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
Pulm endartercomy w/bypass 33916 CPT 33916 not published not published $4,052.27 – $14,712.64 7
Pulmonary decortication partial 32225 CPT 32225 not published not published $985.81 – $3,481.76 7
Pulmonary vent imaging CPT 78579 not published not published $24.22 – $58.88 7
Pulse ox continuous overnight monitoring CPT 94762 $255.36 $448.00 $26.88 – $84.91 7
Pulse ox multiple CPT 94761 not published not published $4.05 – $11.97 7
Pulse ox single CPT 94760 not published not published $2.62 – $7.33 7
Punc of shunt for asp or inj CPT 61070 not published not published $57.63 – $202.76 7
Puncture arterial withdrawal blood for diagnosis CPT 36600 $147.06 $258.00 $15.74 – $110.10 7
Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 $338.01 $593.00 $102.10 – $288.14 7
Puncture/clear windpipe 31612 CPT 31612 not published not published $49.21 – $312.04 7
Puncture spinal lumbar diagnostic CPT 62270 $1,016.31 $1,783.00 $63.44 – $504.71 7
Pvb thoracic 2nd+ inj site CPT 64462 not published not published $50.68 – $270.94 6
Pvb thoracic cont infusion CPT 64463 not published not published $85.30 – $732.45 6
Pvb thoracic single inj site CPT 64461 not published not published $81.49 – $482.66 6
Pyelotomy complicated CPT 50135 not published not published $1,163.84 – $4,102.69 7
Pyelotomy w/drg pyelostomy CPT 50125 not published not published $1,022.24 – $3,592.69 7
Pyelotomy w/exploration CPT 50120 not published not published $987.93 – $3,471.98 7
Pyelotomy w/removal calculus CPT 50130 not published not published $1,073.14 – $3,777.79 7
Pyloroplasty 43800 CPT 43800 not published not published $931.17 – $3,285.94 7
Pyridoxine hcl 100 mg HCPCS J3415 $10.83 $19.00 $9.27 – $19.00 6
Pyruvate CPT 84210 $39.33 $69.00 $15.20 – $55.89 11
Pyruvate kinase CPT 84220 not published not published $9.91 – $36.44 11
Quan puplmtry phy/qhp uni/bi CPT 95919 $494.76 $868.00 $10.40 – $18.89 6
Quant diff pulm perf and vent w/imaging CPT 78598 not published not published $41.34 – $100.72 7
Quant diff pulm perf w/imaging CPT 78597 not published not published $35.82 – $87.25 7
Quest t3 uptake CPT 84479 $22.23 $39.00 $6.79 – $24.97 11
Rabies ig heat-treated human im/subq 90376 CPT 90376 $519.84 $912.00 $239.26 – $1,400.00 6
Rabies ig ht&sol human im/sc CPT 90377 $633.89 $1,112.09 $350.69 – $1,400.00 7
Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 $319.77 $561.00 $235.62 – $1,400.00 7
Rabies vaccine id CPT 90676 not published not published $420.98 – $420.98 2
Radial keratotomy CPT 65771 not published not published $2,259.86 – $2,259.86 2
Radiation handling CPT 77790 not published not published $18.80 – $100.46 7
Radiation physics consult CPT 77336 not published not published $93.40 – $187.74 7
Radiation therapy dose plan CPT 77300 not published not published $34.90 – $80.13 7
Radiation therapy management CPT 77431 not published not published $114.29 – $257.47 7
Radiation treatment aid(s) CPT 77332 not published not published $25.59 – $63.47 7
Radiation treatment aid(s) CPT 77333 not published not published $21.87 – $97.71 7
Radiation treatment aid(s) CPT 77334 not published not published $64.90 – $150.24 7
Radiation treatment delivery CPT 77401 not published not published $44.37 – $58.06 7
Radiation treatment delivery CPT 77402 not published not published $337.48 – $361.58 3
Radiation treatment delivery CPT 77412 not published not published $559.99 – $620.32 3
Radiation tx management x5 CPT 77427 not published not published $202.70 – $463.41 7
Radical abdominal hysterectomy 58210 CPT 58210 not published not published $1,883.30 – $6,521.93 7
Radical rescj tumor clavicle CPT 23200 not published not published $1,541.89 – $5,381.03 7
Radical rescj tumor prox hum CPT 23220 not published not published $1,975.45 – $6,944.33 7
Radical rescj tumor scapula CPT 23210 not published not published $1,804.51 – $6,317.81 7
Radical resection of elbow CPT 24149 not published not published $1,228.14 – $4,208.74 7
Radical resection sternum 21630 CPT 21630 not published not published $1,354.71 – $4,307.40 7
Radic resect abd tumor<5cm 22904 CPT 22904 not published not published $1,063.27 – $3,725.70 7
Radic resect shoulder tumor 5cm/> 23078 CPT 23078 not published not published $1,459.36 – $5,092.46 7
Radiology port images(s) CPT 77417 not published not published $15.82 – $33.00 7
