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
Mopath procedure level 6 CPT 81405 not published not published $316.42 – $1,163.21 7
Mopath procedure level 7 CPT 81406 not published not published $297.02 – $1,091.92 7
Mopath procedure level 8 CPT 81407 not published not published $888.58 – $3,266.60 7
Mopath procedure level 9 CPT 81408 not published not published $2,100.00 – $7,720.00 7
Morphine 4 mg/ml injection (wrapper) HCPCS J2270 $11.71 $20.55 $5.02 – $6.80 6
Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 $241.68 $424.00 $44.79 – $250.57 7
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 $573.42 $1,006.00 $46.24 – $135.89 8
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 $160.17 $281.00 $43.94 – $124.85 8
Motion analysis video/3d CPT 96000 not published not published $89.26 – $311.10 7
Motion test w/ft press meas CPT 96001 not published not published $116.03 – $367.71 7
Motor &/ sens nrve cndj test CPT 95905 not published not published $2.70 – $8.83 7
Mouth vestibule bx/w complex rpr 40814 CPT 40814 not published not published $300.29 – $1,389.41 7
M/phmtrc alys ishquant/semiq CPT 88373 not published not published $26.98 – $53.24 7
M/phmtrc alys ishquant/semiq CPT 88377 $290.70 $510.00 $68.02 – $250.57 7
M/phmtrc alysishquant/semiq CPT 88369 $897.75 $1,575.00 $35.50 – $66.45 7
M/phmtrc alys skeletal musc CPT 88355 not published not published $49.79 – $197.27 8
Mpl gene analysis common variants CPT 81338 not published not published $157.85 – $580.27 7
M.pneumon dna dir probe CPT 87580 not published not published $21.05 – $77.39 11
M.pneumon dna quant CPT 87582 not published not published $59.72 – $1,168.11 11
Mpsv4 vaccine subq CPT 90733 $182.97 $321.00 $142.02 – $142.02 2
MRA abdomen post contrast CPT 74185 $2,357.52 $4,136.00 $89.98 – $218.07 7
MRA aorta thoracic w/wo contrast CPT 71555 not published not published $90.36 – $218.96 7
MRA ext low(run-off)pst cntrst CPT 73725 $3,401.76 $5,968.00 $90.49 – $219.85 7
MRA pelvis CPT 72198 $1,949.97 $3,421.00 $89.98 – $217.20 7
MRA spinal canal CPT 72159 not published not published $91.05 – $220.60 7
MRA upper extremity post contrast-bil CPT 73225 not published not published $87.37 – $212.64 7
Mr elastography CPT 76391 not published not published $55.67 – $136.43 6
MRI brain w/dye CPT 70558 not published not published $178.83 – $420.96 7
MRI brain without dye CPT 70557 not published not published $162.17 – $374.75 7
MRI brain without & w/dye CPT 70559 not published not published $165.33 – $397.25 7
MRI breast c- unilateral CPT 77046 not published not published $73.12 – $177.10 6
MRI breast c-+ w/cad uni CPT 77048 not published not published $106.05 – $256.81 6
MRI breast without cont bi CPT 77047 not published not published $80.62 – $195.63 6
MRI breast w IV cont bi CPT 77049 not published not published $116.13 – $281.23 6
MRI cardiac morph & func wo IV cont CPT 75557 not published not published $117.75 – $284.28 7
MRI cardiac morph & func wwo IV cont CPT 75561 not published not published $130.40 – $313.45 7
MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 not published not published $149.60 – $361.71 7
MRI chest without contrast CPT 71550 $1,575.48 $2,764.00 $73.62 – $178.84 7
MRI chest without & w/contrast CPT 71552 $2,321.61 $4,073.00 $113.92 – $275.38 7
MRI chest w IV cont CPT 71551 not published not published $87.37 – $210.95 7
MRI fetal ea addl gestation CPT 74713 not published not published $93.63 – $226.77 6
MRI fetal sngl/1st gestation CPT 74712 not published not published $151.87 – $366.54 6
MRI guid ndl plc s&i CPT 77021 not published not published $75.57 – $179.30 7
MRI guid parenchymal tiss ablation CPT 77022 not published not published $210.74 – $529.09 7
MRI loex nonjt w IV cont CPT 73719 not published not published $81.72 – $198.55 7
MRI lower extremity other than joint without contrast (both sides) CPT 73718 $1,406.76 $2,468.00 $67.96 – $165.02 7
MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 $2,498.31 $4,383.00 $108.27 – $262.14 7
MRI orbit/face/neck without contrast CPT 70540 $1,383.39 $2,427.00 $67.96 – $164.18 7
MRI orbit/face/neck without & w/contrast CPT 70543 $1,993.29 $3,497.00 $108.27 – $262.14 7
MRI orbit fac&nck w IV cont CPT 70542 not published not published $81.72 – $198.55 7
