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
Storage/year embryo(s) CPT 89342 not published not published $76.99 – $180.91 3
Storage/year oocyte(s) CPT 89346 not published not published $76.99 – $342.78 3
Storage/year reprod tissue CPT 89344 not published not published $76.99 – $180.91 3
Storage/year sperm/semen CPT 89343 not published not published $76.99 – $180.91 3
Stot/tot hysterectomy after cesaren delivery 59525 CPT 59525 not published not published $467.73 – $1,670.40 7
Strapping of ankle and/or ft 29540 CPT 29540 $109.44 $192.00 $18.12 – $85.05 7
Strapping of chest CPT 29200 not published not published $19.43 – $120.45 7
Strapping of elbow or wrist 29260 CPT 29260 not published not published $19.91 – $115.57 7
Strapping of hand or finger CPT 29280 not published not published $20.87 – $113.53 7
Strapping of hip CPT 29520 not published not published $19.43 – $129.41 7
Strapping of knee CPT 29530 not published not published $19.07 – $117.11 7
Strapping of toes 29550 CPT 29550 not published not published $11.71 – $70.77 7
Strep a ag ia CPT 87430 not published not published $17.15 – $64.89 11
Strep a dna dir probe CPT 87650 not published not published $21.05 – $77.39 11
Strep a dna quant CPT 87652 not published not published $43.85 – $161.19 11
Strep b assay w/optic CPT 87802 not published not published $13.37 – $49.14 11
Strep b dna amp probe CPT 87653 $118.56 $208.00 $36.84 – $135.45 11
Streptokinase antibody CPT 86590 not published not published $13.29 – $48.87 11
Stress test pulmonary CPT 94618 $164.16 $288.00 $23.49 – $33.97 6
Stress tte complete CPT 93351 not published not published $87.75 – $286.46 7
Str markers spec anal addl CPT 81266 not published not published $320.05 – $1,176.57 7
Str markers specimen anal CPT 81265 not published not published $244.72 – $899.65 10
St treatment speech individual CPT 92507 $165.87 $291.00 $83.09 – $264.72 7
St treatment swallow dysfunction/oral CPT 92526 $226.29 $397.00 $92.07 – $291.59 7
Subdural tap fontanelle/sutur infant init 61000 CPT 61000 not published not published $110.22 – $379.09 7
Subq i/p critical care pr day age 28 days/less than 99469 CPT 99469 not published not published $408.73 – $877.94 7
Subq njx filling matrl 1cc/< CPT 11950 not published not published $52.91 – $285.04 7
Subq njx fil matrl 5.1-10cc CPT 11952 not published not published $104.29 – $516.64 7
Subsequent intensive care infant 1500-2500 grams 99479 CPT 99479 not published not published $128.13 – $274.68 7
Subsequent intensive care infant 2501-5000 grams 99480 CPT 99480 not published not published $122.97 – $263.92 7
Subsequent repair of nerve CPT 64872 not published not published $115.88 – $415.20 7
Subtalar arthro w/deb CPT 29906 not published not published $686.55 – $2,397.56 7
Subtalar arthro w/exc CPT 29905 not published not published $551.42 – $1,920.19 7
Subtalar arthro w/fb rmvl CPT 29904 not published not published $667.23 – $2,276.93 7
Subtalar arthro w/fusion CPT 29907 not published not published $910.36 – $3,128.93 7
Subtemporal cranial dcmprn CPT 61340 not published not published $1,405.93 – $4,851.60 7
Sugars multiple quant CPT 84379 not published not published $12.11 – $44.51 11
Sugars single quant CPT 84378 not published not published $12.11 – $44.51 11
Sulfonylurea screen qn-sendout CPT 80377 $127.68 $224.00 $31.67 – $33.73 3
Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 $53.58 $94.00 $32.50 – $32.50 2
Sup of prep of antigen # of vials 95144 CPT 95144 not published not published $3.43 – $48.23 7
Suprv interfacilty transport CPT 99485 not published not published $170.13 – $170.13 2
Suprv interfac trnsport addl CPT 99486 not published not published $147.62 – $147.62 2
Surg dx exam anorectal CPT 45990 not published not published $108.16 – $380.40 7
Surg ect salp-oophorectomy 59120 CPT 59120 not published not published $813.17 – $2,808.23 7
Surg ect without salp-oophorectomy 59121 CPT 59121 not published not published $813.17 – $2,810.85 7
Surgery for urethra pouch CPT 53240 not published not published $447.02 – $1,551.30 7
Surgery of pancreatic cyst CPT 48500 not published not published $1,153.42 – $4,063.95 7
Surgery to stop leg growth CPT 27475 not published not published $693.03 – $2,367.11 7
Surgery to stop leg growth CPT 27477 not published not published $763.47 – $2,618.78 7
Surgery to stop leg growth CPT 27479 not published not published $950.08 – $3,280.13 7
