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
Target gsa panel organ/hmtlmph neop CPT 81455 not published not published $3,065.58 – $11,269.66 7
Target gsa panel organ neop CPT 81445 not published not published $122.59 – $2,307.93 10
Tas congenital car anomal CPT 33741 not published not published $731.64 – $2,692.69 6
Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 not published not published $134.43 – $765.34 7
Tavr perq femoral CPT 33361 not published not published $1,177.47 – $4,245.71 7
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 $1.64 $2.88 $0.59 – $2.88 7
Tbp gene detc abnor alleles CPT 81344 not published not published $143.85 – $528.82 7
Tbs dxa cal w/i&r fx risk CPT 77089 not published not published $42.79 – $101.16 6
Tbs i&r fx rsk qhp CPT 77092 not published not published $10.43 – $25.84 6
Tbs techl calculation only CPT 77091 not published not published $29.74 – $69.94 6
Tbs techl prep&transmis data CPT 77090 not published not published $2.62 – $5.38 6
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 $213.18 $374.00 $105.00 – $386.00 11
Tb test cell mediated immunity antigen response gamma interferon CPT 86480 $106.02 $186.00 $65.08 – $239.24 11
Tc-99m labeled rbc HCPCS A9560 $234.27 $411.00 $172.21 – $172.21 2
Tc-99m maa HCPCS A9540 $319.20 $560.00 $54.80 – $54.80 2
Tc-99m mebrofenin HCPCS A9537 $109.44 $192.00 $187.21 – $187.21 2
Tc-99m medronate HCPCS A9503 $248.52 $436.00 $45.29 – $45.29 2
Tc-99m pentetate dtpa aerosol HCPCS A9567 $226.86 $398.00 $35.23 – $35.23 2
Tc-99m pertechnetate per mci HCPCS A9512 $2.28 $4.00 $2.31 – $2.31 2
Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 $87.78 $154.00 $79.40 – $79.40 2
Tc-99m tilmanocept diag HCPCS A9520 $1,136.58 $1,994.00 $696.24 – $696.24 2
Tca peel dermal 15789 CPT 15789 not published not published $435.56 – $1,953.19 7
Tcd emboli detect w/inj CPT 93893 not published not published $62.77 – $200.50 7
Tcd emboli detect without inj CPT 93892 not published not published $62.52 – $198.98 7
Tcd vasoreactivity study CPT 93890 not published not published $53.95 – $172.58 7
T-cell depletion of harvest CPT 38210 not published not published $82.27 – $294.75 6
T cells absolute cd4/cd8 including ratio CPT 86360 $160.74 $282.00 $49.33 – $181.34 11
T cells absolute cd 4 count CPT 86361 $95.19 $167.00 $28.12 – $103.37 11
T cells total count CPT 86359 $127.68 $224.00 $39.62 – $145.64 11
Tcranial magn stim tx deli CPT 90868 not published not published $722.04 – $722.04 2
Tcranial magn stim tx plan CPT 90867 not published not published $1,242.39 – $1,242.39 2
Tcran magn stim redetemine CPT 90869 not published not published $1,041.34 – $1,041.34 2
Tdh sdrl/ventr pnxr CPT 61105 not published not published $466.08 – $1,570.50 7
Teaec w/wo patch graft iliofemoral CPT 35355 not published not published $991.54 – $3,586.58 7
Team conf without pat by hc pro CPT 99368 not published not published $81.97 – $81.97 2
Team conf without pat by phys CPT 99367 not published not published $124.59 – $124.59 2
Team conf w/pat by hc prof CPT 99366 not published not published $95.30 – $95.30 2
Telethx isodose plan cplx CPT 77307 not published not published $163.47 – $323.37 6
Telethx isodose plan simple CPT 77306 not published not published $78.98 – $178.96 6
Temperature gradient studies CPT 93740 not published not published $26.87 – $26.87 2
Temple bne implnt w/stimulat CPT 69715 not published not published $2,945.60 – $6,026.27 3
Tendon lengthening CPT 26476 not published not published $682.81 – $2,199.26 7
Tendon lngth upr a/e ea tdn CPT 24305 not published not published $610.60 – $2,080.35 7
Tendon shortening CPT 26477 not published not published $668.92 – $2,152.31 7
Tendon transfer with graft CPT 26492 not published not published $973.83 – $3,221.18 7
Tenodesis biceps tdn at elbw CPT 24340 not published not published $629.07 – $2,199.23 7
Tenolysis extensor tendon hand/finger each CPT 26445 not published not published $643.54 – $2,122.65 7
Tenolysis triceps CPT 24332 not published not published $646.47 – $2,193.38 7
Tenoplasty elbow to sho 1 CPT 24320 not published not published $811.31 – $2,787.86 7
Tenosynovectomy radic 26145 CPT 26145 not published not published $546.14 – $1,847.63 7
