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
Intrapul surf admin endo tube CPT 94610 $245.10 $430.00 $59.58 – $184.38 7
Intrauterine transfusion ftl CPT 36460 not published not published $349.53 – $1,254.34 7
Intraventricular pacing CPT 93612 not published not published $157.78 – $16,158.00 8
Intrinsic factor antibody CPT 86340 $95.19 $167.00 $14.52 – $58.21 11
Intrm oph exam est patient CPT 92012 not published not published $53.58 – $291.66 7
Intro cath dialysis circuit CPT 36901 not published not published $168.31 – $2,516.48 6
Intro cath dialysis circuit w/pta CPT 36902 not published not published $240.33 – $4,728.53 6
Intro cath dialysis circuit w/stent plcmnt CPT 36903 not published not published $314.09 – $18,758.93 6
Intro catheter aorta CPT 36200 not published not published $135.42 – $2,132.33 7
Intro cath svc/ivc CPT 36010 not published not published $107.26 – $1,914.45 7
Intro long gi tube CPT 44500 not published not published $19.67 – $72.08 7
Intro long gi tube w/mult fluo CPT 74340 not published not published $26.92 – $66.19 7
Intro windpipe wire/tube CPT 31730 not published not published $147.66 – $4,320.90 7
Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 not published not published $87.13 – $4,256.59 6
Intrvasc Ultrasound noncoronary addl vessel CPT 37253 not published not published $69.51 – $675.45 6
Intubation endotracheal emergency procedure CPT 31500 $565.44 $992.00 $143.55 – $515.93 7
Io anal gast n-stim init CPT 95980 not published not published $44.66 – $144.02 7
Io anal gast n-stim subsq CPT 95981 not published not published $17.99 – $114.95 7
Io ga n-stim subsq w/reprog CPT 95982 not published not published $36.77 – $182.01 7
Ionm in operatng room 15 min CPT 95940 not published not published $33.92 – $108.73 7
Io radiation tx management CPT 77469 not published not published $338.74 – $775.62 7
Ip/obs cnsltj new/est low 45 CPT 99253 $226.29 $397.00 $106.02 – $254.88 6
Ip/obs cnsltj new/est mod 60 CPT 99254 $326.61 $573.00 $147.27 – $370.64 6
Ip/obs consltj new/est hi 80 CPT 99255 $395.01 $693.00 $198.12 – $446.12 6
Ip/obs consltj new/est sf 35 CPT 99252 $147.63 $259.00 $75.59 – $165.48 6
Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 $12.31 $21.60 $2.88 – $21.60 6
Iron CPT 83540 $41.61 $73.00 $6.79 – $24.97 11
Iron binding capacity CPT 83550 $47.88 $84.00 $9.18 – $33.74 11
Iron dextran 50 mg/ml injection solution HCPCS J1750 $30.42 $53.37 $14.44 – $37.00 7
Iron stain peripheral blood CPT 85536 not published not published $7.22 – $26.56 11
Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 $1.14 $2.00 $0.29 – $2.00 6
Irradiation of blood product each unit reference CPT 86945 $67.26 $118.00 $20.38 – $39.70 3
Irrigation implantable venous access device for drug delivery systems CPT 96523 $123.12 $216.00 $26.59 – $92.19 7
Irrigation sphenoid sinus CPT 31002 not published not published $201.97 – $689.66 7
Irrigation vagina and/or appl medicament tx disease CPT 57150 not published not published $26.41 – $193.61 7
Island pedicle flap graft CPT 15740 not published not published $879.12 – $3,618.08 7
Ivc venogram s&i CPT 75825 not published not published $54.58 – $131.82 7
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 $193.23 $339.00 $30.40 – $100.35 7
IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 $133.38 $234.00 $21.09 – $68.58 7
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 $133.38 $234.00 $21.82 – $70.98 7
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 $433.77 $761.00 $66.48 – $229.00 7
IV inj ra drug dx study CPT 78808 not published not published $42.28 – $106.73 7
IV njx tst vasc flo flap/grf CPT 15860 not published not published $107.24 – $385.76 7
Ivp w/nephrotomography CPT 74415 not published not published $24.58 – $59.72 7
Ivp w/wo kub w/wo tomography CPT 74400 not published not published $24.70 – $59.72 7
Jak2 targeted sequence analysis CPT 81279 $669.18 $1,174.00 $194.46 – $714.87 7
Jaw arthroscopy/surgery CPT 29800 not published not published $556.18 – $1,889.55 7
Jaw arthroscopy/surgery CPT 29804 not published not published $630.33 – $2,273.48 7
Jejunstmy tube plcmt CPT 44372 not published not published $245.72 – $874.76 7
