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
Prep donor liver/venous CPT 47146 not published not published $320.59 – $1,150.88 7
Prep donor liver whole CPT 47143 not published not published $1,791.79 – $1,791.79 2
Prep donor pancreas CPT 48551 not published not published $822.83 – $822.83 2
Prep donor pancreas/venous CPT 48552 not published not published $230.15 – $826.35 7
Prep donor renal graft CPT 50325 not published not published $610.05 – $610.05 2
Prepj tum cav iort prtl mast CPT 19294 not published not published $161.78 – $577.39 6
Prep renal graft/arterial CPT 50328 not published not published $186.65 – $667.35 7
Prep renal graft/ureteral CPT 50329 not published not published $177.09 – $636.68 7
Prep renal graft/venous CPT 50327 not published not published $212.83 – $761.66 7
Prep skin to 100cm2 other CPT 15004 not published not published $267.96 – $1,448.29 7
Prep skin to 100cm2 trk/ext CPT 15002 $350.55 $615.00 $223.43 – $765.48 7
Prep skn trk/ext adl 100cm2 CPT 15003 $84.93 $149.00 $44.89 – $166.87 7
Pressure treatment esophagus CPT 43460 not published not published $219.16 – $778.65 7
Pressure velocity wire add ves CPT 93572 not published not published $51.76 – $169.58 7
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 not published not published $47.73 – $66.34 3
Pretreat rbc absorption reference CPT 86978 $52.44 $92.00 $34.23 – $47.73 3
Pretreat rbc density gradient separation reference CPT 86972 not published not published $20.38 – $55.77 3
Pretreat rbc w chem/drugs reference CPT 86970 $57.00 $100.00 $20.38 – $39.70 3
Pretreat rbc w enzyme reference CPT 86971 not published not published $20.38 – $31.67 3
Pr evaluation psychiatric diagnostic w/medical services CPT 90792 $377.34 $662.00 $183.95 – $528.09 7
Preventive counseling group CPT 99411 not published not published $7.86 – $43.46 6
Preventive counseling group CPT 99412 not published not published $13.14 – $54.96 6
Prev med cnsl indiv apprx 15 CPT 99401 $37.62 $66.00 $25.04 – $51.32 6
Prev med cnsl indiv apprx 30 CPT 99402 $73.53 $129.00 $50.83 – $104.12 6
Prev med cnsl indiv apprx 45 CPT 99403 not published not published $75.88 – $196.28 6
Prev med cnsl indiv apprx 60 CPT 99404 not published not published $101.30 – $251.22 6
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment HCPCS G0402 $91.77 $161.00 $143.08 – $143.08 4
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm CPT 11420 $2,106.15 $3,695.00 $87.80 – $273.21 7
Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 not published not published $172.54 – $799.13 7
Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 $535.80 $940.00 $108.68 – $493.63 7
Pr gastrorrhaphy suture perforated duodenal or gastric ulcer/wound/ injury CPT 43840 not published not published $1,359.97 – $4,795.16 7
Prgrmg dev eval impltbl sys CPT 93260 not published not published $43.83 – $93.02 6
Prgrmg dev eval pm/ldls pm CPT 93279 $58.71 $103.00 $33.04 – $89.71 7
Prgrmg dev eval scrms ip CPT 93285 not published not published $26.77 – $88.39 7
Prgrmg eval implantable dfb CPT 93282 $80.37 $141.00 $41.77 – $98.80 7
Prgrmg eval implantable dfb CPT 93283 $122.55 $215.00 $48.67 – $108.06 7
Prgrmg eval implantable dfb CPT 93284 $135.66 $238.00 $55.57 – $116.14 7
Prgr stim/pace a/iv drug CPT 93623 not published not published $67.78 – $16,158.00 8
Pr hospital ip/obs care initial high level per day CPT 99223 $408.69 $717.00 $182.93 – $443.71 7
Pr hospital ip/obs care initial moderate level per day CPT 99222 $277.59 $487.00 $137.23 – $300.69 7
Pr hospital ip/obs care initial straightforward or low level per day CPT 99221 $196.65 $345.00 $86.18 – $221.19 7
Pr hospital ip/obs care subsequent high level per day CPT 99233 $205.77 $361.00 $125.24 – $229.23 7
Pr hospital ip/obs care subsequent moderate level per day CPT 99232 $142.50 $250.00 $83.24 – $159.08 7
Pr hospital ip/obs care subsequent straightforward or low level per day CPT 99231 $79.80 $140.00 $51.95 – $86.02 7
Prim art mech thrmbc non-intracranial CPT 37184 not published not published $424.61 – $7,112.48 7
Prim art mech thrmbc non-intracranial add-on CPT 37185 not published not published $159.67 – $2,141.44 7
Prin care mgmt staff 1st 30 CPT 99426 $186.96 $328.00 $52.18 – $141.72 6
Pr incision & drainage abscess complicated/multiple CPT 10061 $509.01 $893.00 $194.83 – $450.96 7
Pr incision & drainage abscess simple/single CPT 10060 $314.64 $552.00 $113.81 – $256.76 7
