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
Perq plmt bile duct stent CPT 47540 not published not published $445.91 – $17,602.28 6
Perq rplcmt g-tube req revsn gstrst trk CPT 43763 not published not published $89.08 – $1,226.63 6
Perq skel fix rad/uln dislc CPT 25671 not published not published $566.59 – $1,904.40 7
Perq skel fix ulnar styld fx CPT 25651 not published not published $521.83 – $1,752.19 7
Perqt bx lung/mediastinum 32405 CPT 32405 not published not published $424.84 – $1,006.04 3
Perq transcath closure each CPT 93592 not published not published $401.97 – $1,322.76 6
Perq transcath closure pda CPT 93582 not published not published $643.00 – $2,097.76 6
Perq transcath cls aortic CPT 93591 not published not published $914.48 – $3,010.19 6
Perq transcath cls mitral CPT 93590 not published not published $1,109.03 – $3,629.41 6
Perq transcath septal reduxn CPT 93583 not published not published $721.81 – $2,348.86 6
Perq trluml angp nt/recr coa CPT 33897 not published not published $565.04 – $2,057.14 6
Perq tx big toe fracture w/manip 28496 CPT 28496 not published not published $293.08 – $1,651.09 7
Perq tx malar fracture CPT 21355 not published not published $347.92 – $1,554.41 7
Perq tx mndblr fx xtrnl fixj CPT 21452 not published not published $488.47 – $2,581.13 7
Perq tx nasoethmoid fx CPT 21340 not published not published $790.78 – $2,685.56 7
Pertussis ag if CPT 87265 not published not published $12.58 – $46.24 11
Pertuzumab 30 mg/ml desensitization HCPCS J9306 $28.59 $50.16 $12.47 – $50.16 7
Pet CT skull-mid thgh initial CPT 78815 $3,064.32 $5,376.00 $120.16 – $292.32 7
Pet CT whole body initial CPT 78816 $3,192.00 $5,600.00 $121.55 – $295.15 7
Pet fdg brain metoblic eval sb CPT 78608 $2,107.29 $3,697.00 $73.43 – $176.46 7
Pet image full body CPT 78813 not published not published $97.44 – $230.00 7
Pet image ltd area CPT 78811 not published not published $75.40 – $184.32 7
Pet image skull-thigh CPT 78812 not published not published $95.19 – $227.72 7
Pet image w/ct lmtd CPT 78814 not published not published $107.87 – $260.65 7
Pet scan brain perf study CPT 78609 not published not published $0.02 – $76.99 6
Ph1 assmt&mgmt nqhp 11-20 CPT 98967 $44.46 $78.00 $23.88 – $71.36 6
Ph1 assmt&mgmt nqhp 21-30 CPT 98968 $53.01 $93.00 $33.56 – $52.54 6
Ph1 assmt&mgmt nqhp 5-10 CPT 98966 $25.08 $44.00 $12.30 – $36.00 6
Phalangectomy ea toe 28150 CPT 28150 $453.15 $795.00 $299.18 – $966.27 7
Pharmacologic management w/psytx CPT 90863 not published not published $25.04 – $87.14 6
Ph body fluid CPT 83986 $17.67 $31.00 $3.76 – $13.82 11
Phencyclidine (pcp) CPT 83992 $59.28 $104.00 $21.02 – $56.72 6
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 $82.00 $143.86 $50.75 – $114.00 6
Phenobarbital therapeutic drug level CPT 80184 $41.04 $72.00 $16.07 – $59.06 11
Phenylephrine 10 mg/ml injection solution HCPCS J2371 $13.24 $23.22 $0.01 – $0.01 2
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 $1.71 $3.00 $0.64 – $3.00 6
Phenytoin total therapeutic drug level CPT 80185 $63.84 $112.00 $13.91 – $51.15 11
Phlebotomy therapeutic CPT 99195 $345.99 $607.00 $101.00 – $325.33 7
Phleb veins 1 extrm 10-20 stab CPT 37765 not published not published $266.97 – $1,575.98 7
Phleb veins 1 extrm >20 stab CPT 37766 not published not published $327.05 – $1,838.74 7
Phone e/m phys/qhp 11-20 min CPT 99442 not published not published $69.56 – $163.26 6
Phone e/m phys/qhp 21-30 min CPT 99443 not published not published $102.92 – $237.46 6
Phone e/m phys/qhp 5-10 min CPT 99441 not published not published $37.06 – $98.51 6
Phosphorus CPT 84100 $22.80 $40.00 $4.98 – $18.30 11
Phosphorus 24 hour urine CPT 84105 $24.51 $43.00 $6.07 – $22.31 11
Photchmtx tar&uvb/ptrltm&uvb CPT 96910 not published not published $126.55 – $378.15 7
Photochemotherapy puva CPT 96912 not published not published $107.64 – $323.36 7
Photochemotherapy uv-a or b CPT 96913 not published not published $163.07 – $468.47 7
Photodynamic tx addl 15 min CPT 96571 not published not published $26.35 – $86.43 7
Photodynmc tx 30 min add-on CPT 96570 not published not published $52.82 – $181.00 7
Photo patch test CPT 95052 not published not published $6.55 – $20.08 7
Photopheresis CPT 36522 not published not published $100.62 – $7,015.24 7