Surgery to stop leg growth CPT 27485 not published not published $700.98 – $2,398.05 7
Surgical exposure prostate 55860 CPT 55860 not published not published $910.73 – $3,202.54 7
Surgical opening esophagus CPT 43351 not published not published $1,309.26 – $4,614.86 7
Surgical opening esophagus CPT 43352 not published not published $1,059.97 – $3,737.59 7
Surgical opening of stomach CPT 43510 not published not published $954.61 – $3,340.46 7
Surgical opening of stomach 43500 CPT 43500 not published not published $790.93 – $2,771.81 7
Surgical opening of throat CPT 42955 not published not published $799.49 – $2,749.80 7
Surgical pathology level 1 gross examination only CPT 88300 $39.90 $70.00 $4.53 – $23.29 8
Surgical pathology level 2 gross & microscopic examination CPT 88302 $55.29 $97.00 $7.11 – $23.29 8
Surgical pathology level 3 gross & microscopic examination CPT 88304 $83.22 $146.00 $11.89 – $49.79 8
Surgical pathology level 4 gross & microscopic examination CPT 88305 $385.32 $676.00 $39.50 – $77.44 8
Surgical pathology level 5 gross & microscopic examination CPT 88307 $199.50 $350.00 $76.99 – $195.18 8
Surgical pathology level 6 gross & microscopic examination CPT 88309 $478.80 $840.00 $76.99 – $344.65 8
Surgical repair stomach bleedin ulcer 43501 CPT 43501 not published not published $1,351.52 – $4,749.45 7
Surgical repair stomach gastric lac 43502 CPT 43502 not published not published $1,519.71 – $5,365.28 7
Surgical revision intestine CPT 44680 not published not published $1,073.99 – $3,749.29 7
Surg tx anal fistula 2nd stage 46285 CPT 46285 not published not published $443.58 – $1,988.59 7
Susceptibility agar dilution per agent CPT 87181 $18.24 $32.00 $4.99 – $18.34 11
Susceptibility enzyme detection per enzyme CPT 87185 $18.24 $32.00 $4.99 – $18.34 11
Susceptibility mic per plate CPT 87186 $52.44 $92.00 $9.08 – $33.39 11
Suscept studies macrobroth dilution ea CPT 87188 not published not published $6.97 – $25.63 11
Suspend bowel w/prosthesis CPT 44700 not published not published $1,022.95 – $3,606.00 7
Suspension of testis CPT 54620 not published not published $312.26 – $1,094.70 7
Suspension of uterus CPT 58410 not published not published $845.44 – $2,939.59 7
Suspension of uterus 58400 CPT 58400 not published not published $485.88 – $1,648.65 7
Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 not published not published $1,056.05 – $3,737.40 7
Suture bile duct injury 47900 CPT 47900 not published not published $1,378.42 – $4,813.39 7
Svc venogram s&i CPT 75827 not published not published $55.17 – $132.11 7
Sweat collection by iontophoresis CPT 89230 not published not published $2.98 – $49.79 8
Sympathectomy cervical CPT 64802 not published not published $843.33 – $2,834.96 7
Sympathectomy digital artery CPT 64820 not published not published $799.36 – $2,628.71 7
Sympathectomy lumbar CPT 64818 not published not published $802.97 – $2,782.24 7
Sympathectomy supfc palmar CPT 64823 not published not published $822.03 – $2,818.39 7
Sympathectomy thoracolumbar CPT 64809 not published not published $1,071.00 – $3,665.03 7
Synthetic sentence id test CPT 92576 not published not published $45.44 – $117.32 7
Synvisc or synvisc-one HCPCS J7325 $14.82 $26.00 $12.28 – $26.00 7
Syphilis test non-treponemal antibody quantitative rpr CPT 86593 $14.25 $25.00 $4.62 – $16.98 11
T3 (triiodothyronine) free CPT 84481 $50.16 $88.00 $16.91 – $65.39 11
T3 (triiodothyronine) total CPT 84480 $51.87 $91.00 $14.89 – $54.73 11
T4 (thyroxine) free CPT 84439 $50.16 $88.00 $9.47 – $34.82 11
T4 (thyroxine) total CPT 84436 $38.19 $67.00 $7.21 – $26.52 11
Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 $2.59 $4.54 $0.37 – $4.54 6
Tacrolimus therapeutic drug level CPT 80197 $40.47 $71.00 $14.42 – $53.00 11
Tah rad debulk/lymph remove 58954 CPT 58954 not published not published $2,238.42 – $7,776.30 7
Tah rad dissect for debulk 58953 CPT 58953 not published not published $2,070.31 – $7,177.28 7
Tah w/mmk 58152 CPT 58152 not published not published $1,277.37 – $4,520.33 7
Tap block bilat cont infusion 64489 CPT 64489 not published not published $80.73 – $1,027.58 6
Tap block uni by cont infusion 64487 CPT 64487 not published not published $66.29 – $663.60 6
Target gsa panel hmtlmph neop CPT 81450 not published not published $122.59 – $2,931.79 10

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.