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 |
|---|---|---|---|---|
| Myocrd img pet 1std rst/strs CPT 78491 | not published | not published | $76.62 – $181.84 | 7 |
| Myocrd img pet 1 std w/ct CPT 78429 | $1,901.52 | $3,336.00 | $84.20 – $205.97 | 6 |
| Myocrd img pet 2rtracer CPT 78432 | not published | not published | $100.16 – $241.92 | 6 |
| Myocrd img pet 2rtracer CT CPT 78433 | not published | not published | $109.51 – $264.32 | 6 |
| Myocrd img pet mlt rst&strs CPT 78492 | not published | not published | $89.97 – $213.80 | 7 |
| Myocrd img pet rst&strs CT CPT 78431 | not published | not published | $93.70 – $226.72 | 6 |
| Myocrd img pet rst/strs w/ct CPT 78430 | not published | not published | $80.36 – $195.38 | 6 |
| Myomectomy abdom complex CPT 58146 | not published | not published | $1,191.93 – $4,182.53 | 7 |
| Myomectomy abdom method CPT 58140 | not published | not published | $953.93 – $3,345.79 | 7 |
| Myomectomy vag method CPT 58145 | not published | not published | $593.20 – $2,029.31 | 7 |
| Myringoplasty CPT 69620 | not published | not published | $523.01 – $2,547.15 | 7 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $11.18 | $19.62 | $4.02 – $9.00 | 6 |
| Naltrexone, depot form HCPCS J2315 | $5.70 | $10.00 | $3.80 – $10.00 | 7 |
| Narcosynthesis CPT 90865 | not published | not published | $131.39 – $564.90 | 7 |
| Nasal endoscopy dx uni/bi separate proc CPT 31231 | $485.64 | $852.00 | $66.89 – $700.39 | 7 |
| Nasal function studies CPT 92512 | not published | not published | $28.85 – $195.23 | 7 |
| Nasal/sinus endoscopy surg CPT 31287 | not published | not published | $208.01 – $725.78 | 7 |
| Nasal/sinus endoscopy surg CPT 31290 | not published | not published | $1,184.96 – $4,105.50 | 7 |
| Nasal/sinus endoscopy surg CPT 31291 | not published | not published | $1,256.42 – $4,350.53 | 7 |
| Nasal/sinus endoscopy surg w/bx 31237 CPT 31237 | $661.20 | $1,160.00 | $166.20 – $914.25 | 7 |
| Nasal/sinus endo spendt remove tiss 31288 CPT 31288 | not published | not published | $241.61 – $842.59 | 7 |
| Nasal/sinus endo surg w/concha bullosa resct 31240 CPT 31240 | not published | not published | $165.15 – $568.84 | 7 |
| Nasal/sinus endo w/ethmoidectomy part 31254 CPT 31254 | not published | not published | $251.28 – $1,520.18 | 7 |
| Nasal/sinus endo w/ethmoidectomy tot 31255 CPT 31255 | not published | not published | $333.43 – $1,168.39 | 7 |
| Nasal/sinus endo w/front sinus expl 31276 CPT 31276 | not published | not published | $389.82 – $1,364.18 | 7 |
| Nasal/sinus maxillary endoscopy dx 31233 CPT 31233 | not published | not published | $140.88 – $946.43 | 7 |
| Nasal/sinus sphenoid endoscopy dx 31235 CPT 31235 | not published | not published | $166.14 – $1,081.46 | 7 |
| Nasal sinus therapy CPT 30210 | not published | not published | $109.63 – $539.63 | 7 |
| Nasopharyngoscopy w/endoscope CPT 92511 | not published | not published | $40.36 – $368.08 | 7 |
| Natriuretic peptide CPT 83880 | $118.56 | $208.00 | $41.22 – $151.54 | 11 |
| Natural killer cells total count CPT 86357 | not published | not published | $39.62 – $145.64 | 11 |
| Navigational bronchoscopy 31627 CPT 31627 | not published | not published | $98.92 – $4,661.96 | 7 |
| N block inj common digit CPT 64632 | not published | not published | $71.35 – $321.94 | 7 |