Radiotherapy dose plan imrt CPT 77301 not published not published $450.50 – $1,039.17 7
Radphm lcl tmr plnr bdy sgl day img CPT 78802 not published not published $39.24 – $95.13 7
Radphm lcl tmr plnr bdy two day img CPT 78804 $2,285.70 $4,010.00 $49.69 – $120.73 7
Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 $2,285.70 $4,010.00 $90.01 – $215.32 6
Radphm lcl tomogr sgl area sgl day CPT 78803 $2,285.70 $4,010.00 $53.39 – $128.74 7
Radphm lcl tumor plr sgl day CPT 78800 not published not published $32.09 – $77.40 7
Radphm quant measure sgl area add-on CPT 78835 not published not published $22.41 – $55.38 6
Rad rescj tum dstl/shft hum CPT 24150 not published not published $1,581.22 – $5,523.30 7
Rad rescj tum shoulder<5 cm CPT 23077 not published not published $1,144.69 – $3,991.24 7
Rad rescj tum tiss a/e 5 cm+ CPT 24079 $2,090.76 $3,668.00 $1,347.28 – $2,829.08 7
Rad rescj tum tiss a/e <5cm CPT 24077 not published not published $1,047.68 – $3,689.25 7
Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 not published not published $739.96 – $2,628.15 7
Rad resect abd tumor 5 cm/> CPT 22905 $2,488.05 $4,365.00 $1,342.23 – $2,833.95 7
Rad resect hand tumor < 3 cm CPT 26117 not published not published $777.90 – $2,662.76 7
Rad resect hand tumor 3 cm/> CPT 26118 not published not published $1,086.27 – $3,767.74 7
Rad resection tum radial h/n CPT 24152 not published not published $1,379.23 – $4,800.60 7
Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 not published not published $980.07 – $3,397.50 7
Range of motion measurements CPT 95852 not published not published $5.65 – $62.43 7
Ranibizumab injection HCPCS J2778 $441.18 $774.00 $213.33 – $774.00 7
Rapid desensitization CPT 95180 not published not published $109.46 – $453.63 7
Rapid Strep Test CPT 87880 $43.32 $76.00 $17.15 – $63.81 11
Rbc count only automated CPT 85041 not published not published $3.17 – $11.66 11
Rbc depletion of harvest CPT 38212 not published not published $49.12 – $177.38 6
Rbc mechanical fragility CPT 85547 not published not published $9.03 – $33.20 11
Rbc osmotic fragility CPT 85555 not published not published $7.84 – $28.83 11
Rbc serum pretx incubj drugs CPT 86975 not published not published $34.23 – $43.01 3
Rcm img acquisj&i&r 1st les CPT 96931 not published not published $181.95 – $565.68 6
Rcm img acquisj&i&r ea addl CPT 96934 not published not published $126.46 – $346.25 6
Rcm img acquisj only 1st les CPT 96932 not published not published $135.70 – $412.50 6
Rcm img acquisj only ea addl CPT 96935 not published not published $82.77 – $200.27 6
Rcm i&r only 1st lesion CPT 96933 not published not published $46.25 – $153.18 6
Rcm i&r only ea addl lesion CPT 96936 not published not published $43.69 – $145.98 6
Rcnst bfrnt sp orb rm&lw fhd CPT 21175 not published not published $2,264.26 – $7,999.99 7
Rcnstj forehead w/autograft CPT 21180 not published not published $1,742.50 – $6,144.49 7
Rcnstj forehead with grafts CPT 21179 not published not published $1,561.55 – $5,495.40 7
Rcnstj mdfc lefort i 1 w/grf CPT 21145 not published not published $1,628.49 – $5,749.09 7
Rcnstj mdfc lefort i 2 w/grf CPT 21146 not published not published $1,700.56 – $5,998.76 7
Rcnstj mdfc lefort iii w/i CPT 21155 not published not published $2,244.69 – $7,822.69 7
Rcnstj mdfc lefort iii without i CPT 21154 not published not published $2,025.24 – $7,050.23 7
Rcnstj mdfc lefrtii w/b1 grf CPT 21151 not published not published $1,881.60 – $6,553.13 7
Rcnst mdfc lfrtiii advm w/i CPT 21160 not published not published $2,911.75 – $10,172.10 7
Rcnst mdfc lfrtiii advm wo i CPT 21159 not published not published $2,686.05 – $9,376.99 7
Rdctj forehead cntrg only CPT 21137 not published not published $779.24 – $2,711.36 7
Rdctj forehead cntrg&prostc CPT 21138 not published not published $946.13 – $3,308.70 7
Rdctj forehead cntrg&setback CPT 21139 not published not published $1,126.13 – $3,999.83 7
Realignment of knee CPT 27457 not published not published $975.76 – $3,431.40 7
Realignment of knee CPT 27455 not published not published $994.78 – $3,399.26 7
Realignment of tendons CPT 26437 not published not published $707.28 – $2,300.89 7
Realignment of thigh bone CPT 27454 not published not published $1,329.43 – $4,621.01 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.