Tenotomy hip flexor open CPT 27005 not published not published $750.12 – $2,588.70 7
Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 not published not published $314.45 – $1,654.24 7
Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 $1,202.13 $2,109.00 $259.33 – $882.97 7
Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 $12.35 $21.67 $1.39 – $9.00 6
Tert gene targeted seq alys CPT 81345 not published not published $194.46 – $714.87 7
Test for chlorohydrocarbons CPT 82441 not published not published $6.31 – $23.20 11
Test for porphobilinogen CPT 84106 not published not published $6.11 – $22.47 11
Test for urine cystines CPT 82615 $16.53 $29.00 $10.03 – $36.86 11
Testicular imaging w/vasc flow CPT 78761 not published not published $35.88 – $87.35 7
Testosterone response panel CPT 80414 not published not published $54.22 – $199.33 11
Testosterone undecanoate 1mg HCPCS J3145 $2.28 $4.00 $1.42 – $4.00 7
Test stress cardiovascular tracing only CPT 93017 $437.76 $768.00 $39.85 – $109.21 7
Test urine for lactose CPT 83633 not published not published $7.86 – $43.43 11
Test urine for porphyrins CPT 84119 not published not published $12.33 – $51.57 11
Test urine urobilinogen CPT 84578 not published not published $4.65 – $17.25 11
Tetanus ig im CPT 90389 $489.63 $859.00 $756.31 – $756.31 2
Tetanus immune globulin inj HCPCS J1670 $675.45 $1,185.00 $451.88 – $1,185.00 7
Tgfbi gene common variants CPT 81333 not published not published $143.85 – $528.82 7
Tgsap hl neo 5-50 rna alys CPT 81451 not published not published $797.51 – $2,931.79 7
Tgsap so/hl 51/< rna alys CPT 81456 not published not published $3,065.58 – $11,269.66 7
Tgsap so neo 5-50 rna alys CPT 81449 not published not published $627.81 – $2,307.93 7
Thaw cryoprsvrd reprod tiss CPT 89354 not published not published $76.99 – $180.91 3
Thawing cryopresrved embryo CPT 89352 not published not published $76.99 – $180.91 3
Thawing cryopresrved oocyte CPT 89356 not published not published $76.99 – $180.91 3
Thawing cryopresrved sperm CPT 89353 not published not published $63.73 – $76.99 3
Thaw preserved stem cells CPT 38208 not published not published $29.47 – $106.24 6
Theophylline therapeutic drug level CPT 80198 $51.30 $90.00 $14.85 – $54.58 11
Therapeutic procd strg endur HCPCS G0237 $72.39 $127.00 $11.90 – $29.34 6
Therapy activation ipnss CPT 93150 not published not published $44.92 – $44.92 4
Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 $63.84 $112.00 $35.44 – $95.79 7
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 $55.29 $97.00 $30.18 – $81.64 7
Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 not published not published $146.41 – $435.65 7
Ther fx nasal inf turbinate CPT 30930 not published not published $125.75 – $426.60 7
Ther nma rdctj intus/obstrcj CPT 74283 not published not published $106.16 – $253.88 7
Ther/proph/diag inj ia CPT 96373 not published not published $20.02 – $60.50 7
Ther radiology tx plng cplx CPT 77263 not published not published $178.18 – $411.68 7
Ther radiology tx plng intrm CPT 77262 not published not published $115.42 – $264.29 7
Ther radiology tx plng smpl CPT 77261 not published not published $75.50 – $174.15 7
Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 $12.20 $21.41 $3.01 – $8.00 6
Thorabd diaphr hern repair CPT 43336 not published not published $1,421.19 – $5,078.10 7
Thorabd diaphr hern repair CPT 43337 not published not published $1,513.18 – $5,413.95 7
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 $1,658.70 $2,910.00 $112.68 – $1,420.71 7
Thoracic aortic graft 33875 CPT 33875 not published not published $2,668.99 – $9,569.89 7
Thoracic duct procedure CPT 38380 not published not published $602.08 – $2,043.30 7
Thoracic duct procedure CPT 38381 not published not published $800.48 – $2,816.21 7
Thoracic duct procedure CPT 38382 not published not published $684.97 – $2,388.45 7
Thoracic lymphadenect/thoracotomy 38746 CPT 38746 not published not published $207.45 – $748.39 7
Thoracoabdominal graft 33877 CPT 33877 not published not published $3,487.10 – $12,591.34 7
Thoracoscop w/esoph musc exc CPT 32665 not published not published $1,209.30 – $4,302.94 7
Thoracoscopy bilobectomy 32670 CPT 32670 not published not published $1,568.62 – $5,605.88 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.