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
Nuclear rx intracav admin CPT 79200 not published not published $85.50 – $132.22 7
Nuclear rx IV admin CPT 79101 not published not published $99.63 – $121.20 7
Nuclear Stress Test (Heart) CPT 78452 $2,649.36 $4,648.00 $80.76 – $194.28 7
Nuclr rx interstit colloid CPT 79300 not published not published $68.82 – $185.43 7
Nudt15 gene common variants CPT 81306 not published not published $305.93 – $1,124.65 7
Nursing fac care supervision CPT 99379 not published not published $153.23 – $153.23 2
Nursing fac care supervision CPT 99380 not published not published $229.66 – $229.66 2
Nursing facility discharge management > 30 min 99316 CPT 99316 $152.76 $268.00 $139.19 – $232.17 7
Nursing facility discharge management 30 min/less than 99315 CPT 99315 $117.42 $206.00 $86.77 – $160.93 7
Obltrj a-pulm sep def w/byp CPT 33814 not published not published $1,499.09 – $5,328.83 7
Observation care discharge CPT 99217 not published not published $132.74 – $150.47 3
Observation/inpatient hospital care hi severity 99236 CPT 99236 $435.48 $764.00 $219.92 – $477.38 7
Observation/inpatient hospital care low severity 99234 CPT 99234 $267.33 $469.00 $102.71 – $291.72 7
Observation/inpatient hospital care mod severity 99235 CPT 99235 $350.55 $615.00 $168.35 – $370.93 7
Obstetrical care 59410 CPT 59410 not published not published $1,069.80 – $2,721.49 7
Obstetric panel inc HIV tstg CPT 80081 not published not published $78.60 – $288.96 10
Obstetrics panel CPT 80055 not published not published $50.20 – $184.55 10
Obtaining screen pap smear HCPCS Q0091 $45.03 $79.00 $13.59 – $21.46 7
Ob Ultrasound nuchal meas 1 gest CPT 76813 not published not published $60.42 – $144.44 7
Ob Ultrasound nuchal meas add-on CPT 76814 not published not published $50.71 – $73.48 7
Occlude fallopian tube(s) device 58615 CPT 58615 not published not published $264.34 – $904.46 7
Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 $5.77 $10.12 $1.40 – $9.90 6
Ocular function screen CPT 99172 not published not published $56.18 – $56.18 2
Ocular instrumnt screen bil CPT 99174 not published not published $6.55 – $17.75 6
Ocular instrumnt screen bil CPT 99177 not published not published $5.12 – $14.30 6
Ocular photodynamic ther CPT 67221 not published not published $218.53 – $1,023.23 7
Ocular reconst transplant CPT 65780 not published not published $626.97 – $2,425.24 7
Ocular reconst transplant CPT 65781 not published not published $1,398.96 – $4,850.44 7
Ocular reconst transplant CPT 65782 not published not published $1,208.63 – $4,185.60 7
Office consultation CPT 99241 not published not published $67.42 – $67.42 2
Office emergency care CPT 99058 not published not published $70.34 – $70.34 2
Off/op cnsltj new/est low 30 CPT 99243 $243.39 $427.00 $93.80 – $161.19 6
Off/op cnsltj new/est mod 40 CPT 99244 $360.24 $632.00 $142.94 – $241.34 6
Off/op consltj new/est hi 55 CPT 99245 $438.33 $769.00 $191.88 – $394.32 6
Off/op consltj new/est sf 20 CPT 99242 $176.13 $309.00 $59.32 – $141.63 6
Ol dig e/m svc 11-20 min CPT 99422 not published not published $26.63 – $66.08 6
Ol dig e/m svc 21+ min CPT 99423 not published not published $42.70 – $106.83 6
Ol dig e/m svc 5-10 min CPT 99421 not published not published $13.49 – $33.29 6
Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 $52.44 $92.00 $36.44 – $92.00 7
Omental flap extra-abdom 49904 CPT 49904 not published not published $1,407.65 – $4,976.63 7
Omental flap intra-abdom 49905 CPT 49905 not published not published $348.80 – $1,248.38 7
Onc breast mrna 12 genes CPT 81522 not published not published $4,066.65 – $14,949.78 7
Onc breast mrna 58 genes CPT 81520 not published not published $2,635.72 – $9,689.41 7
Onc breast mrna 70 genes CPT 81521 not published not published $4,066.65 – $14,949.78 7
Onc brst mrna 11 genes CPT 81518 not published not published $4,066.65 – $14,949.78 7
Onc brst mrna 70 cnt 31 gene CPT 81523 not published not published $4,066.65 – $14,949.78 7
Onc cutan mlnma mrna 31 gene CPT 81529 not published not published $7,552.65 – $27,764.98 7
Oncology colon mrna CPT 81525 not published not published $3,271.80 – $12,027.76 7
Oncology colorectal scr CPT 81528 not published not published $534.31 – $1,964.24 10
Oncology gynecologic CPT 81535 not published not published $369.71 – $2,236.72 10
Oncology gynecologic CPT 81536 not published not published $186.44 – $685.38 10
