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
Rpr rem hernia init reduce CPT 49550 not published not published $584.98 – $2,036.44 7
Rpr tga aortic pulm art rcns CPT 33778 not published not published $2,291.32 – $8,208.08 7
Rpr tga atr bfl clsr vsd CPT 33776 not published not published $1,921.16 – $6,850.43 7
Rpr tga atr bfl rmvl plm bnd CPT 33775 not published not published $1,815.62 – $6,478.76 7
Rpr tga atrial baffle px CPT 33774 not published not published $1,766.01 – $6,290.93 7
Rpr tga bfl rpr sbpulm obstr CPT 33777 not published not published $1,846.31 – $6,613.01 7
Rpr tga rcnstj clsr vsd CPT 33780 not published not published $2,298.39 – $8,267.18 7
Rpr tga rcnstj rmvl plm bnd CPT 33779 not published not published $2,254.31 – $8,118.56 7
Rpr tga rcnstj rpr sbpl obst CPT 33781 not published not published $2,239.65 – $8,073.49 7
Rpr tga without surg enlgmnt vsd CPT 33770 not published not published $2,055.82 – $7,392.60 7
Rpr tga w/surg enlgmnt vsd CPT 33771 not published not published $2,110.12 – $7,604.85 7
Rpr umbil hern block < 5 yr CPT 49582 not published not published $1,037.15 – $2,128.73 3
Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 not published not published $384.21 – $1,304.70 7
Rp therapy unlisted px CPT 79999 not published not published $561.65 – $561.65 2
Rrp hypspad comp moblj&urtp CPT 54344 not published not published $983.52 – $3,462.38 7
Rsect hip tum incl femur CPT 27078 not published not published $2,091.17 – $7,345.88 7
Rsv assay w/optic CPT 87807 $43.32 $76.00 $13.76 – $50.57 11
Rtm 1st set-up&pt educaj eqp CPT 98975 not published not published $20.94 – $42.33 6
Rtm dev sply mscskl 16-30 d CPT 98977 not published not published $50.43 – $124.10 6
Rtm dev sply resp sys 16-30d CPT 98976 not published not published $50.43 – $124.10 6
Rtm tx mgmt 1st 20 min CPT 98980 not published not published $32.53 – $112.77 6
Rtm tx mgmt ea addl 20 min CPT 98981 not published not published $32.16 – $91.33 6
Rubella antibody igg CPT 86762 $52.44 $92.00 $15.11 – $55.55 11
Rubeola ag if CPT 87283 not published not published $17.15 – $234.69 11
Rubeola antibody igg CPT 86765 $63.84 $112.00 $13.52 – $49.72 11
Runx1 gene targeted seq alys CPT 81334 not published not published $345.99 – $1,271.91 7
Russell viper venom diluted CPT 85613 $28.50 $50.00 $10.06 – $36.98 11
Rx metab gen seq alys pnl 6 CPT 81418 not published not published $3,539.93 – $4,044.32 5
Salivary gland function exam CPT 78232 not published not published $20.14 – $49.15 7
Salivary gland imaging CPT 78230 not published not published $22.73 – $55.31 7
Salivary glnd img serial img CPT 78231 not published not published $22.36 – $58.51 7
Salmonella antibody CPT 86768 not published not published $11.70 – $50.91 11
Salpingostomy 58770 CPT 58770 not published not published $892.50 – $3,110.36 7
Same day nb discharge 99463 CPT 99463 not published not published $114.44 – $243.72 7
Sars-cov-2 antb quantitative CPT 86413 not published not published $55.30 – $55.30 2
Sarscov2 vac 5mcg/0.5ml im CPT 91304 not published not published $0.02 – $229.71 4
Sarscov coronavirus ag ia CPT 87426 not published not published $37.10 – $136.37 7
Sarscov & inf vir a&b ag ia CPT 87428 not published not published $107.30 – $107.30 2
S bowel endoscope w/stent CPT 44379 not published not published $421.55 – $1,499.29 7
Sbrt management CPT 77435 not published not published $680.46 – $1,565.95 7
Sbsq ic vlbw inf<1,500 gm CPT 99478 not published not published $140.91 – $302.55 7
Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 $215.46 $378.00 $163.23 – $296.49 7
Sbsq nursing facil care/day minor complj 15 min CPT 99308 not published not published $79.19 – $151.67 7
Sbsq nursing facil care/day new problem 25 min CPT 99309 $161.31 $283.00 $114.57 – $200.78 7
Sbsq nursing facility care/day e/m stable 10 min CPT 99307 $82.08 $144.00 $42.77 – $96.59 7
Sbsq psyc collab care mgmt CPT 99493 not published not published $108.84 – $272.67 6
Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 $1,003.77 $1,761.00 $57.56 – $189.01 7
Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 $539.79 $947.00 $40.08 – $131.96 7
Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 not published not published $38.91 – $127.73 7
Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 $574.56 $1,008.00 $24.38 – $79.57 7
