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
Platelet aggregation each agent teg CPT 85576 $75.81 $133.00 $25.36 – $96.15 11
Platelet automated CPT 85049 $17.67 $31.00 $4.70 – $17.29 11
Platelet deplete of harvest CPT 38213 not published not published $12.41 – $44.93 6
Platelet survival CPT 78191 not published not published $26.43 – $70.49 7
Plcg2 gene common variants CPT 81320 not published not published $305.93 – $1,124.65 7
Plcmnt biliary drainage cath w/img ext CPT 47533 not published not published $268.38 – $4,594.35 6
Plcmnt stent transcath ctrl dialysis seg add-on CPT 36908 not published not published $205.39 – $7,634.40 6
Plcmnt ureteral stent pq w/img exstng trct CPT 50693 not published not published $208.59 – $3,809.10 6
Plcmnt ureteral stent pq w/img new w/cath CPT 50695 not published not published $349.09 – $5,124.79 6
Plcmt dlyd xtn pros 1st vsl CPT 34710 not published not published $770.65 – $2,808.83 6
Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 $1,122.33 $1,969.00 $86.88 – $1,649.78 6
Plcmt sft tiss loc pq w/img ea addl lsn CPT 10036 $560.88 $984.00 $43.63 – $201.91 6
Plcmt xtn pros evasc rpr per vsl CPT 34709 not published not published $308.80 – $1,127.44 6
Plc pq device breast ea addl lesion MRI guide CPT 19288 not published not published $65.13 – $2,257.35 6
Plc pq device breast ea addl lesion stereo guide CPT 19284 not published not published $51.13 – $754.46 6
Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 not published not published $43.50 – $1,421.29 6
Plethysmography lung volumes/airway resistance CPT 94726 $171.00 $300.00 $12.67 – $41.37 7
Pleurectomy parietal ; separate 32310 CPT 32310 not published not published $910.19 – $3,195.68 7
Plmt access bil tree sm bwl CPT 47541 not published not published $341.53 – $4,442.06 6
Plmt biliary drainage cath CPT 47534 not published not published $375.62 – $5,224.13 6
Plmt nephroureteral catheter CPT 50433 not published not published $259.98 – $4,201.16 6
Plmt ureteral stent prq CPT 50694 not published not published $272.43 – $4,229.10 6
Pm device progr eval dual CPT 93280 $70.11 $123.00 $39.30 – $105.98 7
Pm device progr eval multi CPT 93281 $83.79 $147.00 $43.83 – $109.21 7
Pml/raralpha 1 breakpoint CPT 81316 not published not published $217.68 – $800.22 10
Pmp22 gene dup/delet CPT 81324 not published not published $796.28 – $2,927.27 7
Pmp22 gene full sequence CPT 81325 not published not published $808.06 – $2,970.58 7
Pmp22 gene known fam variant CPT 81326 not published not published $48.93 – $179.88 7
Pm phone r-strip device eval CPT 93293 not published not published $15.25 – $50.94 7
Pms2 gene dup/delet variants CPT 81319 not published not published $213.68 – $785.51 10
Pms2 gene full seq analysis CPT 81317 not published not published $710.33 – $2,611.29 10
Pms2 known familial variants CPT 81318 not published not published $193.55 – $1,277.66 10
Pneumothrx tx-intraplrl inj ai CPT 32960 not published not published $94.71 – $465.30 7
#pnh-flow cytometry interp CPT 88187 not published not published $15.07 – $162.08 8
Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 $70.68 $124.00 $27.37 – $100.63 11
Polysom <6 yrs cpap/bilvl CPT 95783 $1,874.73 $3,289.00 $143.72 – $462.18 7
Polysom any age 1-3> param CPT 95808 not published not published $88.45 – $294.47 7
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 $4,268.16 $7,488.00 $130.63 – $423.72 7
Polyvalent mult org ea ag ia CPT 87451 not published not published $11.04 – $40.57 11
Positional change of finger CPT 26555 not published not published $1,439.94 – $4,918.35 7
Positional nystagmus test CPT 92532 not published not published $54.96 – $54.96 2
Post non-seg/spine instrumentation 22840 CPT 22840 not published not published $736.56 – $2,620.99 7
Postpartum Care Only CPT 59430 $221.16 $388.00 $176.47 – $400.74 7
Post seg spine instrument/3-6 seg 22842 CPT 22842 not published not published $740.38 – $2,629.88 7
Potassium 24 hour urine CPT 84133 $20.52 $36.00 $4.97 – $18.26 11
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 $1.96 $3.43 $0.15 – $1.01 6
Potassium serum/plasma/whole blood CPT 84132 $17.67 $31.00 $5.00 – $18.37 11
Ppp2r2b gen detc abnor allel CPT 81343 not published not published $143.85 – $528.82 7
Pq biliary strict dil s&i CPT 74363 not published not published $43.77 – $106.54 7
Pq dr cath chg w cont s&i CPT 75984 not published not published $39.89 – $84.57 7
Pq kyphplsty 1 bdy lumb w/img CPT 22514 $16,506.06 $28,958.00 $483.73 – $2,192.00 6
