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
Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 $41.61 $73.00 $30.66 – $1,400.00 7
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 $54.15 $95.00 $39.90 – $1,400.00 7
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 $39.33 $69.00 $28.15 – $28.15 2
Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 $11.40 $20.00 $7.61 – $7.61 2
Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 $196.65 $345.00 $253.58 – $253.58 2
Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 not published not published $354.32 – $354.32 2
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 not published not published $303.81 – $303.81 2
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 $133.38 $234.00 $178.19 – $178.19 2
Vaccine mmr live subcutaneous CPT 90707 $108.87 $191.00 $177.19 – $177.19 2
Vaccine mmrv live subcutaneous CPT 90710 $331.74 $582.00 $264.00 – $264.00 2
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 $137.94 $242.00 $101.64 – $1,400.00 7
Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 $258.21 $453.00 $190.26 – $1,400.00 7
Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 not published not published $344.68 – $1,400.00 5
Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 $370.50 $650.00 $273.00 – $1,400.00 7
Vaccine polio (ipv) subcutaneous/im CPT 90713 $45.60 $80.00 $48.78 – $48.78 2
Vaccine rabies im CPT 90675 $799.08 $1,401.89 $459.97 – $1,400.00 7
Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 $170.43 $299.00 $222.09 – $222.09 2
Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 $117.42 $206.00 $184.27 – $184.27 2
Vaccine tdap >=7 years im CPT 90715 $106.75 $187.28 $54.14 – $1,400.00 7
Vaccine td preservative free >= 7 years im CPT 90714 $91.34 $160.25 $35.97 – $1,400.00 7
Vaccine typhoid vicps im CPT 90691 $137.94 $242.00 $168.56 – $168.56 2
Vaccine varicella live subcutaneous CPT 90716 $200.64 $352.00 $316.54 – $316.54 2
Vaccine yellow fever live subcutaneous CPT 90717 $478.80 $840.00 $247.47 – $247.47 2
Vaccinia vrs vac 0.3 ml perq CPT 90622 not published not published $0.02 – $0.02 2
Vag hys/<250g/rmv tube/rpr entero 58263 CPT 58263 not published not published $1,029.81 – $3,596.85 7
Vag hyst incl t/o complex CPT 58291 not published not published $1,283.06 – $4,520.33 7
Vag hyst including t/o CPT 58262 not published not published $961.29 – $3,350.59 7
Vag hyst t/o & repair compl CPT 58292 not published not published $1,351.71 – $4,756.35 7
Vag hyst w/enterocele compl 58294 CPT 58294 not published not published $1,255.80 – $4,412.78 7
Vag hyst w/enterocele repair CPT 58270 not published not published $926.56 – $3,219.41 7
Vag hyst w/uro repair compl 58293 CPT 58293 not published not published $2,970.52 – $6,204.26 3
Vaginal delivery after cesarean delivery 59612 CPT 59612 not published not published $881.79 – $2,360.54 7
Vaginal Delivery (full care) CPT 59400 not published not published $2,425.82 – $5,571.02 7
Vaginal hysterectomy CPT 58260 not published not published $870.40 – $3,019.09 7
Vaginectomy partial w/nodes CPT 57109 not published not published $1,797.72 – $6,154.50 7
Vagnc compl rmvl paravag tis CPT 57111 not published not published $1,797.72 – $6,154.50 7
Vagnc compl rmvl vag wall CPT 57110 not published not published $936.95 – $3,262.99 7
Vagotomy pfrmd w/prtl dstl gstrct 43635 CPT 43635 not published not published $110.33 – $395.18 7
Vagotomy & pylorus repair CPT 43641 not published not published $1,205.02 – $4,237.05 7
Vagotomy & pylorus repair 43640 CPT 43640 not published not published $1,191.39 – $4,158.08 7
Valproic acid total therapeutic drug level CPT 80164 $76.95 $135.00 $14.22 – $52.26 11
Valrubicin injection HCPCS J9357 $1,908.36 $3,348.00 $1,325.72 – $3,348.00 8
Valvuloplasty aortic CPT 92986 not published not published $1,306.57 – $4,179.51 7
Valvuloplasty aortic valve CPT 33390 not published not published $1,878.94 – $6,748.58 6
Valvuloplasty aortic valve CPT 33391 not published not published $2,225.22 – $8,016.00 6
Valvuloplasty mitral CPT 92987 not published not published $1,347.01 – $4,314.10 7
Valvuloplasty pulmonary CPT 92990 not published not published $1,078.59 – $3,440.40 7
Valvuloplasty/tv without ring insert 33463 CPT 33463 not published not published $3,006.05 – $10,820.85 7
Valvuloplasty/tv w/ring insertion 33464 CPT 33464 not published not published $2,384.02 – $8,543.96 7