Scan duplex extracranial arteries unilateral/limited study CPT 93882 $654.36 $1,148.00 $24.38 – $80.34 7
Scan duplex extremity veins unilateral/limited study CPT 93971 $661.77 $1,161.00 $22.14 – $73.45 7
Scan duplex lower extremity arteries complete bilateral CPT 93925 $1,584.60 $2,780.00 $39.25 – $128.88 7
Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 $792.30 $1,390.00 $23.90 – $79.16 7
Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 $792.30 $1,390.00 $24.25 – $80.31 7
Scan proc cranial extra CPT 61782 not published not published $177.16 – $626.36 7
Scan proc cranial intra 61781 CPT 61781 not published not published $222.68 – $786.83 7
Scan proc spinal CPT 61783 not published not published $221.76 – $788.03 7
Sclerotherapy fluid collection pq w/img CPT 49185 not published not published $121.99 – $4,289.81 6
Scope plantar fasciotomy CPT 29893 $615.60 $1,080.00 $471.70 – $1,375.01 7
Screening Colonoscopy (average risk) HCPCS G0121 $372.21 $653.00 $164.42 – $430.88 7
Screening Colonoscopy (high risk) HCPCS G0105 $372.78 $654.00 $164.42 – $430.31 7
Screening Mammogram CPT 77067 $309.51 $543.00 $38.46 – $93.25 6
Screening prostate cancer PSA HCPCS G0103 $33.06 $58.00 $20.28 – $41.35 9
Screen/visual acuity/bilat/quant 99173 CPT 99173 $9.69 $17.00 $3.33 – $5.67 6
Sc ther infusion reset pump CPT 96371 not published not published $64.35 – $207.23 7
Sec abd wall suture evisceration/dehsn 49900 CPT 49900 not published not published $837.67 – $2,896.65 7
Sec art mech thrmbc non-intracranial add-on CPT 37186 not published not published $237.64 – $4,784.14 7
Sedimentation rate erythrocyte automated CPT 85652 $11.40 $20.00 $2.84 – $10.42 11
Segmentectomy 32484 CPT 32484 not published not published $1,407.10 – $5,004.86 7
Select picture audiometry CPT 92583 not published not published $60.78 – $156.66 7
Self-meas bp 2 readg bid 30d CPT 99474 not published not published $9.33 – $32.75 6
Self-meas bp pt educaj/train CPT 99473 not published not published $15.11 – $23.48 6
Self-mgmt educ/train 2-4 pt 30min CPT 98961 not published not published $42.08 – $42.08 2
Self-mgmt educ/train 5-8 pt 30min CPT 98962 not published not published $30.49 – $30.49 2
Semen analysis presence/motility CPT 89321 $20.52 $36.00 $12.65 – $46.51 11
Semen analysis w/count CPT 89310 $29.07 $51.00 $9.04 – $33.23 11
Sensorimotor examination CPT 92060 not published not published $39.76 – $82.57 7
Sensorineural acuity lvl tst CPT 92575 not published not published $78.74 – $211.49 7
Separate eyelid adhesions CPT 68340 not published not published $419.67 – $2,114.36 7
Sept9 promoter methylation analysis CPT 81327 not published not published $114.18 – $741.12 8
Sequestrectomy olecrn proces CPT 24138 not published not published $722.99 – $2,436.00 7
Sequestrectomy radial h/n CPT 24136 not published not published $662.28 – $2,257.61 7
Sequestrectomy shft/dstl hum CPT 24134 not published not published $778.83 – $2,669.44 7
Serial tonometry CPT 92100 not published not published $34.41 – $271.99 7
Serpina1 gene CPT 81332 not published not published $45.83 – $168.49 10
Sertraline (zoloft) - sendout CPT 80332 $55.29 $97.00 $31.67 – $33.34 3
Set radiation therapy field CPT 77280 not published not published $40.38 – $92.41 7
Set radiation therapy field CPT 77285 not published not published $61.05 – $142.13 7
Set radiation therapy field CPT 77290 not published not published $88.28 – $204.20 7
Set-up cardiovert-defibrill CPT 93745 not published not published $123.81 – $123.81 2
Sever cranial nerve CPT 64771 not published not published $601.63 – $2,185.91 7
Sex chromatin identification CPT 88130 not published not published $18.88 – $69.40 11
Sex chromatin identification CPT 88140 not published not published $8.39 – $30.84 11
Sex transformation f to m CPT 55980 not published not published $13,986.53 – $13,986.53 2
Sex transformation m to f CPT 55970 not published not published $13,248.79 – $13,248.79 2
Sf3b1 gene common variants CPT 81347 not published not published $202.91 – $745.95 7
Sgmdsc w/band ligation CPT 45350 not published not published $104.36 – $2,280.34 6
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 $201.78 $354.00 $47.35 – $252.82 7
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 $254.79 $447.00 $65.33 – $300.84 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.