg CPT 22208 | not published | not published | $569.82 – $2,024.93 | 7 |
| Incis spine 3 column lumbar CPT 22207 | not published | not published | $2,388.88 – $8,351.10 | 7 |
| Incis spine 3 column thorac CPT 22206 | not published | not published | $2,426.35 – $8,484.45 | 7 |
| Inc&subq plmt crnl bone grf CPT 61316 | not published | not published | $82.76 – $292.54 | 7 |
| Induced ab 1+vag supp d&c CPT 59856 | not published | not published | $495.69 – $1,714.80 | 7 |
| Induced ab 1+vag supp hyst CPT 59857 | not published | not published | $575.55 – $2,004.45 | 7 |
| Induced ab 1+ vag sup w/dlv fetus CPT 59855 | not published | not published | $425.07 – $1,464.08 | 7 |
| Induced abortion 1+njx d&c CPT 59851 | not published | not published | $432.38 – $1,448.89 | 7 |
| Induced abortion 1+njx hyst CPT 59852 | not published | not published | $593.27 – $1,992.75 | 7 |
| Induced abortion d&c CPT 59840 | not published | not published | $224.31 – $828.00 | 7 |
| Induced abortion dilat&evac CPT 59841 | not published | not published | $372.44 – $1,418.29 | 7 |
| Induction of vomiting CPT 99175 | not published | not published | $31.88 – $80.28 | 7 |
| Infect ag drug suscept pheno predict CPT 87900 | $259.92 | $456.00 | $136.87 – $503.15 | 11 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $15.75 – $57.90 | 11 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $14.84 – $54.54 | 11 |
| Infect ag genotype na cytomegalovirus CPT 87910 | not published | not published | $270.32 – $993.76 | 11 |
| Infect ag genotype na dna hepatitis b CPT 87912 | not published | not published | $270.32 – $993.76 | 11 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $580.26 | $1,018.00 | $135.17 – $496.90 | 11 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | not published | not published | $270.32 – $993.76 | 11 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | $55.86 | $98.00 | $34.41 – $126.49 | 10 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $17.15 – $136.22 | 11 |
| Infect ag ia optc obs influenza CPT 87804 | not published | not published | $14.00 – $63.88 | 11 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | not published | not published | $12.58 – $46.24 | 11 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $19.28 – $70.87 | 11 |
| Infect ag if influenza a CPT 87276 | not published | not published | $16.87 – $62.03 | 11 |
| Infect ag if influenza b CPT 87275 | not published | not published | $12.86 – $47.29 | 11 |
| Infect ag if legionella pneumophila CPT 87278 | $35.91 | $63.00 | $16.38 – $60.22 | 11 |
| Infect ag if nos ea CPT 87299 | not published | not published | $16.91 – $62.15 | 11 |
| Infect ag if pneumocystis carinii CPT 87281 | not published | not published | $12.58 – $46.24 | 11 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $14.09 – $51.80 | 11 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $50.00 – $206.39 | 11 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $36.84 – $135.45 | 11 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $44.98 – $165.36 | 11 |
| Infect ag na hpv high-risk types CPT 87624 | $83.79 | $147.00 | $36.84 – $135.45 | 10 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $167.58 | $294.00 | $100.59 – $369.79 | 11 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $53.88 – $198.06 | 11 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | not published | not published | $69.95 – $69.95 | 2 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $482.79 | $847.00 | $437.62 – $1,608.77 | 11 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $974.70 | $1,710.00 | $513.09 – $1,886.23 | 11 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | not published | not published | $27.37 – $100.63 | 11 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $43.45 – $159.73 | 7 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $140.22 | $246.00 | $12.58 – $46.24 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | not published | not published | $14.09 – $51.80 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $23.37 | $41.00 | $14.51 – $53.35 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $19.38 | $34.00 | $12.58 – $46.24 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $42.18 | $74.00 | $15.10 – $55.51 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $38.19 | $67.00 | $10.85 – $39.87 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | not published | not published | $10.85 – $39.87 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $79.80 | $140.00 | $25.28 – $92.95 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $235.41 | $413.00 | $12.58 – $46.24 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $43.32 | $76.00 | $12.58 – $46.24 | 11 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | not published | not published | $12.58 – $46.24 | 11 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $259.92 | $456.00 | $36.84 – $135.45 | 11 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $156.75 | $275.00 | $36.84 – $135.45 | 11 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $118.56 | $208.00 | $39.13 – $143.86 | 11 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $1,095.54 | $1,922.00 | $437.62 – $1,608.77 | 8 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $115.14 | $202.00 | $36.84 – $135.45 | 11 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $110.01 | $193.00 | $36.84 – $135.45 | 11 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $70.68 | $124.00 | $43.76 – $160.88 | 11 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $156.75 | $275.00 | $36.84 – $135.45 | 11 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $110.01 | $193.00 | $51.31 – $198.06 | 8 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $239.40 | $420.00 | $149.76 – $550.55 | 7 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $395.01 | $693.00 | $149.76 – $550.55 | 7 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $36.84 – $135.45 | 11 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $59.85 | $105.00 | $36.84 – $135.45 | 10 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | not published | not published | $437.62 – $1,608.77 | 10 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $243.39 | $427.00 | $134.70 – $495.20 | 10 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $638.40 | $1,120.00 | $276.14 – $1,015.14 | 10 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $129.39 | $227.00 | $44.98 – $165.36 | 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.