Ascension Calumet Hospital, Inc.
614 Memorial Dr, Chilton, WI · Ascension · · NPI 1376541748
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 |
|---|---|---|---|---|
| Remove eyelid lesion CPT 67840 | not published | not published | $166.00 – $1,016.78 | 7 |
| Remove eyelid lesion(s) CPT 67808 | not published | not published | $389.55 – $1,337.78 | 7 |
| Remove eyelid lesions CPT 67801 | not published | not published | $138.71 – $594.23 | 7 |
| Remove eyelid lesions CPT 67805 | not published | not published | $172.48 – $736.73 | 7 |
| Remove eye/revise socket CPT 65112 | not published | not published | $1,604.36 – $5,346.64 | 7 |
| Remove eye/revise socket CPT 65114 | not published | not published | $1,673.89 – $5,594.33 | 7 |
| Remove femur lesion CPT 27355 | not published | not published | $636.39 – $2,163.15 | 7 |
| Remove femur lesion/bursa CPT 27062 | not published | not published | $478.08 – $1,625.85 | 7 |
| Remove femur lesion/fixation CPT 27358 | not published | not published | $275.49 – $985.05 | 7 |
| Remove femur lesion/graft CPT 27356 | not published | not published | $771.48 – $2,641.13 | 7 |
| Remove femur lesion/graft CPT 27357 | not published | not published | $851.42 – $2,914.95 | 7 |
| Remove finger bone CPT 26185 | not published | not published | $590.36 – $1,975.91 | 7 |
| Remove forearm bone lesion CPT 25145 | not published | not published | $549.48 – $1,857.04 | 7 |
| Remove foreign body brain CPT 61570 | not published | not published | $1,820.92 – $6,282.53 | 7 |
| Remove foreign body from eye CPT 65235 | not published | not published | $775.80 – $2,618.51 | 7 |
| Remove foreign body from eye CPT 65260 | not published | not published | $1,037.75 – $3,543.00 | 7 |
| Remove foreign body from eye CPT 65265 | not published | not published | $1,167.72 – $3,980.63 | 7 |
| Remove gastric port open 43887 CPT 43887 | not published | not published | $341.62 – $1,164.26 | 7 |
| Remove/graft bone lesion CPT 26205 | not published | not published | $634.37 – $2,159.25 | 7 |
| Remove/graft finger lesion CPT 26215 | not published | not published | $596.16 – $2,021.03 | 7 |
| Remove/graft foot lesion CPT 28102 | not published | not published | $640.07 – $2,174.18 | 7 |
| Remove/graft foot lesion CPT 28103 | not published | not published | $415.64 – $1,446.38 | 7 |
| Remove/graft foot lesion CPT 28107 | not published | not published | $371.88 – $1,897.91 | 7 |
| Remove/graft forearm lesion CPT 25125 | not published | not published | $625.85 – $2,122.31 | 7 |
| Remove/graft forearm lesion CPT 25126 | not published | not published | $630.13 – $2,137.80 | 7 |
| Remove/graft hip bone lesion CPT 27067 | not published | not published | $1,071.06 – $3,691.88 | 7 |
| Remove/graft leg bone lesion CPT 27637 | not published | not published | $780.22 – $2,682.83 | 7 |
| Remove/graft leg bone lesion CPT 27638 | not published | not published | $775.69 – $2,746.24 | 7 |
| Remove & graft wrist lesion CPT 25135 | not published | not published | $591.08 – $1,999.58 | 7 |
| Remove & graft wrist lesion CPT 25136 | not published | not published | $525.61 – $1,773.75 | 7 |
| Remove groin lymph nodes CPT 38760 | not published | not published | $853.82 – $2,974.39 | 7 |
| Remove hand bone lesion CPT 26200 | not published | not published | $477.65 – $1,621.69 | 7 |
| Remove hip bone les deep CPT 27066 | not published | not published | $848.62 – $2,897.25 | 7 |
