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 |
|---|---|---|---|---|
| Treatment of choroid lesion CPT 67220 | not published | not published | $527.16 – $1,941.23 | 7 |
| Treatment of corneal lesion CPT 65450 | not published | not published | $344.15 – $1,187.78 | 7 |
| Treatment of eyelid lesions CPT 68040 | not published | not published | $50.74 – $230.25 | 7 |
| Treatment of fibula fracture CPT 27784 | not published | not published | $747.76 – $2,548.20 | 7 |
| Treatment of fibula fracture 27780 CPT 27780 | not published | not published | $310.19 – $1,104.79 | 7 |
| Treatment of foot infection CPT 28002 | not published | not published | $148.13 – $1,628.14 | 7 |
| Treatment of foot infection CPT 28003 | not published | not published | $270.25 – $2,575.43 | 7 |
| Treatment of gum lesion CPT 41850 | not published | not published | $432.71 – $432.71 | 2 |
| Treatment of head injury 62010 CPT 62010 | not published | not published | $1,502.01 – $5,164.61 | 7 |
| Treatment of heel fracture 28400 CPT 28400 | not published | not published | $250.41 – $895.13 | 7 |
| Treatment of miscarriage CPT 59821 | not published | not published | $382.06 – $1,433.59 | 7 |
| Treatment of mouth lesion physical 40820 CPT 40820 | not published | not published | $177.63 – $951.19 | 7 |
| Treatment of penis lesion CPT 54110 | not published | not published | $653.66 – $2,283.68 | 7 |
| Treatment of penis lesion CPT 54115 | not published | not published | $449.78 – $1,660.84 | 7 |
| Treatment of rectal prolapse CPT 45520 | not published | not published | $42.78 – $568.54 | 7 |
| Treatment of retinal lesion CPT 67208 | not published | not published | $609.67 – $2,188.65 | 7 |
| Treatment of retinal lesion CPT 67210 | not published | not published | $526.93 – $1,884.71 | 7 |
| Treatment of retinal lesion CPT 67218 | not published | not published | $1,463.13 – $5,074.84 | 7 |
| Treatment of thigh fracture CPT 27501 | not published | not published | $523.87 – $1,809.71 | 7 |
| Treatment of thigh fracture CPT 27503 | not published | not published | $830.55 – $2,859.64 | 7 |
| Treatment of thigh fracture CPT 27506 | not published | not published | $1,376.97 – $4,771.61 | 7 |
| Treatment of thigh fracture CPT 27508 | not published | not published | $527.72 – $1,879.88 | 7 |
| Treatment of thigh fracture CPT 27509 | not published | not published | $708.69 – $2,368.80 | 7 |
| Treatment of thigh fracture CPT 27510 | not published | not published | $709.26 – $2,428.01 | 7 |
| Treatment of thigh fracture CPT 27511 | $1,776.69 | $3,117.00 | $1,021.88 – $2,138.04 | 7 |
| Treatment of thigh fracture CPT 27507 | $1,695.18 | $2,974.00 | $994.76 – $2,088.84 | 7 |
| Treatment of thigh fracture CPT 27513 | $2,282.85 | $4,005.00 | $1,262.24 – $2,656.84 | 7 |
| Treatment of thigh fracture CPT 27514 | not published | not published | $991.63 – $3,452.96 | 7 |
| Treatment of tibia fracture CPT 27756 | not published | not published | $608.07 – $2,059.09 | 7 |
| Treatment of tibia fracture CPT 27758 | $1,433.55 | $2,515.00 | $929.75 – $1,921.25 | 7 |
| Treatment of tibia fracture CPT 27759 | $1,676.37 | $2,941.00 | $1,029.55 – $2,147.85 | 7 |
| Treatment of toe fracture 28510 CPT 28510 | $355.68 | $624.00 | $132.40 – $276.70 | 7 |
| Treatment of urethra lesion CPT 53220 | not published | not published | $474.81 – $1,652.33 | 7 |
| Treatment of urethra lesion CPT 53260 | not published | not published | $189.74 – $741.71 | 7 |
| Treatment of urethra lesion CPT 53265 | not published | not published | $196.88 – $815.48 | 7 |
| Treatment radiation delivery level 2 CPT 77407 | not published | not published | $463.19 – $526.68 | 3 |
| Treatment x10sv retinopathy CPT 67228 | not published | not published | $319.27 – $2,236.84 | 7 |
| Treat metacarpal fracture CPT 26608 | $616.74 | $1,082.00 | $512.93 – $1,036.04 | 7 |
| Treat metacarpal fracture CPT 26615 | $788.88 | $1,384.00 | $608.85 – $1,248.57 | 7 |
| Treat metatarsal fracture CPT 28476 | not published | not published | $415.73 – $1,332.75 | 7 |
| Treat metatarsal fracture CPT 28485 | $803.70 | $1,410.00 | $600.59 – $1,156.16 | 7 |
| Treat midfoot fracture each CPT 28455 | not published | not published | $249.83 – $1,052.25 | 7 |
| Treat midfoot fracture each CPT 28465 | not published | not published | $678.79 – $2,290.46 | 7 |
| Treat neck spine fracture CPT 22326 | not published | not published | $1,499.94 – $5,143.28 | 7 |
| Treat odontoid fx w/graft CPT 22319 | not published | not published | $1,788.37 – $6,143.48 | 7 |
| Treat odontoid fx without graft CPT 22318 | not published | not published | $1,622.97 – $5,554.20 | 7 |
| Treat pelvic fracture(s) CPT 27215 | not published | not published | $639.60 – $2,242.43 | 6 |
| Treat pelvic ring fracture CPT 27216 | not published | not published | $945.26 – $3,323.81 | 6 |
| Treat pelvic ring fracture CPT 27217 | not published | not published | $888.78 – $3,119.78 | 6 |