Oncology lung CPT 81538 not published not published $3,014.55 – $11,082.06 7
Oncology prostate prob score CPT 81539 not published not published $798.00 – $2,933.60 8
Oncology thyroid CPT 81545 not published not published $20,675.37 – $20,675.37 2
Oncology tissue of origin CPT 81504 not published not published $546.00 – $2,007.20 7
Oncology tum unknown origin CPT 81540 not published not published $3,937.50 – $14,475.00 7
Onco (ovar) five proteins CPT 81503 not published not published $941.85 – $3,462.42 7
Onco (ovar) two proteins CPT 81500 not published not published $273.53 – $1,005.53 7
Oncoprotein dcp CPT 83951 not published not published $67.63 – $248.62 11
Oncoprotein her-2/neu CPT 83950 not published not published $67.63 – $248.62 11
Onc prostate 3 genes CPT 81551 not published not published $2,131.50 – $7,835.80 7
Onc prostate mrna 22 cnt gen CPT 81542 not published not published $4,066.65 – $14,949.78 7
Onc prostate mrna 46 genes CPT 81541 not published not published $4,066.65 – $14,949.78 7
Onc thyr mrna 10,196 gen alg CPT 81546 not published not published $3,780.00 – $13,896.00 7
Onc uveal mlnma mrna 15 gene CPT 81552 not published not published $8,164.80 – $30,015.36 7
Ondansetron 8 mg disintegrating tablet HCPCS Q0162 $2.98 $5.22 $0.02 – $5.22 6
Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 $0.57 $1.00 $0.13 – $0.58 6
Oocyte identification CPT 89254 not published not published $76.99 – $180.91 3
Oophorectomy partial or total 58943 CPT 58943 not published not published $1,246.69 – $4,197.34 7
Open ablate liver tumor cryo CPT 47381 not published not published $1,475.73 – $5,208.83 7
Open ablate liver tumor rf CPT 47380 not published not published $1,448.49 – $5,106.90 7
Open aortic tube prosth repair 34830 CPT 34830 not published not published $1,692.36 – $6,102.38 7
Open aortofemor prosth repr CPT 34832 not published not published $1,818.74 – $6,560.70 7
Open aortoiliac prosth repr 34831 CPT 34831 not published not published $1,853.00 – $6,689.93 7
Open bx/exc inguinofem nodes CPT 38531 $694.83 $1,219.00 $455.38 – $576.31 6
Open bx of lung pleura 32098 CPT 32098 not published not published $750.28 – $2,660.03 7
Open cor endarterect w cabg/ea ves 33572 CPT 33572 not published not published $222.74 – $802.88 7
Open nasoethmoid fx with fixj CPT 21339 not published not published $799.95 – $2,695.88 7
Open nasoethmoid fx without fixj CPT 21338 not published not published $709.35 – $2,375.36 7
Open periprosthetic breast capsule 19370 CPT 19370 not published not published $697.29 – $2,482.09 7
Open skull for drainage 61312 CPT 61312 not published not published $2,004.28 – $6,969.38 7
Open tenotomy tendon flexor foot single or multiple 28230 CPT 28230 $1,122.90 $1,970.00 $305.10 – $971.32 7
Open thrombectomy of av fistula without revision 36831 CPT 36831 not published not published $601.13 – $2,152.58 7
Open tx compl front sinus fx CPT 21344 not published not published $1,453.87 – $4,993.54 7
Open tx nose fx w/skele fixj CPT 21330 not published not published $566.01 – $2,022.38 7
Open tx nose & septal fx CPT 21335 not published not published $754.81 – $2,569.80 7
Open tx rib 1-3 fx w/fix 21811 CPT 21811 not published not published $587.17 – $2,087.55 6
Open tx rib 4-6 fx w/fix 21812 CPT 21812 not published not published $709.04 – $2,546.33 6
Open tx rib 7+ fx w/fix 21813 CPT 21813 not published not published $964.56 – $3,450.83 6
Open tx/sternum fracture 21825 CPT 21825 not published not published $565.09 – $1,915.46 7
Open wedge/bx lung infiltr CPT 32096 not published not published $790.63 – $2,805.11 7
Open wedge bx lung nodule 32097 CPT 32097 not published not published $792.06 – $2,807.66 7
Ophthalmic biometry CPT 92136 not published not published $32.39 – $101.09 7
Ophthalmic endoscope add-on CPT 66990 not published not published $92.39 – $328.61 7
Ophthalmodynamometry CPT 92260 not published not published $11.50 – $64.15 7
Ophth Ultrasound b & quant a CPT 76510 not published not published $41.92 – $200.45 7
Oph Ultrasound dx ant sgm Ultrasound uni/bi CPT 76513 not published not published $34.62 – $89.08 7
Oph Ultrasound dx quan a-scan only CPT 76511 not published not published $38.26 – $118.71 7
Opioids & opiate analogs 3/4 CPT 80363 not published not published $121.92 – $121.92 2
Opn abltj 1/> rnl mas crysrg CPT 50250 not published not published $1,263.24 – $4,449.30 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.