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 |
|---|---|---|---|---|
| Lap jejunostomy 44186 CPT 44186 | not published | not published | $655.98 – $2,300.59 | 7 |
| Lap mobil splenic fl add-on 44213 CPT 44213 | $415.53 | $729.00 | $185.63 – $664.69 | 7 |
| Lap myotomy heller CPT 43279 | not published | not published | $1,276.19 – $4,533.98 | 7 |
| Lap paraesophag hern repair CPT 43281 | $3,199.98 | $5,614.00 | $1,524.90 – $5,427.71 | 7 |
| Lap paraesoph her rpr w/mesh CPT 43282 | $3,620.07 | $6,351.00 | $1,716.44 – $6,099.83 | 7 |
| Lap part colectomy w/stoma 44206 CPT 44206 | not published | not published | $1,745.91 – $6,200.14 | 7 |
| Lap place gastr adj device CPT 43770 | not published | not published | $1,129.83 – $3,966.49 | 7 |
| Lap proctopexy w/sig resect 45402 CPT 45402 | not published | not published | $1,538.57 – $5,434.28 | 7 |
| Lap radical hyst CPT 58548 | not published | not published | $1,949.32 – $6,731.59 | 7 |
| Lap removal of rectum w/colostomy 45395 CPT 45395 | $3,910.77 | $6,861.00 | $1,990.32 – $4,288.13 | 7 |
| Lap remove rectum w/pouch CPT 45397 | not published | not published | $2,164.48 – $7,702.13 | 7 |
| Lap replace gastr adj device CPT 43773 | not published | not published | $1,279.25 – $4,503.83 | 7 |
| Lap resect s/intestine addl 44203 CPT 44203 | not published | not published | $236.65 – $848.21 | 7 |
| Lap revise gastr adj device CPT 43771 | not published | not published | $1,279.25 – $4,503.83 | 7 |
| Lap revise/remv eltrd antrum CPT 43648 | not published | not published | $4,985.29 – $4,985.29 | 2 |
| Lap revision perm ip cath CPT 49325 | not published | not published | $413.21 – $1,462.80 | 7 |
| Lap rmvl gastr adj all parts CPT 43774 | not published | not published | $962.56 – $3,385.46 | 7 |
| Lap rmvl gastr adj device CPT 43772 | not published | not published | $950.93 – $3,349.95 | 7 |
| Laps abltj uterine fibroids CPT 58674 | not published | not published | $841.04 – $2,950.95 | 6 |
| Laps esophgl sphnctr agmntj 43284 CPT 43284 | $1,155.39 | $2,027.00 | $657.49 – $838.42 | 6 |
| Lap sleeve gastrectomy CPT 43775 | not published | not published | $1,089.78 – $3,910.50 | 6 |
| Laps pelvic lymphadec CPT 38573 | not published | not published | $1,212.66 – $4,182.64 | 6 |
| Laps surg prst8ect rpbic rad CPT 55866 | not published | not published | $1,239.73 – $5,277.19 | 7 |
| Laps surg prst8ect smpl stot CPT 55867 | $1,688.34 | $2,962.00 | $1,089.30 – $3,904.43 | 6 |
| Laps tot hyst resj mal CPT 58575 | not published | not published | $2,000.07 – $6,844.54 | 6 |
| Lap tot proctocolectomy 44210 CPT 44210 | not published | not published | $1,798.49 – $6,352.58 | 7 |
| Lapt stg/restg ovarian tubal/prim mal 2nd 58960 CPT 58960 | not published | not published | $1,037.65 – $3,481.54 | 7 |
| Lap vent/abd hernia repair 49652 CPT 49652 | not published | not published | $1,517.22 – $3,330.25 | 3 |
| Lap vent/abd hern proc comp 49653 CPT 49653 | not published | not published | $1,891.18 – $4,156.53 | 3 |
| Lap w/omentopexy add-on 49326 CPT 49326 | not published | not published | $184.28 – $661.84 | 7 |
| Largsc w/laser dstrj les CPT 31572 | not published | not published | $187.10 – $1,880.81 | 6 |
| Largsc w/njx augmentation CPT 31574 | not published | not published | $154.98 – $3,653.85 | 6 |
| Largsc w/removal lesion CPT 31578 | not published | not published | $154.98 – $1,094.14 | 7 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | not published | not published | $138.17 – $1,006.43 | 7 |
| Largsc w/ther injection CPT 31573 | not published | not published | $154.50 – $993.98 | 6 |
| Laryngeal function studies CPT 92520 | not published | not published | $42.60 – $264.79 | 7 |
| Laryngoplasty cricoid split CPT 31587 | not published | not published | $1,270.67 – $4,275.94 | 7 |
| Laryngoplasty fx rdctj fixj CPT 31584 | not published | not published | $1,482.77 – $5,075.59 | 7 |
| Laryngoplasty laryngeal sten CPT 31551 | not published | not published | $1,617.40 – $5,497.35 | 6 |
| Laryngoplasty laryngeal sten CPT 31552 | not published | not published | $1,562.32 – $5,303.70 | 6 |
| Laryngoplasty laryngeal sten CPT 31553 | not published | not published | $1,763.92 – $6,043.28 | 6 |
| Laryngoplasty laryngeal sten CPT 31554 | not published | not published | $1,764.63 – $6,044.55 | 6 |
| Laryngoplasty laryngeal web CPT 31580 | not published | not published | $1,351.97 – $4,591.05 | 7 |
| Laryngoplasty medialization CPT 31591 | not published | not published | $1,159.24 – $3,886.39 | 6 |
| Laryngoscope w/vc inj CPT 31570 | not published | not published | $235.64 – $1,222.35 | 7 |
| Laryngoscopic sensory i&r CPT 92615 | not published | not published | $34.68 – $110.05 | 7 |
| Laryngoscopic sensory vid CPT 92614 | not published | not published | $69.62 – $489.53 | 7 |
| Laryngoscop w/arytenoidectom CPT 31560 | not published | not published | $321.40 – $1,121.74 | 7 |