Photosensitivity tests CPT 95056 not published not published $55.55 – $150.88 7
Phys blood bank serv authrj CPT 86079 $88.35 $155.00 $23.29 – $126.02 8
Phys blood bank serv reactj CPT 86078 $278.16 $488.00 $49.79 – $126.80 8
Phys blood bank serv xmatch CPT 86077 $48.45 $85.00 $23.29 – $126.02 8
Physician standby services CPT 99360 not published not published $62.37 – $135.85 6
Phys review of motion tests CPT 96004 not published not published $113.51 – $374.61 7
Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 $12.20 $21.40 $4.17 – $11.00 6
Pierce earlobes 69090 CPT 69090 not published not published $108.30 – $108.30 2
Pik3ca gene trgt seq alys CPT 81309 not published not published $288.57 – $1,060.84 7
Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050 CPT 15050 not published not published $477.01 – $2,111.66 7
Pin finger dislocation CPT 26776 not published not published $480.46 – $1,607.18 7
Pin finger fracture each CPT 26756 $465.69 $817.00 $454.20 – $912.11 7
Pin hand dislocation CPT 26676 not published not published $543.81 – $1,818.79 7
Pin knuckle dislocation CPT 26706 not published not published $478.70 – $1,587.60 7
Pinworm exam CPT 87172 $17.10 $30.00 $4.48 – $16.48 11
Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 $8.50 $14.91 $1.25 – $14.91 6
Pituitary evaluation panel CPT 80418 not published not published $608.45 – $2,236.79 11
Place breast cath for rad CPT 19297 not published not published $92.50 – $331.99 7
Place breast rad tube/caths CPT 19298 not published not published $335.88 – $3,629.18 7
Place cath intracranial art CPT 36228 not published not published $238.38 – $4,776.64 7
Place cath xtrnl carotid CPT 36227 not published not published $116.38 – $884.33 7
Place cecostomy tube perc CPT 49442 not published not published $214.52 – $3,240.83 7
Place duod/jej tube perc CPT 49441 not published not published $244.56 – $3,861.11 7
Place gastrostomy tube open 43832 CPT 43832 not published not published $1,048.50 – $3,671.40 7
Place gastrostomy tube perc CPT 49440 not published not published $208.31 – $3,418.50 7
Placement bile duct support CPT 47801 not published not published $1,119.39 – $3,934.95 7
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 $2,268.03 $3,979.00 $102.12 – $895.43 6
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 not published not published $51.24 – $631.16 6
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 $2,268.03 $3,979.00 $86.88 – $1,665.23 6
Placement nephrostomy catheter (both sides) CPT 50432 not published not published $209.72 – $3,247.28 6
Placement of drain pancreas CPT 48001 not published not published $2,284.11 – $8,114.10 7
Placement of seton CPT 46020 $335.16 $588.00 $119.69 – $613.77 7
Placement stent(s) intravascular transcatheter artery initial CPT 37236 not published not published $427.57 – $12,221.89 6
Place ndl musc/tis for right CPT 20555 not published not published $355.44 – $1,202.10 7
Place needles h&n for right CPT 41019 not published not published $517.09 – $1,793.63 7
Place needles pelvic for right CPT 55920 not published not published $486.50 – $1,684.24 7
Place non-slctv cath thoracic arta CPT 36221 not published not published $194.47 – $3,815.63 7
Placental lactogen CPT 83632 not published not published $21.23 – $78.05 11
Place po breast cath for rad CPT 19296 not published not published $208.88 – $14,624.78 7
Place right device/marker pros CPT 55876 not published not published $107.16 – $530.96 7
Place slctv cath carotd art uni CPT 36224 not published not published $355.41 – $7,478.51 7
Place slctv cath carotid/inom art excrn uni CPT 36222 not published not published $278.54 – $4,503.83 7
Place slctv cath carotid/inom art intcrn uni CPT 36223 not published not published $318.10 – $5,789.81 7
Place slctv cath subclavian art CPT 36225 not published not published $315.48 – $5,545.80 7
Place slctv cath vertebral art uni CPT 36226 not published not published $353.62 – $7,070.89 7
Plasma volume multiple CPT 78111 not published not published $9.40 – $23.39 7
Plasma volume single CPT 78110 not published not published $8.28 – $21.72 7
Plastic surgery neck CPT 15819 not published not published $830.01 – $2,862.83 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.