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 |
|---|---|---|---|---|
| Resect neck tumor 5 cm/> CPT 21558 | not published | not published | $1,362.38 – $4,768.24 | 7 |
| Resect ovarian malignancy CPT 58952 | not published | not published | $1,707.39 – $5,853.49 | 7 |
| Resect ovarian malignancy w/bso 58950 CPT 58950 | not published | not published | $1,195.06 – $4,075.39 | 7 |
| Resect ovarian malignancy w/bso+omntc tah 58951 CPT 58951 | not published | not published | $1,494.16 – $5,154.49 | 7 |
| Resect part/compl phalangeal base ea 28126 CPT 28126 | not published | not published | $267.78 – $1,450.16 | 7 |
| Resect phalanx of toe tumor CPT 28175 | not published | not published | $502.39 – $1,756.46 | 7 |
| Resect prox finger tumor CPT 26260 | not published | not published | $827.16 – $2,853.30 | 7 |
| Resect radius/ulnar tumor CPT 25170 | not published | not published | $1,503.58 – $5,249.93 | 7 |
| Resect recurrent gyn mal CPT 58957 | not published | not published | $1,646.41 – $5,658.94 | 7 |
| Resect talus/calcaneus tum CPT 27647 | not published | not published | $1,057.65 – $3,774.41 | 7 |
| Resect tarsal tumor CPT 28171 | not published | not published | $1,138.15 – $3,960.64 | 7 |
| Resect thigh/knee tum < 5 cm CPT 27329 | not published | not published | $1,061.02 – $3,693.11 | 7 |
| Resect thigh/knee tum 5 cm/> CPT 27364 | not published | not published | $1,588.37 – $5,544.04 | 7 |
| Resect tibia tumor CPT 27645 | not published | not published | $1,804.51 – $6,317.81 | 7 |
| Respirator motion mgmt simul CPT 77293 | not published | not published | $113.01 – $261.44 | 6 |
| #resp virpnl dfa-adenovirus CPT 87260 | not published | not published | $15.15 – $55.70 | 11 |
| #resp virpnl dfa-parainfluenza CPT 87279 | not published | not published | $17.15 – $63.42 | 11 |
| Resp virus 6-11 targets CPT 87632 | $624.15 | $1,095.00 | $228.96 – $841.71 | 11 |
| Restore/remodelventricle 33548 CPT 33548 | not published | not published | $2,875.12 – $10,343.63 | 7 |
| Resuscitation cardiopulmonary CPT 92950 | $1,397.64 | $2,452.00 | $190.10 – $1,055.44 | 7 |
| Resuscitation delivery/birthing room CPT 99465 | not published | not published | $150.24 – $322.14 | 7 |
| Reticulated platelet assay CPT 85055 | $60.99 | $107.00 | $37.53 – $137.96 | 11 |
| Reticulocyte automated CPT 85045 | not published | not published | $4.19 – $15.40 | 11 |
| Reticulocyte direct measurement automated CPT 85046 | $37.62 | $66.00 | $5.85 – $21.50 | 11 |
| Retr bone flap to fix skull CPT 62148 | not published | not published | $118.93 – $422.36 | 7 |
| Retrieval of oocyte CPT 58970 | not published | not published | $201.31 – $843.71 | 7 |
| Retrograde ejaculation anal CPT 89331 | not published | not published | $20.57 – $75.62 | 11 |
| Revascularization penis CPT 37788 | not published | not published | $1,309.31 – $4,623.19 | 7 |
| Revise abdomen-venous shunt CPT 49426 | not published | not published | $675.92 – $2,353.50 | 7 |
| Revise additional leg tendon CPT 27692 | not published | not published | $103.40 – $372.34 | 7 |
| Revise aqueous shunt eye CPT 66185 | not published | not published | $900.62 – $3,083.25 | 7 |
| Revise arm/leg nerve CPT 64708 | not published | not published | $538.11 – $1,806.49 | 7 |