| Treat pelvic ring fracture CPT 27218 | not published | not published | $1,217.51 – $4,301.44 | 6 |
| Treat penis lesion graft CPT 54111 | not published | not published | $833.22 – $2,927.63 | 7 |
| Treat penis lesion graft CPT 54112 | not published | not published | $976.13 – $3,429.30 | 7 |
| Treat radius fracture CPT 24665 | not published | not published | $691.56 – $2,347.16 | 7 |
| Treat radius fracture CPT 24666 | not published | not published | $765.35 – $2,624.89 | 7 |
| Treat sesamoid bone fracture CPT 28531 | not published | not published | $196.40 – $1,249.58 | 7 |
| Treat skull fracture CPT 62000 | not published | not published | $1,018.10 – $3,481.76 | 7 |
| Treat skull fracture CPT 62005 | not published | not published | $1,245.35 – $4,279.35 | 7 |
| Treat slipped epiphysis CPT 27176 | not published | not published | $955.27 – $3,284.44 | 7 |
| Treat slipped epiphysis CPT 27175 | not published | not published | $692.49 – $2,377.99 | 7 |
| Treat slipped epiphysis CPT 27177 | not published | not published | $1,150.81 – $3,975.49 | 7 |
| Treat slipped epiphysis CPT 27178 | not published | not published | $955.27 – $3,284.44 | 7 |
| Treat slipped epiphysis CPT 27181 | not published | not published | $1,155.48 – $3,997.54 | 7 |
| Treat spinal cord lesion CPT 62280 | not published | not published | $168.46 – $1,273.76 | 7 |
| Treat spinal cord lesion CPT 62281 | not published | not published | $164.45 – $873.49 | 7 |
| Treat spine fracture CPT 22325 | not published | not published | $1,476.68 – $5,028.60 | 7 |
| Treat sternum fracture CPT 21820 | not published | not published | $159.89 – $523.31 | 7 |
| Treat tail bone fracture CPT 27202 | not published | not published | $549.60 – $1,892.03 | 7 |
| Treat thigh fracture CPT 27230 | not published | not published | $506.62 – $1,728.15 | 7 |
| Treat thigh fracture CPT 27235 | not published | not published | $937.90 – $3,241.31 | 7 |
| Treat thigh fracture CPT 27236 | $2,042.88 | $3,584.00 | $1,228.30 – $2,572.73 | 7 |
| Treat thigh fracture CPT 27238 | not published | not published | $494.86 – $1,662.26 | 7 |
| Treat thigh fracture CPT 27245 | $2,134.65 | $3,745.00 | $1,261.13 – $2,645.33 | 7 |
| Treat thigh fracture CPT 27246 | not published | not published | $409.93 – $1,391.59 | 7 |
| Treat thigh fracture CPT 27248 | not published | not published | $769.91 – $2,663.96 | 7 |
| Treat thigh fracture CPT 27240 | not published | not published | $984.82 – $3,402.41 | 7 |
| Treat thigh fracture CPT 27244 | $2,110.14 | $3,702.00 | $1,262.44 – $2,644.58 | 7 |
| Treat thigh fx growth plate CPT 27516 | not published | not published | $517.20 – $1,837.50 | 7 |
| Treat thigh fx growth plate CPT 27517 | not published | not published | $722.37 – $2,455.76 | 7 |
| Treat thigh fx growth plate CPT 27519 | not published | not published | $915.50 – $3,181.43 | 7 |
| Treat thorax spine fracture CPT 22327 | not published | not published | $1,534.59 – $5,225.18 | 7 |
| Treat thumb fracture CPT 26650 | not published | not published | $513.42 – $1,721.44 | 7 |
| Treat thumb fracture CPT 26665 | not published | not published | $664.60 – $2,245.69 | 7 |
| Treat toe dislocation CPT 28636 | not published | not published | $233.99 – $1,137.68 | 7 |
| Treat toe dislocation CPT 28665 | not published | not published | $135.73 – $562.16 | 7 |
| Treat toe dislocation CPT 28666 | not published | not published | $188.46 – $615.75 | 7 |
| Treat toe fracture CPT 28525 | not published | not published | $434.97 – $2,101.95 | 7 |
| Treat trigeminal nerve CPT 61790 | not published | not published | $872.59 – $2,975.18 | 7 |
| Treat trigeminal tract CPT 61791 | not published | not published | $1,105.90 – $3,793.76 | 7 |
| Treat ulnar fracture CPT 24675 | not published | not published | $447.52 – $1,646.48 | 7 |
| Treat ulnar fracture CPT 24685 | $949.05 | $1,665.00 | $686.95 – $1,417.47 | 7 |
| Treat vaginal bleeding CPT 57180 | not published | not published | $127.13 – $627.49 | 7 |
| Treat wrist bone fracture CPT 25635 | not published | not published | $455.23 – $1,653.34 | 7 |
| Treat wrist dislocation CPT 25675 | not published | not published | $442.27 – $1,588.09 | 7 |
| Treponema pallidum ag if CPT 87285 | not published | not published | $12.79 – $47.01 | 11 |
| Treponema pallidum antibody CPT 86780 | $26.22 | $46.00 | $11.32 – $51.11 | 11 |
| Trg gene rearrangement anal CPT 81342 | not published | not published | $211.58 – $777.79 | 10 |
| Trh stimulation panel CPT 80439 | not published | not published | $70.57 – $259.43 | 11 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $5.33 | $9.35 | $1.60 – $4.00 | 6 |
| Triamcinolone a inj prs-free HCPCS J3300 | $0.57 | $1.00 | $1.00 – $1.00 | 1 |
| Trichinella antibody CPT 86784 | not published | not published | $8.32 – $48.48 | 11 |
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.