Pr incision & drainage abscess vulva/perineal CPT 56405 $473.67 $831.00 $133.92 – $240.56 7
Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 $630.99 $1,107.00 $112.27 – $338.38 7
Pr management transitional care high w/in 7 days of discharge CPT 99496 $477.09 $837.00 $202.06 – $432.67 7
Pr management transitional care moderate w/in 14 days of discharge CPT 99495 $334.02 $586.00 $148.68 – $306.61 7
Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 $364.23 $639.00 $12.54 – $34.38 6
Pr neuroplasty and/or transposition ulnar nerve at elbow CPT 64718 $804.84 $1,412.00 $633.95 – $1,286.77 7
Probe nasolacrimal duct CPT 68810 not published not published $135.60 – $580.54 7
Probe nasolacrimal duct CPT 68811 not published not published $142.72 – $491.59 7
Probe nasolacrimal duct CPT 68815 not published not published $235.39 – $1,417.88 7
Probe nl duct w/balloon CPT 68816 not published not published $166.02 – $2,859.86 7
Procalcitonin CPT 84145 $94.62 $166.00 $28.58 – $105.07 11
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 $14.60 $25.61 $3.99 – $18.00 6
Prochlorperazine maleate 5 mg tablet HCPCS Q0164 $0.71 $1.24 $0.46 – $0.46 2
Proctectomy combined abd pull-thru px 45112 CPT 45112 not published not published $1,868.76 – $6,686.21 7
Proctectomy complete abd w/clst 45110 CPT 45110 not published not published $1,850.59 – $6,562.50 7
Proctosigmoidoscopy ablate CPT 45320 not published not published $104.92 – $719.14 7
Proctosigmoidoscopy control bleed 45317 CPT 45317 not published not published $114.14 – $731.70 7
Proctosigmoidoscopy dilate 45303 CPT 45303 not published not published $87.98 – $3,491.66 7
Proctosigmoidoscopy dx 45300 CPT 45300 not published not published $49.63 – $448.28 7
Proctosigmoidoscopy removal CPT 45308 not published not published $84.77 – $656.10 7
Proctosigmoidoscopy removal CPT 45309 not published not published $89.82 – $678.23 7
Proctosigmoidoscopy tumor removal 45315 CPT 45315 not published not published $105.79 – $737.70 7
Proctosigmoidoscopy volvul CPT 45321 not published not published $103.45 – $363.19 7
Proctosigmoidoscopy w/bx 45305 CPT 45305 not published not published $74.96 – $586.46 7
Proctosigmoidoscopy w/fb remove 45307 CPT 45307 not published not published $100.62 – $673.54 7
Proctosigmoidoscopy w/stent CPT 45327 not published not published $116.72 – $411.19 7
Progesterone CPT 84144 $66.12 $116.00 $21.90 – $80.52 11
Prolactin CPT 84146 $113.43 $199.00 $20.35 – $74.81 11
Prolng clin staff svc 1st hr CPT 99415 not published not published $21.15 – $21.65 6
Prolng clin staff svc ea add CPT 99416 not published not published $9.29 – $10.11 6
Prolng ip/obs e/m ea 15 min CPT 99418 $46.74 $82.00 $41.88 – $91.10 6
Prolng off/op e/m ea 15 min 99417 CPT 99417 $46.74 $82.00 $31.80 – $75.05 6
Prolng svc o/p 1st hour CPT 99354 not published not published $182.56 – $251.45 3
Prolng svc o/p ea addl 30 CPT 99355 not published not published $178.77 – $190.12 3
Prolong home eval add 15m HCPCS G0318 $45.60 $80.00 $31.57 – $71.71 6
Prolong service without contact CPT 99358 $216.60 $380.00 $93.44 – $245.91 6
Prolong serv without contact add CPT 99359 $104.31 $183.00 $38.93 – $119.26 6
Promethazine hcl injection HCPCS J2550 $4.56 $8.00 $4.87 – $8.00 6
Proph rta dtchmnt crtx dthrm CPT 67141 not published not published $229.52 – $1,910.66 7
Proph rta dtchmnt pc CPT 67145 not published not published $229.52 – $1,922.96 7
Proph tx w/wo mthylmthcrylt CPT 24498 not published not published $899.10 – $3,093.68 7
Prophylactic tx radius CPT 25490 not published not published $750.41 – $2,567.10 7
Prophylactic tx radius&ulna CPT 25492 not published not published $940.67 – $3,232.09 7
Prophylactic tx ulna CPT 25491 not published not published $770.39 – $2,639.40 7
Propofol infusion 10 mg/ml HCPCS J2704 $0.64 $1.12 $0.14 – $1.12 6
_propoxygc/msur CPT 80367 not published not published $31.67 – $33.34 3
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 $6.27 $11.00 $10.40 – $10.40 2
Prostatectomy (turp) CPT 52601 not published not published $758.82 – $2,667.08 7
Prostate laser enucleation CPT 52649 not published not published $861.16 – $3,018.53 7
Prostatic microwave thermotx CPT 53850 not published not published $375.76 – $5,679.56 7
Prostatic rf thermotx CPT 53852 not published not published $402.06 – $5,507.59 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.