| Laryngoscop w/vc inj + scope CPT 31571 | not published | not published | $256.74 – $892.05 | 7 |
| Laryngoscopy and dilation CPT 31528 | not published | not published | $149.41 – $514.50 | 7 |
| Laryngoscopy and dilation CPT 31529 | not published | not published | $166.81 – $576.60 | 7 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | not published | not published | $166.02 – $905.06 | 7 |
| Laryngoscopy for treatment CPT 31527 | not published | not published | $201.57 – $698.03 | 7 |
| Laryngoscopy telescopic CPT 31579 | $437.76 | $768.00 | $124.91 – $692.18 | 7 |
| Laryngoscopy w/biopsy CPT 31535 | not published | not published | $195.56 – $676.73 | 7 |
| Laryngoscopy w/bx & op scope CPT 31536 | not published | not published | $217.14 – $753.53 | 7 |
| Laryngoscopy w/exc of tumor CPT 31540 | not published | not published | $248.78 – $865.84 | 7 |
| Laryngoscopy w/fb & op scope CPT 31531 | not published | not published | $218.26 – $758.89 | 7 |
| Laryngoscopy w/fb removal CPT 31530 | not published | not published | $205.09 – $714.68 | 7 |
| Laryngoscopy with biopsy CPT 31576 | not published | not published | $124.46 – $970.95 | 7 |
| Laryngoscopy with biopsy 31510 CPT 31510 | not published | not published | $126.29 – $768.64 | 7 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | not published | not published | $115.74 – $749.81 | 7 |
| Larynscop remve cart + scop CPT 31561 | not published | not published | $351.44 – $1,225.24 | 7 |
| Larynscop w/tumr exc + scope CPT 31541 | not published | not published | $271.21 – $944.40 | 7 |
| Laser surgery eye strands CPT 67031 | not published | not published | $374.22 – $1,424.18 | 7 |
| Laser surgery of cervix 57513 CPT 57513 | not published | not published | $154.20 – $639.60 | 7 |
| Laser surgery of prostate CPT 52647 | not published | not published | $679.86 – $5,922.30 | 7 |
| Laser surgery of prostate CPT 52648 | not published | not published | $723.97 – $6,107.63 | 7 |
| Laser surg penis lesion(s) CPT 54057 | not published | not published | $103.94 – $503.89 | 7 |
| Laser treatment of retina CPT 67039 | not published | not published | $1,011.36 – $3,507.34 | 7 |
| Laser treatment of retina CPT 67040 | not published | not published | $1,090.80 – $3,790.39 | 7 |
| Lateral canthopexy CPT 21282 | not published | not published | $424.76 – $1,410.53 | 7 |
| Lat retinacular release open CPT 27425 | not published | not published | $480.81 – $1,612.61 | 7 |
| Lavage cannulation maxillary sinus CPT 31000 | not published | not published | $117.48 – $658.73 | 7 |
| Lavh >250 gms 58553 CPT 58553 | not published | not published | $1,154.83 – $4,072.65 | 7 |
| Lb with mastopexy 15839 CPT 15839 | not published | not published | $766.00 – $3,178.61 | 7 |
| Lead capillary CPT 83655 | $37.05 | $65.00 | $12.72 – $46.74 | 11 |
| Lefort i-1 piece without graft CPT 21141 | not published | not published | $1,402.70 – $4,921.91 | 7 |
| Lefort i-2 piece without graft CPT 21142 | not published | not published | $1,439.08 – $5,057.44 | 7 |
| Lefort i-3/> piece with graft CPT 21147 | not published | not published | $1,788.59 – $6,322.01 | 7 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | $1,483.04 – $5,253.30 | 7 |
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $1,710.94 – $5,953.73 | 7 |
| Legion pneumo dna dir prob CPT 87540 | not published | not published | $21.05 – $77.39 | 11 |
| Legion pneumo dna quant CPT 87542 | not published | not published | $43.85 – $161.19 | 11 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $911.77 – $3,258.71 | 7 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $992.37 | $1,741.00 | $34.33 – $113.20 | 7 |
| Leishmania antibody CPT 86717 | not published | not published | $8.32 – $47.29 | 11 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $697.85 – $2,296.01 | 7 |
| Lengthening of palate CPT 42227 | not published | not published | $888.63 – $2,992.09 | 7 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $954.08 – $3,199.05 | 7 |
| Lengthening of thigh bone CPT 27466 | not published | not published | $1,220.26 – $4,224.49 | 7 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $527.65 – $1,821.86 | 7 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $684.95 – $2,338.69 | 7 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $916.06 – $3,142.65 | 7 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $1,105.93 – $3,823.24 | 7 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $977.38 – $3,270.26 | 7 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $1,029.87 – $3,555.19 | 7 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $1,163.15 – $4,029.34 | 7 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $295.94 | $519.20 | $118.79 – $118.79 | 2 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $188.10 | $330.00 | $118.79 – $118.79 | 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.