Vancomycin hcl injection HCPCS J3370 $25.58 $44.88 $2.93 – $9.00 6
Vancomycin peak therapeutic drug level CPT 80202 $83.22 $146.00 $14.22 – $52.26 11
Vanomycin dna amp probe CPT 87500 not published not published $36.84 – $135.45 11
Varicella zoster antibody igg CPT 86787 $33.63 $59.00 $8.32 – $49.72 11
Varicella-zoster immue globin im CPT 90396 not published not published $3,717.81 – $3,717.81 2
Vasc graft into carpal bone CPT 25430 not published not published $765.24 – $2,610.19 7
Vasectomy CPT 55250 not published not published $243.32 – $1,315.61 7
Vasopressin 20 unit/ml intravenous solution HCPCS J2598 $160.65 $281.84 $2.99 – $281.84 6
Vbac delivery 59610 CPT 59610 not published not published $2,514.83 – $5,810.57 7
Vbac/include postpartum care 59614 CPT 59614 not published not published $1,140.61 – $2,936.23 7
Veeg cont 2-12 hrs CPT 95713 not published not published $1,641.36 – $1,641.36 2
Veeg ea 12-26hr cont mntr CPT 95716 not published not published $3,072.25 – $3,072.25 2
Veeg intrmnt 2-12 hrs CPT 95712 not published not published $855.48 – $855.48 2
Veeg unmon 12-26 hrs CPT 95714 not published not published $1,641.36 – $1,641.36 2
Veeg unmon 2-12 hrs CPT 95711 not published not published $855.48 – $855.48 2
Vein bypass grft fem-popliteal 35583 CPT 35583 not published not published $1,388.15 – $5,022.30 7
Vein byp fem-tibial peroneal 35585 CPT 35585 not published not published $1,606.31 – $5,817.41 7
Vein byp pop-tibl peroneal CPT 35587 not published not published $1,282.88 – $4,738.73 7
Vein gft fem a/p tib/pero/dis art 35566 CPT 35566 not published not published $1,598.21 – $5,810.93 7
Vein x-ray adrenal gland CPT 75840 not published not published $57.51 – $140.00 7
Vein x-ray adrenal glands CPT 75842 not published not published $75.45 – $183.23 7
Vein x-ray eye socket CPT 75880 not published not published $35.51 – $86.68 7
Vein x-ray kidney CPT 75831 not published not published $53.96 – $135.25 7
Vein x-ray liver CPT 75891 not published not published $54.78 – $134.34 7
Vein x-ray liver w/hemodynam CPT 75885 not published not published $68.48 – $165.44 7
Vein x-ray liver w/hemodynam CPT 75889 not published not published $54.55 – $131.79 7
Vein x-ray liver without hemodyn CPT 75887 not published not published $68.83 – $167.15 7
Vein x-ray skull CPT 75870 not published not published $59.23 – $146.59 7
Vein x-ray skull epidural CPT 75872 not published not published $57.51 – $140.00 7
Vein x-ray spleen/liver CPT 75810 not published not published $50.16 – $131.32 7
Vemp test i&r cervical CPT 92517 not published not published $45.18 – $293.25 6
Vemp test i&r ocular CPT 92518 not published not published $45.43 – $272.39 6
Vemp tst i&r cervical&ocular CPT 92519 not published not published $68.07 – $456.27 6
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 $59.28 $104.00 $9.46 – $62.48 7
Venipuncture <3 yrs other vein CPT 36406 not published not published $9.33 – $60.75 7
Venogram ext bil s&i CPT 75822 not published not published $71.77 – $124.64 7
Venogram extremity supervision & interpretation unilateral CPT 75820 not published not published $51.55 – $83.06 7
Venous mech thrombectomy CPT 37187 not published not published $391.36 – $7,027.24 7
Venous m-thrombectomy add-on CPT 37188 not published not published $278.32 – $5,913.75 7
Venous sampling s&i CPT 75893 not published not published $26.46 – $65.05 7
Venous thrombosis imaging CPT 78457 not published not published $35.79 – $91.86 7
Ven thrombosis images bilat CPT 78458 not published not published $45.59 – $110.88 7
Ventilator each subsequent day CPT 94003 $868.68 $1,524.00 $67.42 – $220.07 7
Ventilator initial day CPT 94002 $868.68 $1,524.00 $95.79 – $305.35 7
Vent mgmt nf per day CPT 94004 not published not published $50.04 – $162.58 7
Ventricular puncture prev burr hole without inj 61020 CPT 61020 not published not published $104.95 – $358.01 7
Ventriculomyotomy/ihss 33416 CPT 33416 not published not published $1,979.08 – $7,071.64 7
Version cephalic external CPT 59412 not published not published $100.85 – $356.36 7
Vertebral corpectomy partial/complete 63082 CPT 63082 not published not published $257.39 – $912.98 7
Very long chain fatty acids CPT 82726 not published not published $20.74 – $76.24 11
Vesiculotomy complicated CPT 55605 not published not published $551.14 – $1,911.11 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.