| Remove hip bone les super CPT 27065 | not published | not published | $550.43 – $1,863.11 | 7 |
| Remove hip foreign body 27086 CPT 27086 | not published | not published | $177.49 – $1,107.83 | 7 |
| Remove hip/pelvis lesion 27047 CPT 27047 | $1,511.64 | $2,652.00 | $374.60 – $1,027.81 | 7 |
| Remove humerus lesion CPT 23174 | not published | not published | $799.12 – $2,717.93 | 7 |
| Remove humerus lesion CPT 23184 | not published | not published | $774.00 – $2,638.05 | 7 |
| Remove implant of eye CPT 65920 | not published | not published | $838.05 – $2,879.21 | 7 |
| Remove in/ex hem groups 2+ CPT 46260 | $730.17 | $1,281.00 | $499.23 – $1,032.77 | 7 |
| Remove in/ex hem grp & fiss 46257 CPT 46257 | not published | not published | $439.87 – $1,535.14 | 7 |
| Remove in/ex hem grps & fiss CPT 46261 | not published | not published | $553.62 – $1,888.61 | 7 |
| Remove in/ex hem grps w/fist CPT 46262 | not published | not published | $597.89 – $2,011.20 | 7 |
| Remove in/ex hem grp w/fistu CPT 46258 | not published | not published | $493.75 – $1,673.96 | 7 |
| Remove inguinofem lymph nodes 38765 CPT 38765 | not published | not published | $1,328.16 – $4,619.85 | 7 |
| Remove inner ear CPT 69905 | not published | not published | $968.79 – $3,289.73 | 7 |
| Remove inner ear lesion CPT 69970 | not published | not published | $2,219.77 – $7,662.98 | 7 |
| Remove inner ear & mastoid CPT 69910 | not published | not published | $1,039.94 – $3,591.30 | 7 |
| Remove intact mammary implant CPT 19328 | not published | not published | $574.98 – $1,797.90 | 7 |
| Remove intestinal allograft CPT 44137 | not published | not published | $3,703.61 – $3,703.61 | 2 |
| Remove int/ext hem 1 group CPT 46255 | $513.00 | $900.00 | $368.72 – $1,122.62 | 7 |
| Remove intra-aortic balloon CPT 33974 | not published | not published | $881.59 – $3,117.68 | 7 |
| Remove intracorporeal device CPT 33980 | not published | not published | $1,728.99 – $6,211.76 | 7 |
| Remove iris and lesion CPT 66600 | not published | not published | $959.69 – $3,166.13 | 7 |
| Remove jaw joint cartilage CPT 21060 | not published | not published | $827.22 – $2,932.73 | 7 |
| Remove kidney living donor CPT 50320 | not published | not published | $1,540.74 – $5,307.49 | 7 |
| Remove knee cyst CPT 27347 | not published | not published | $555.37 – $1,887.04 | 7 |
| Remove knee joint lining CPT 27334 | not published | not published | $717.13 – $2,448.53 | 7 |
| Remove knee joint lining CPT 27335 | not published | not published | $797.59 – $2,734.28 | 7 |
| Remove lamina/facets lumbar CPT 63012 | not published | not published | $1,189.02 – $4,106.06 | 7 |
| Remove limb nerve lesion CPT 64782 | not published | not published | $480.37 – $1,655.63 | 7 |
| Remove lower leg bone lesion CPT 27635 | $939.93 | $1,649.00 | $608.04 – $1,276.66 | 7 |
| Remove lung artery emboli 33910 CPT 33910 | not published | not published | $2,546.87 – $9,291.49 | 7 |
| Remove lung artery emboli without bypass 33915 CPT 33915 | not published | not published | $1,344.85 – $4,820.66 | 7 |
| Remove lung foreign body CPT 32151 | not published | not published | $994.26 – $3,515.25 | 7 |
| Remove lung pneumonectomy 32440 CPT 32440 | not published | not published | $1,542.86 – $5,474.66 | 7 |
| Remove mandible cyst complex CPT 21046 | not published | not published | $1,043.26 – $3,849.79 | 7 |