| N block inj hypogas plxs CPT 64517 | not published | not published | $133.25 – $701.59 | 7 |
| Nctrnl pen tmscn&/rgdity tst CPT 54250 | not published | not published | $24.11 – $112.94 | 7 |
| Ndl emg musc 1 xtr/non-limb CPT 95870 | $182.97 | $321.00 | $20.82 – $66.76 | 7 |
| Ndl insj without njx 1 or 2 musc CPT 20560 | $21.66 | $38.00 | $15.98 – $35.08 | 6 |
| Ndl insj without njx 3+ musc CPT 20561 | $29.07 | $51.00 | $23.85 – $140.36 | 6 |
| Ndl oculoelectromyography 1+ CPT 92265 | not published | not published | $48.87 – $130.06 | 7 |
| Ndsc dcmprn 1 ntrspc lumbar CPT 62380 | not published | not published | $5,170.61 – $5,170.61 | 2 |
| Ndsc hrv uxtr art 1 sgm cab CPT 33509 | not published | not published | $167.10 – $608.03 | 6 |
| Neck (Cervical Spine) CT scan (with and without contrast) CPT 72127 | not published | not published | $63.91 – $155.32 | 7 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | not published | not published | $61.57 – $149.15 | 7 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $731.88 | $1,284.00 | $50.39 – $122.37 | 7 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $2,382.60 | $4,180.00 | $115.76 – $293.52 | 7 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $2,155.74 | $3,782.00 | $90.43 – $220.06 | 7 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $2,005.26 | $3,518.00 | $74.72 – $182.83 | 7 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $2,449.29 | $4,297.00 | $90.70 – $220.60 | 7 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $1,641.03 | $2,879.00 | $75.82 – $183.27 | 7 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $1,553.25 | $2,725.00 | $60.46 – $147.37 | 7 |
| Neck spine disk surgery CPT 63020 | not published | not published | $1,101.45 – $3,998.55 | 7 |
| Neck spine disk surgery 63075 CPT 63075 | not published | not published | $1,347.48 – $4,670.81 | 7 |
| Neck spine disk surgery 63076 CPT 63076 | not published | not published | $236.54 – $845.63 | 7 |
| Needle emg guid w/chemodenervation add-on CPT 95874 | not published | not published | $20.70 – $66.35 | 7 |
| Neg press ventilation cnp CPT 94662 | not published | not published | $36.57 – $119.38 | 7 |
| Neg pres wound ther drsg set HCPCS A6550 | $404.94 | $710.42 | $25.86 – $25.86 | 2 |
| Neisseria meningitidis CPT 86741 | not published | not published | $8.32 – $50.91 | 11 |
| Nephrectomy open 50220 CPT 50220 | not published | not published | $1,082.94 – $3,797.74 | 7 |
| Nephrectomy partial CPT 50240 | not published | not published | $1,376.85 – $4,840.88 | 7 |
| Nephrotomy w/exploration CPT 50045 | not published | not published | $970.64 – $3,409.31 | 7 |
| Nerobehav stas exam by psy/md f2f 1st hr CPT 96116 | not published | not published | $85.67 – $324.18 | 7 |
| Nerobehav stas exam phys/qhp f2f ea l hr CPT 96121 | not published | not published | $72.10 – $280.44 | 6 |
| Nerve conduction 7-8 studies CPT 95910 | $1,189.59 | $2,087.00 | $111.59 – $270.13 | 7 |
| Nerve conduction studies 11-12 CPT 95912 | not published | not published | $166.49 – $333.03 | 7 |
| Nerve conduction studies 1-2 CPT 95907 | $271.32 | $476.00 | $55.97 – $134.69 | 7 |
| Nerve conduction studies 13+ CPT 95913 | not published | not published | $196.89 – $370.08 | 7 |