| Revise bladder & ureter(s) CPT 51565 | not published | not published | $1,337.12 – $4,740.11 | 7 |
| Revise breast reconst 19380 CPT 19380 | not published | not published | $836.72 – $2,800.76 | 7 |
| Revise circulation to head CPT 61708 | not published | not published | $2,457.54 – $8,538.94 | 7 |
| Revise circulation to head CPT 61705 | not published | not published | $2,510.75 – $8,728.65 | 7 |
| Revise circulation to head CPT 61710 | not published | not published | $2,074.59 – $7,206.94 | 7 |
| Revise esophagus & stomach 43325 CPT 43325 | not published | not published | $1,354.90 – $4,778.66 | 7 |
| Revise eye CPT 65091 | not published | not published | $791.71 – $2,511.30 | 7 |
| Revise eyelashes CPT 67825 | not published | not published | $129.60 – $484.73 | 7 |
| Revise eyelashes CPT 67835 | not published | not published | $466.98 – $1,599.30 | 7 |
| Revise eyelid defect CPT 67909 | not published | not published | $462.38 – $1,979.44 | 7 |
| Revise eyelid defect CPT 67911 | not published | not published | $590.54 – $2,039.51 | 7 |
| Revise eyelid lining CPT 68330 | not published | not published | $487.21 – $2,245.01 | 7 |
| Revise eyelid lining CPT 68360 | not published | not published | $434.59 – $1,962.49 | 7 |
| Revise eyelid lining CPT 68362 | not published | not published | $691.89 – $2,384.55 | 7 |
| Revise eye muscle CPT 67311 | not published | not published | $482.22 – $2,174.51 | 7 |
| Revise eye muscle CPT 67314 | not published | not published | $482.22 – $2,469.71 | 7 |
| Revise eye muscle add-on CPT 67340 | not published | not published | $305.75 – $1,303.84 | 7 |
| Revise eye muscle(s) CPT 67318 | not published | not published | $727.25 – $2,579.03 | 7 |
| Revise eye muscle(s) add-on CPT 67320 | not published | not published | $182.95 – $1,171.24 | 7 |
| Revise eye muscle w/suture CPT 67334 | not published | not published | $161.55 – $1,096.88 | 7 |
| Revise eye socket implant CPT 67560 | not published | not published | $1,175.87 – $3,817.54 | 7 |
| Revise eye sockets CPT 21260 | not published | not published | $1,413.92 – $5,008.16 | 7 |
| Revise eye sockets CPT 21261 | not published | not published | $2,495.73 – $8,862.79 | 7 |
| Revise eye sockets CPT 21263 | not published | not published | $2,310.75 – $8,197.80 | 7 |
| Revise eye sockets CPT 21267 | not published | not published | $1,654.10 – $5,856.19 | 7 |
| Revise eye sockets CPT 21268 | not published | not published | $2,072.43 – $7,338.68 | 7 |
| Revise eye with implant CPT 65093 | not published | not published | $784.94 – $2,485.39 | 7 |
| Revise finger joint each CPT 26135 | not published | not published | $584.56 – $1,986.11 | 7 |
| Revise finger joint each CPT 26140 | not published | not published | $538.62 – $1,819.16 | 7 |
| Revise gastric port open 43886 CPT 43886 | not published | not published | $378.80 – $1,294.99 | 7 |
| Revise/graft eyelid lining CPT 68320 | not published | not published | $571.63 – $2,683.39 | 7 |
| Revise/graft eyelid lining CPT 68325 | not published | not published | $692.99 – $2,389.84 | 7 |
| Revise/graft eyelid lining CPT 68326 | not published | not published | $680.29 – $2,344.73 | 7 |
| Revise/graft eyelid lining CPT 68328 | not published | not published | $743.21 – $2,572.01 | 7 |
| Revise/graft eyelid lining CPT 68335 | not published | not published | $682.37 – $2,352.71 | 7 |