Pq thr inj ext pse CPT 36002 not published not published $105.08 – $558.71 7
Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 not published not published $208.32 – $3,121.99 6
Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 not published not published $443.59 – $6,643.88 6
Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 not published not published $417.78 – $6,579.98 6
Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr CPT 26951 not published not published $745.20 – $2,404.46 7
Pr application of long arm splint CPT 29105 $305.52 $536.00 $42.15 – $195.10 7
Pr application splint static short arm CPT 29125 $305.52 $536.00 $42.23 – $229.58 7
Pr assessment emotional/behavioral per instrument brief CPT 96127 $35.34 $62.00 $4.76 – $15.45 6
Pr biopsy skin punch single lesion CPT 11104 $310.65 $545.00 $48.59 – $229.22 6
Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method CPT 28297 $821.37 $1,441.00 $637.52 – $1,827.01 7
Pr correction hammertoe CPT 28285 $548.34 $962.00 $413.75 – $1,198.71 7
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 $58.14 $102.00 $12.74 – $26.30 7
Prcrd drg 0-5yr or w/anomly CPT 33018 not published not published $281.92 – $998.25 6
Prcrd drg 6+yr without anomly CPT 33017 not published not published $241.81 – $867.41 6
Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 not published not published $160.48 – $1,655.51 7
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 $305.52 $536.00 $46.86 – $158.59 7
Pr discharge day management hospital ip/obs <=30 min on ecounter date CPT 99238 $141.93 $249.00 $85.82 – $160.17 7
Pr discharge day management hospital ip/obs > 30 min on encounter date CPT 99239 $208.05 $365.00 $121.25 – $235.51 7
Prealbumin CPT 84134 $76.38 $134.00 $7.99 – $56.32 11
Pr ecg 12 lead report only CPT 93010 $25.65 $45.00 $8.60 – $28.09 7
Pr ecg external < 48 hours continuous recording/storage r&i by a phys/qhp CPT 93227 $68.40 $120.00 $19.66 – $88.52 7
Prednisone 1 mg tablet HCPCS J7512 $0.71 $1.24 $0.01 – $1.23 6
Pregabalin - sendout CPT 80366 $99.18 $174.00 $29.42 – $31.67 3
Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 $534.66 $938.00 $204.09 – $726.23 7
Pregnancy associated plasma protein-a CPT 84163 not published not published $15.80 – $58.09 11
Pregnancy Ultrasound (complete, after first trimester) CPT 76805 $431.49 $757.00 $50.60 – $121.47 7
Pregnancy Ultrasound (first trimester) CPT 76801 $352.26 $618.00 $50.25 – $121.47 7
Pr e&m preventive medicine initial comprehensive new patient 12-17 years CPT 99384 $205.20 $360.00 $103.87 – $181.00 6
Prenatal Care Only (4-6 visits) CPT 59425 not published not published $426.87 – $1,645.05 7
Prenatal Care Only (7+ visits) CPT 59426 $1,780.11 $3,123.00 $783.12 – $1,765.94 7
Preparation for bladder xray CPT 51605 not published not published $40.19 – $140.63 7
Preparation palate mold CPT 42280 not published not published $115.13 – $652.39 7
Prepare donor heart CPT 33944 not published not published $1,010.29 – $1,010.29 2
Prepare donor heart/lung CPT 33933 not published not published $1,433.74 – $1,433.74 2
Prepare donor intestine CPT 44715 not published not published $1,236.04 – $1,236.04 2
Prepare donor lung double CPT 32856 not published not published $1,251.19 – $1,251.19 2
Prepare donor lung single CPT 32855 not published not published $1,036.84 – $1,036.84 2
Prepare embryo for transfer CPT 89255 not published not published $63.73 – $76.99 3
Prepare fecal microbiota CPT 44705 not published not published $74.41 – $406.31 6
Prepare heart-aorta conduit CPT 33404 not published not published $1,712.02 – $6,118.76 7
Prepare penis study CPT 54230 not published not published $83.33 – $365.14 7
Prepare sperm duct x-ray CPT 55300 not published not published $192.40 – $681.64 7
Prep cadaver renal allograft CPT 50323 not published not published $1,036.73 – $1,036.73 2
Prep corneal endo allograft CPT 65757 not published not published $241.01 – $241.01 2
Prep donor intestine/artery CPT 44721 not published not published $374.40 – $1,344.64 7
Prep donor intestine/venous CPT 44720 not published not published $267.50 – $961.01 7
Prep donor liver 3-segment CPT 47144 not published not published $1,791.79 – $1,791.79 2
Prep donor liver/arterial CPT 47147 not published not published $374.74 – $1,342.46 7
Prep donor liver lobe split CPT 47145 not published not published $1,791.79 – $1,791.79 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.