| Nerve conduction studies 3-4 CPT 95908 | $555.75 | $975.00 | $70.05 – $175.19 | 7 |
| Nerve conduction studies 5-6 CPT 95909 | $872.10 | $1,530.00 | $83.78 – $209.90 | 7 |
| Nerve conduction studies 9-10 CPT 95911 | $1,503.66 | $2,638.00 | $139.39 – $309.47 | 7 |
| Nerve graft add-on CPT 64901 | not published | not published | $594.34 – $2,125.16 | 7 |
| Nerve graft add-on CPT 64902 | not published | not published | $687.93 – $2,461.05 | 7 |
| Nerve graft head/neck <4 cm CPT 64885 | not published | not published | $1,118.88 – $3,993.15 | 7 |
| Nerve graft head/neck >4 cm CPT 64886 | not published | not published | $1,335.66 – $4,609.91 | 7 |
| Nerve palsy fascial graft CPT 15840 | not published | not published | $1,053.81 – $3,634.91 | 7 |
| Nerve palsy microsurg graft CPT 15842 | not published | not published | $2,764.21 – $9,758.03 | 7 |
| Nerve palsy muscle graft CPT 15841 | not published | not published | $1,830.97 – $6,415.76 | 7 |
| Nerve pedicle transfer CPT 64905 | not published | not published | $1,029.43 – $3,649.99 | 7 |
| Nerve pedicle transfer CPT 64907 | not published | not published | $1,327.20 – $4,640.78 | 7 |
| Nerve repair w/allograft CPT 64910 | not published | not published | $794.29 – $2,840.89 | 7 |
| Nerve surgery CPT 64859 | not published | not published | $247.44 – $885.79 | 7 |
| Nerve teasing preparations CPT 88362 | not published | not published | $76.99 – $258.53 | 8 |
| Neurectomy foot CPT 28055 | not published | not published | $414.62 – $1,423.24 | 7 |
| Neurectomy hamstring CPT 27325 | not published | not published | $592.94 – $2,007.26 | 7 |
| Neurectomy popliteal CPT 27326 | not published | not published | $550.55 – $1,854.41 | 7 |
| Neuroeltrd stim post tibial CPT 64566 | not published | not published | $31.21 – $457.58 | 7 |
| Neuroendoscopy add-on CPT 62160 | not published | not published | $177.69 – $630.75 | 7 |
| Neurolysis celiac plexus CPT 64680 | $1,738.50 | $3,050.00 | $169.11 – $1,222.91 | 7 |
| Neurolysis trigeminal nerve CPT 64600 | $982.68 | $1,724.00 | $241.79 – $1,602.64 | 7 |
| Neuromuscular junction testing ea nerve any 1 method CPT 95937 | not published | not published | $36.38 – $116.34 | 7 |
| Neuroplasty digital 1/both same digit CPT 64702 | not published | not published | $542.52 – $1,815.11 | 7 |
| Neuroplasty nerve of hand or foot 64704 CPT 64704 | not published | not published | $345.76 – $1,176.71 | 7 |
| Neurorraphy w/vein autograft CPT 64911 | not published | not published | $1,055.44 – $3,659.81 | 7 |
| Neurovascular pedicle flap CPT 15750 | not published | not published | $963.37 – $3,292.16 | 7 |
| Neutrlzg antb sarscov2 scr CPT 86408 | not published | not published | $44.24 – $162.62 | 7 |
| Neutrlzg antb sarscov2 titer CPT 86409 | not published | not published | $138.01 – $138.01 | 2 |
| Neutron beam tx complex CPT 77423 | not published | not published | $223.40 – $671.92 | 3 |
| New Patient Office Visit (level 2) CPT 99202 | $139.08 | $244.00 | $49.93 – $139.05 | 7 |
| New Patient Office Visit (level 3) CPT 99203 | $200.07 | $351.00 | $85.89 – $201.06 | 7 |
| New Patient Office Visit (level 4) CPT 99204 | $306.09 | $537.00 | $140.21 – $306.26 | 7 |
| New Patient Office Visit (level 5) CPT 99205 | $380.76 | $668.00 | $190.58 – $379.86 | 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.