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
Protein analysis w/probe CPT 88372 not published not published $25.36 – $101.21 11
Protein c activity CPT 85303 $43.89 $77.00 $14.53 – $53.42 11
Protein electrophoretic fractionation & quantitation serum CPT 84165 $51.87 $91.00 $11.28 – $41.46 11
Protein s total CPT 85305 $62.70 $110.00 $12.19 – $44.81 11
Protein total 24 hour urine CPT 84156 $27.93 $49.00 $3.85 – $14.17 11
Protein total body fluid CPT 84157 $31.35 $55.00 $4.20 – $15.44 11
Protein total serum plasma whole blood CPT 84155 $14.25 $25.00 $3.85 – $14.17 11
Protein western blot tissue CPT 88371 not published not published $23.34 – $85.81 11
Prothrombin complex kcentra HCPCS J7168 $3.96 $6.94 $3.60 – $3.60 2
Prothrombin time substitution plasma fractions each CPT 85611 $11.97 $21.00 $4.14 – $15.21 11
Proton treatment complex CPT 77525 not published not published $2,202.81 – $2,202.81 2
Proton trmt intermediate CPT 77523 not published not published $2,068.77 – $2,068.77 2
Proton trmt simple w/comp CPT 77522 not published not published $1,743.22 – $1,743.22 2
Proton trmt simple without comp CPT 77520 not published not published $1,697.46 – $1,697.46 2
Protoporphyrin rbc screen CPT 84203 not published not published $10.23 – $37.60 11
Prpertl pel pack hemrrg trma 49013 CPT 49013 not published not published $447.01 – $1,568.70 6
Prp i/hern init block >5 yr CPT 49507 $1,123.47 $1,971.00 $595.37 – $1,252.49 7
Pr planning advance care 1st 30 minutes CPT 99497 $168.72 $296.00 $82.13 – $114.30 6
Pr prolonged e&m service office outpatient each 15 minutes (g2212) HCPCS G2212 $55.86 $98.00 $32.99 – $75.05 6
Prq av fstl crtj uxtr 1 acs CPT 36836 not published not published $359.03 – $26,959.05 6
Prq av fstl crt uxtr sep acs CPT 36837 not published not published $462.82 – $38,356.58 6
Prq card angio/athrect addl CPT 92925 not published not published $21,365.00 – $21,365.00 1
Prq cardiac angio addl art CPT 92921 not published not published $21,365.00 – $21,365.00 1
Prq card revasc chronic addl CPT 92944 not published not published $22,700.00 – $22,700.00 1
Prq card revasc mi 1 vsl CPT 92941 not published not published $643.46 – $22,700.00 8
Prq card stent/ath/angio CPT 92934 not published not published $22,700.00 – $22,700.00 1
Prq card stent w/angio addl CPT 92929 not published not published $22,700.00 – $22,700.00 1
Prq revasc byp graft 1 art and/or branches CPT 92937 not published not published $572.76 – $22,700.00 8
Prq revasc byp graft addl CPT 92938 not published not published $22,700.00 – $22,700.00 1
Prq skel fix clcnl fx w/mnpj CPT 28406 not published not published $623.73 – $1,947.86 7
Prq skel fix epcndylr hum fx CPT 24566 not published not published $756.76 – $2,569.65 7
Prq skel fix sprcndlr hum fx CPT 24538 $1,043.10 $1,830.00 $826.60 – $1,606.14 7
Prq skel fix talus fx w/mnpj CPT 28436 not published not published $527.56 – $1,679.81 7
Prq skel fix tarsl fx w/mnpj CPT 28456 not published not published $397.79 – $1,223.18 7
Prq tcat plmt ntrac st 1 les CPT 92928 not published not published $573.01 – $22,700.00 8
Prq trlml c athrc st angiop1 CPT 92933 not published not published $642.48 – $22,700.00 8
Prq trluml c angiop 1art&/br CPT 92920 not published not published $514.98 – $21,365.00 8
Prq trluml c athrc 1 art&/br CPT 92924 not published not published $614.07 – $21,365.00 8
Prq trluml revsc ch occ ant CPT 92943 not published not published $643.22 – $22,700.00 8
Pr removal drug delivery implant CPT 11982 $338.58 $594.00 $74.33 – $337.57 7
Pr removal foreign body external auditory canal without anesthesia CPT 69200 $394.44 $692.00 $49.33 – $281.19 7
Pr removal intrauterine device CPT 58301 $306.09 $537.00 $67.78 – $209.33 7
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 $662.34 $1,162.00 $200.64 – $1,097.74 7
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 $325.47 $571.00 $56.04 – $242.96 7
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 $341.43 $599.00 $58.08 – $410.59 7
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 $270.75 $475.00 $45.42 – $199.45 7
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 $325.47 $571.00 $59.49 – $240.97 7
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child CPT 15100 $978.69 $1,717.00 $738.28 – $1,876.47 7
Pr subsequent hospital care e/m normal newborn per day CPT 99462 not published not published $43.12 – $92.52 7
Prtl exc bone olecrn process CPT 24147 not published not published $661.54 – $2,239.05 7