John cunningham antibody CPT 86711 $33.63 $59.00 $17.73 – $65.20 11
J-tube placement CPT 44015 not published not published $138.76 – $498.49 7
Kafo fem fx cast molded to p HCPCS L2128 $4,404.39 $7,727.00 $1,606.26 – $1,606.26 2
Keratomileusis CPT 65760 not published not published $4,107.26 – $4,107.26 2
Keratophakia CPT 65765 not published not published $5,955.11 – $5,955.11 2
Keratoprosthesis CPT 65770 not published not published $1,483.99 – $5,097.45 7
Ketamine and metabolite screen - quest CPT 80357 not published not published $29.42 – $31.67 3
Ketogenic steroids fract CPT 83582 not published not published $16.24 – $59.71 11
Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 $41.04 $72.00 $8.58 – $31.54 11
Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 $3.03 $5.31 $0.81 – $2.00 6
Kidney endoscopy CPT 50551 not published not published $302.07 – $1,315.69 7
Kidney endoscopy CPT 50553 not published not published $322.94 – $1,407.04 7
Kidney endoscopy CPT 50570 not published not published $504.01 – $1,794.49 7
Kidney endoscopy CPT 50575 not published not published $730.89 – $2,610.60 7
Kidney endoscopy & biopsy CPT 50555 not published not published $350.59 – $1,506.30 7
Kidney endoscopy & biopsy CPT 50574 not published not published $578.99 – $2,064.60 7
Kidney endoscopy & treatment CPT 50557 not published not published $355.14 – $1,531.76 7
Kidney endoscopy & treatment CPT 50561 not published not published $405.16 – $1,733.74 7
Kidney endoscopy & treatment CPT 50576 not published not published $577.39 – $2,059.28 7
Kidney endoscopy & treatment CPT 50580 not published not published $622.01 – $2,219.48 7
Kidney function study CPT 78725 not published not published $18.22 – $44.50 7
Kidney imaging (3d) CPT 78710 not published not published $69.30 – $123.15 3
Kidney imaging morphology CPT 78700 not published not published $22.02 – $53.59 7
Kidney imag w/bld flow multi CPT 78709 not published not published $69.36 – $167.55 7
Kidney img w/bldflw sgl without rx CPT 78707 not published not published $46.99 – $114.55 7
Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 $593.94 $1,042.00 $37.36 – $90.02 7
Kit gene analys d816 variant CPT 81273 not published not published $131.11 – $482.00 10
Knee Arthroscopy (Cartilage Repair) CPT 29877 $951.90 $1,670.00 $648.54 – $1,349.90 7
Knee arthroscopy/drainage CPT 29871 $762.66 $1,338.00 $540.09 – $1,114.26 7
Knee arthroscopy dx CPT 29870 not published not published $431.69 – $2,062.39 7
Knee Arthroscopy (Meniscus Repair) CPT 29881 $1,079.58 $1,894.00 $567.30 – $1,177.80 7
Knee arthroscopy/surgery CPT 29850 not published not published $652.32 – $2,227.16 7
Knee arthroscopy/surgery CPT 29851 not published not published $961.55 – $3,320.21 7
Knee arthroscopy/surgery CPT 29873 $687.42 $1,206.00 $567.16 – $1,143.13 7
Knee arthroscopy/surgery CPT 29874 $826.50 $1,450.00 $562.82 – $1,165.49 7
Knee arthroscopy/surgery CPT 29875 not published not published $520.53 – $1,776.34 7
Knee arthroscopy/surgery CPT 29876 $1,020.30 $1,790.00 $681.14 – $1,420.37 7
Knee arthroscopy/surgery CPT 29879 $1,033.41 $1,813.00 $690.03 – $1,436.08 7
Knee arthroscopy/surgery CPT 29880 $1,039.11 $1,823.00 $588.13 – $1,222.98 7
Knee arthroscopy/surgery CPT 29882 $1,254.00 $2,200.00 $717.67 – $1,513.33 7
Knee arthroscopy/surgery CPT 29883 not published not published $874.58 – $3,005.29 7
Knee arthroscopy/surgery CPT 29884 not published not published $647.44 – $2,213.06 7
Knee arthroscopy/surgery CPT 29886 not published not published $665.17 – $2,272.80 7
Knee arthroscopy/surgery CPT 29887 not published not published $785.04 – $2,683.58 7
Knee arthroscopy/surgery CPT 29888 $1,671.24 $2,932.00 $1,007.95 – $2,130.90 7
Knee arthroscopy/surgery CPT 29889 not published not published $1,265.44 – $4,363.69 7
Knee MRI (with and without contrast) CPT 73723 $2,253.21 $3,953.00 $108.63 – $262.98 7
Knee MRI (with contrast) CPT 73722 $2,179.11 $3,823.00 $82.08 – $199.39 7
Knee MRI (without contrast) CPT 73721 $2,001.27 $3,511.00 $68.68 – $165.89 7
Knee X-ray CPT 73564 $224.58 $394.00 $11.89 – $27.63 7
Ko elastic w/joints pre ots HCPCS L1812 $174.42 $306.00 $103.13 – $103.13 2

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.