MRI tmj CPT 70336 $1,208.40 $2,120.00 $74.36 – $180.65 7
MRI upper extremity other than joint without contrast (both sides) CPT 73218 $1,439.82 $2,526.00 $68.68 – $165.89 7
MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 $2,022.36 $3,548.00 $108.63 – $262.98 7
MRI upper extremity w/dye CPT 73219 not published not published $82.08 – $199.39 7
Mr spectroscopy CPT 76390 not published not published $172.91 – $172.91 2
Msh2 gene dup/delete variant CPT 81297 not published not published $159.05 – $823.34 10
Msh2 gene full seq CPT 81295 not published not published $159.05 – $1,473.36 10
Msh2 gene known variants CPT 81296 not published not published $135.81 – $1,303.64 10
Msh6 gene dup/delete variant CPT 81300 not published not published $169.51 – $918.68 10
Msh6 gene full seq CPT 81298 not published not published $301.77 – $2,477.54 10
Msh6 gene known variants CPT 81299 not published not published $169.05 – $1,188.88 10
Mt bone graft microvasc CPT 20957 not published not published $2,800.62 – $9,802.99 7
Mthfr gene analy common variants CPT 81291 $287.85 $505.00 $62.43 – $252.21 10
M.tuberculo dna dir probe CPT 87555 not published not published $28.22 – $103.76 11
M.tuberculo dna quant CPT 87557 not published not published $44.98 – $165.36 11
Mucin synovial fluid CPT 83872 not published not published $6.15 – $22.62 11
Mucopolysaccharides CPT 83864 not published not published $28.49 – $110.01 11
Mucormycosis antibody CPT 86732 not published not published $15.75 – $57.90 11
Multi family grp psychotherapy CPT 90849 not published not published $31.92 – $120.23 7
Multifocal erg w/i&r CPT 92274 not published not published $35.35 – $110.70 6
Multiple sleep latency test CPT 95805 not published not published $60.93 – $198.14 7
Mumps antibody igg CPT 86735 $60.99 $107.00 $13.70 – $50.37 11
Muscle-skin graft arm CPT 15736 not published not published $1,254.14 – $4,381.50 7
Muscle-skin graft leg CPT 15738 not published not published $1,300.08 – $4,639.99 7
Muscle-skin graft trunk CPT 15734 $2,385.45 $4,185.00 $1,526.55 – $3,251.44 7
Muscle test cran nerv unilat CPT 95867 not published not published $43.86 – $142.33 7
Muscle test hemidiaphragm CPT 95866 not published not published $67.20 – $221.53 7
Muscle test larynx CPT 95865 not published not published $87.46 – $223.79 7
Muscle test one fiber CPT 95872 not published not published $106.61 – $156.91 7
Muscle transfers CPT 23397 not published not published $1,175.02 – $4,074.38 7
Muscle transfer shoulder/arm CPT 23395 not published not published $1,325.82 – $4,585.65 7
Musc myoq/fscq flp h&n pedcl CPT 15733 not published not published $1,066.08 – $3,760.91 6
Musc/tdn transfer upr a/e 1 CPT 24301 not published not published $781.82 – $2,680.80 7
Mycobacteria dna amp probe CPT 87551 not published not published $50.19 – $186.21 11
Mycobacteria dna dir probe CPT 87550 not published not published $21.05 – $77.39 11
Mycobacteria dna quant CPT 87552 not published not published $44.98 – $165.36 11
Mycophenolate mofetil 250 mg capsule HCPCS J7517 $1.36 $2.38 $0.25 – $2.38 6
Mycophenolic acid HCPCS J7518 $2.84 $4.98 $0.57 – $4.98 6
Mycoplasma antibody igm CPT 86738 $48.45 $85.00 $13.90 – $51.11 11
Myd88 gene p.leu265pro vrnt CPT 81305 not published not published $184.17 – $677.04 7
Myelogphy 2/> spine regions CPT 72270 not published not published $69.13 – $164.94 7
Myelography l-s spine CPT 72265 not published not published $42.50 – $99.53 7
Myelography neck spine CPT 72240 not published not published $46.08 – $111.77 7
Myelography thoracic spine CPT 72255 not published not published $45.96 – $114.33 7
Myelography via inj w/s&i 2+ regions CPT 62305 not published not published $127.08 – $1,016.03 6
Myelography via inj w/s&i cervical CPT 62302 not published not published $123.77 – $946.24 6
Myelography via inj w/s&i lumbosacral CPT 62304 not published not published $122.28 – $933.11 6
Myelography via inj w/s&i thoracic CPT 62303 not published not published $124.00 – $964.24 6
Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 $91.77 $161.00 $12.11 – $44.51 11
Myocardial resection 33542 CPT 33542 not published not published $2,555.96 – $9,181.28 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.