Prtl exc bone radial h/n CPT 24145 not published not published $623.23 – $2,121.15 7
Prtl exchange transfuse nb CPT 36456 not published not published $102.34 – $376.54 6
Prtl excision bone clavicle CPT 23180 not published not published $688.16 – $2,369.70 7
Prtl excision bone scapula CPT 23182 not published not published $704.27 – $2,358.41 7
Pr tube thoracostomy w/connection to drainage open CPT 32551 $1,638.18 $2,874.00 $156.27 – $561.68 7
Pr visit complexity e&m service serious/complex condition HCPCS G2211 $34.20 $60.00 $17.54 – $38.28 6
PSA (Prostate) Test CPT 84153 $96.33 $169.00 $19.31 – $70.99 11
Psych/neuropsych test admin automated result 96146 CPT 96146 not published not published $2.26 – $6.19 6
Psychoanalysis CPT 90845 not published not published $94.66 – $328.00 7
Psychophysiological therapy CPT 90875 not published not published $62.37 – $204.32 6
Psychophysiological therapy CPT 90876 not published not published $98.72 – $356.89 6
Psychotherapy group therapy CPT 90853 not published not published $26.22 – $92.44 7
Psychotherapy patient individual therapy 30 minutes CPT 90832 $158.46 $278.00 $74.83 – $177.15 7
Psychotherapy patient individual therapy 45 minutes CPT 90834 $212.04 $372.00 $99.06 – $236.30 7
Psychotherapy patient individual therapy 60 minutes CPT 90837 $298.68 $524.00 $146.18 – $354.65 7
Psych test eval svc phys/qhp 1st hr CPT 96130 not published not published $117.26 – $400.33 6
Psych test eval svc phys/qhp ea addl hr CPT 96131 not published not published $82.25 – $306.30 6
Psycl/nrpsyc tech 1st CPT 96138 not published not published $36.52 – $123.10 6
Psy evaluation of records CPT 90885 not published not published $164.67 – $164.67 2
Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 not published not published $25.03 – $155.07 6
Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 not published not published $19.41 – $142.57 6
Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 not published not published $37.59 – $123.10 6
Psytx complex interactive CPT 90785 not published not published $9.67 – $51.07 7
Psytx pt w/e&m 16-37 min CPT 90833 not published not published $69.39 – $238.59 7
Psytx pt w/e&m 38-52 min CPT 90836 not published not published $88.02 – $302.04 7
Psytx pt w/e&m 53+ min CPT 90838 not published not published $116.52 – $397.62 7
Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 $68.40 $120.00 $18.13 – $39.04 7
Pt application of modality >=1 area hot/cold packs CPT 97010 not published not published $7.50 – $7.50 2
Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 $100.89 $177.00 $25.37 – $67.36 7
Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 $68.40 $120.00 $17.61 – $25.82 7
Pt application of modality traction mechanical CPT 97012 $67.26 $118.00 $18.55 – $32.83 7
Pt/caregiver traing home inr CPT 93792 not published not published $74.58 – $210.71 6
Pten gene dup/delet variant CPT 81323 not published not published $91.84 – $1,158.00 10
Pten gene full sequence CPT 81321 not published not published $629.79 – $2,316.00 10
Pten gene known fam variant CPT 81322 not published not published $48.93 – $179.88 10
Pterygomaxillary fossa surg any appr 31040 CPT 31040 not published not published $850.14 – $2,834.96 7
Pt evaluation high complexity patient/family CPT 97163 $323.19 $567.00 $104.53 – $108.93 6
Pt evaluation low complexity patient/family CPT 97161 $223.44 $392.00 $104.53 – $108.93 6
Pt evaluation moderate complexity patient/family CPT 97162 $269.04 $472.00 $104.53 – $108.93 6
Pt-focused hlth risk assmt CPT 96160 not published not published $3.21 – $8.11 6
Pt init/spiromet rec/review/interp 94016 CPT 94016 not published not published $26.06 – $85.04 7
Pt prgrm for implt neurostim HCPCS L8681 $1,231.59 $2,160.68 $1,144.82 – $1,144.82 2
Pt re-evaluation patient/family CPT 97164 $141.93 $249.00 $71.80 – $75.41 6
Pt repositioning canalith procedure(s) per day CPT 95992 $48.45 $85.00 $38.32 – $88.26 7
Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 $101.46 $178.00 $36.99 – $58.09 7
Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 not published not published $35.76 – $53.82 7
Pt wheelchair management each 15 minutes CPT 97542 $71.82 $126.00 $40.45 – $62.37 7
Pul art balloon repr percut CPT 92997 not published not published $625.96 – $2,046.69 7
Pul art balloon repr percut CPT 92998 not published not published $311.08 – $1,020.22 7
Pulm ds ipf mrna 190 gen alg CPT 81554 not published not published $5,796.00 – $21,230.00 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.