| Revise graft w/vein CPT 35879 | not published | not published | $889.59 – $3,222.04 | 7 |
| Revise graft w/vein 35881 CPT 35881 | not published | not published | $995.66 – $3,552.60 | 7 |
| Revise hand/finger tendon CPT 26390 | not published | not published | $920.09 – $3,049.61 | 7 |
| Revise head/neck of femur CPT 27179 | not published | not published | $1,011.51 – $3,489.64 | 7 |
| Revise hernia & sperm veins CPT 55540 | not published | not published | $562.41 – $1,950.23 | 7 |
| Revise hip joint replacement CPT 27134 | $3,589.29 | $6,297.00 | $1,938.03 – $4,105.29 | 7 |
| Revise hip joint replacement CPT 27138 | $2,795.28 | $4,904.00 | $1,554.15 – $3,285.29 | 7 |
| Revise hip joint replacement CPT 27137 | $2,674.44 | $4,692.00 | $1,496.91 – $3,160.84 | 7 |
| Revise/implant finger joint CPT 26536 | not published | not published | $794.93 – $2,621.29 | 7 |
| Revise kneecap CPT 27437 | not published | not published | $691.13 – $2,356.80 | 7 |
| Revise kneecap with implant CPT 27438 | not published | not published | $872.63 – $3,005.74 | 7 |
| Revise knuckle joint CPT 26530 | not published | not published | $573.55 – $1,934.70 | 7 |
| Revise knuckle with implant CPT 26531 | not published | not published | $665.93 – $2,254.73 | 7 |
| Revise low back nerve(s) CPT 64714 | not published | not published | $787.73 – $2,614.35 | 7 |
| Revise lower leg tendon CPT 27690 | not published | not published | $673.92 – $2,318.29 | 7 |
| Revise lower leg tendon CPT 27691 | not published | not published | $779.46 – $2,684.33 | 7 |
| Revise lower leg tendons CPT 27686 | not published | not published | $560.99 – $1,953.11 | 7 |
| Revise middle ear bone CPT 69660 | not published | not published | $972.94 – $3,316.99 | 7 |
| Revise middle ear bone CPT 69661 | not published | not published | $1,267.11 – $4,329.75 | 7 |
| Revise middle ear bone CPT 69662 | not published | not published | $1,214.18 – $4,130.14 | 7 |
| Revise middle ear & mastoid CPT 69641 | not published | not published | $1,098.41 – $3,734.85 | 7 |
| Revise middle ear & mastoid CPT 69642 | not published | not published | $1,408.76 – $4,794.98 | 7 |
| Revise middle ear & mastoid CPT 69643 | not published | not published | $1,287.37 – $4,382.25 | 7 |
| Revise middle ear & mastoid CPT 69644 | not published | not published | $1,585.53 – $5,317.58 | 7 |
| Revise middle ear & mastoid CPT 69646 | not published | not published | $1,652.29 – $5,543.51 | 7 |
| Revise middle ear & mastoid 69645 CPT 69645 | not published | not published | $1,555.77 – $5,229.64 | 7 |
| Revise ocular implant CPT 65125 | not published | not published | $313.02 – $1,665.86 | 7 |
| Revise ocular implant CPT 65150 | not published | not published | $747.54 – $2,321.89 | 7 |
| Revise ovarian tube(s) CPT 58752 | not published | not published | $939.04 – $3,275.74 | 7 |
| Revise palsy hand tendon(s) CPT 25315 | not published | not published | $800.79 – $2,750.18 | 7 |
| Revise palsy hand tendon(s) CPT 25316 | not published | not published | $949.88 – $3,266.33 | 7 |
| Revise penis/urethra CPT 54328 | not published | not published | $975.15 – $3,432.08 | 7 |
| Revise penis/urethra CPT 54332 | not published | not published | $1,050.98 – $3,703.99 | 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.