| Remove mastoid air cells CPT 69670 | not published | not published | $995.03 – $3,388.13 | 7 |
| Remove mastoid structures CPT 69505 | not published | not published | $1,296.30 – $4,333.16 | 7 |
| Remove maxilla cyst complex CPT 21048 | not published | not published | $1,052.41 – $3,902.51 | 7 |
| Remove middle ear nerve CPT 69676 | not published | not published | $881.50 – $2,980.76 | 7 |
| Remove muti-comp penis pros CPT 54406 | not published | not published | $764.44 – $2,674.61 | 7 |
| Remove nasal foreign body CPT 30310 | not published | not published | $221.23 – $735.04 | 7 |
| Remove nasal foreign body CPT 30320 | not published | not published | $519.26 – $1,683.75 | 7 |
| Remove nerve lesion CPT 64784 | not published | not published | $749.49 – $2,615.63 | 7 |
| Remove part lumbar vertebra CPT 22102 | not published | not published | $799.41 – $2,896.69 | 7 |
| Remove part lumbar vertebra CPT 22114 | not published | not published | $1,128.01 – $3,803.44 | 7 |
| Remove part of neck vertebra CPT 22100 | not published | not published | $944.83 – $2,990.25 | 7 |
| Remove part of neck vertebra CPT 22110 | not published | not published | $1,066.44 – $3,613.73 | 7 |
| Remove part of temporal bone CPT 69535 | not published | not published | $2,785.90 – $9,523.50 | 7 |
| Remove part thorax vertebra CPT 22112 | not published | not published | $1,128.01 – $3,803.44 | 7 |
| Remove pelvis lymph nodes 38770 CPT 38770 | not published | not published | $835.54 – $2,913.83 | 7 |
| Remove penis & nodes CPT 54130 | not published | not published | $1,240.01 – $4,364.44 | 7 |
| Remove penis & nodes CPT 54135 | not published | not published | $1,564.72 – $5,529.49 | 7 |
| Remove pilonidal cyst compl CPT 11772 | not published | not published | $597.78 – $2,604.79 | 7 |
| Remove pilonidal cyst exten CPT 11771 | $1,486.56 | $2,608.00 | $463.04 – $1,247.14 | 7 |
| Remove pituit tumor w/scope CPT 62165 | not published | not published | $1,518.68 – $5,269.95 | 7 |
| Remove prostate regrowth CPT 52630 | not published | not published | $427.35 – $1,470.56 | 7 |
| Remove pulmonary shunt CPT 33924 | not published | not published | $274.86 – $996.53 | 7 |
| Remove rectum w/reservoir CPT 45119 | not published | not published | $1,936.58 – $6,935.59 | 7 |
| Remove renal tube w/fluoro CPT 50389 | not published | not published | $54.62 – $1,372.91 | 7 |
| Remove/repair hearing aid CPT 69711 | not published | not published | $883.88 – $3,036.08 | 7 |
| Remove/replace penis prosth CPT 54410 | not published | not published | $902.03 – $3,149.55 | 7 |
| Remove/replace ur sphincter CPT 53447 | not published | not published | $841.66 – $2,955.75 | 7 |
| Remove/revise male sling CPT 53442 | not published | not published | $822.87 – $2,866.76 | 7 |
| Remove sacrum pressure sore close 15936 CPT 15936 | not published | not published | $918.04 – $3,204.00 | 7 |
| Remove sacrum pressure sore ostc 15937 CPT 15937 | not published | not published | $1,064.02 – $3,725.59 | 7 |
| Remove sciatic nerve lesion CPT 64786 | not published | not published | $1,007.78 – $3,530.66 | 7 |
| Remove self-contd penis pros CPT 54415 | not published | not published | $559.19 – $1,935.94 | 7 |
| Remove shoulder blade lesion CPT 23172 | not published | not published | $599.20 – $2,030.74 | 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.