Ascension Calumet Hospital
Chilton, WI · Critical Access Hospital
Posts prices for 51 of the 66 common shoppable procedures we track. Price file retrieved 2026-09-08.
See something wrong with these prices? Tell us →
Compare this hospital against others interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Breast lesion removal (open) (19120) | $540.93 | $949 | 0.1× |
| Shoulder arthroscopy with decompression (29826) | $1,353.18 | $2,374 | — |
| Knee arthroscopy with meniscectomy (29881) | $1,079.58 | $1,894 | 0.3× |
| Upper GI endoscopy (EGD), diagnostic (43235) | $234.27 | $411 | 0.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) | $241.68 | $424 | 0.3× |
| Diagnostic colonoscopy (45378) | $372.78 | $654 | 0.4× |
| Colonoscopy with biopsy (45380) | $430.35 | $755 | 0.4× |
| Colonoscopy with lesion removal (45385) | $599.64 | $1,052 | 0.5× |
| Laparoscopic gallbladder removal (47562) likely a partial charge, not the full procedure |
$1,353.75 | $2,375 | 0.2× |
| Inguinal hernia repair (age 5+) (49505) | $900.60 | $1,580 | 0.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) range across 2 matching MRF lines |
$668.61–$1,268.82 | $1,173–$2,226 | varies |
| Transforaminal epidural injection, lumbar/sacral (64483) | $836.76 | $1,468 | 1.0× |
| CT head/brain without contrast (70450) | $640.68 | $1,124 | 6.3× |
| MRI brain without contrast (70551) | $1,943.70 | $3,410 | 8.3× |
| MRI brain with contrast (70552) | $2,068.53 | $3,629 | 6.1× |
| MRI brain without and with contrast (70553) | $2,608.32 | $4,576 | 7.7× |
| X-ray lower spine, 4+ views (72110) | $239.40 | $420 | 2.3× |
| MRI lumbar spine without contrast (72148) | $1,945.98 | $3,414 | 8.4× |
| CT pelvis with contrast (72193) | $823.08 | $1,444 | 4.8× |
| MRI lower-extremity joint without contrast (73721) | $2,001.27 | $3,511 | 8.6× |
| CT abdomen and pelvis with contrast (74177) | $1,553.25 | $2,725 | 4.6× |
| Ultrasound, abdomen complete (76700) | $791.16 | $1,388 | 7.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | $431.49 | $757 | 4.2× |
| Ultrasound, transvaginal (76830) | $522.69 | $917 | 5.1× |
| Mammography, one breast (diagnostic) (77065) | $581.40 | $1,020 | 6.7× |
| Mammography, both breasts (diagnostic) (77066) | $725.61 | $1,273 | 6.6× |
| Mammography, screening (bilateral) (77067) | $309.51 | $543 | 3.4× |
| Basic metabolic panel (80048) | $98.04 | $172 | 11.6× |
| Comprehensive metabolic panel (80053) | $115.71 | $203 | 11.0× |
| Lipid panel (80061) | $75.24 | $132 | 5.6× |
| Renal function panel (80069) | $95.76 | $168 | 11.0× |
| Hepatic function panel (80076) | $95.76 | $168 | 11.7× |
| Urinalysis, non-automated, without microscopy (81002) | $5.70 | $10 | 1.6× |
| PSA, total (84153) range across 2 matching MRF lines |
$31.35–$96.33 | $55–$169 | varies |
| Thyroid stimulating hormone (TSH) (84443) | $87.21 | $153 | 5.2× |
| CBC with automated differential (85025) | $41.61 | $73 | 5.4× |
| CBC, automated (85027) | $34.20 | $60 | 5.3× |
| Prothrombin time (PT) (85610) | $19.95 | $35 | 4.7× |
| Partial thromboplastin time (PTT) (85730) | $33.63 | $59 | 5.6× |
| Psychotherapy, 30 minutes (90832) range across 2 matching MRF lines |
$123.69–$158.46 | $217–$278 | varies |
| Psychotherapy, 45 minutes (90834) range across 2 matching MRF lines |
$165.87–$212.04 | $291–$372 | varies |
| Psychotherapy, 60 minutes (90837) range across 2 matching MRF lines |
$234.27–$298.68 | $411–$524 | varies |
| Sleep study (attended polysomnography) (95810) | $4,056.12 | $7,116 | 4.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) | $98.61 | $173 | 3.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) range across 3 matching MRF lines |
$100.32–$200.07 | $176–$351 | varies |
| Office visit, new patient (moderate complexity, ~45 min) (99204) range across 3 matching MRF lines |
$166.44–$306.09 | $292–$537 | varies |
| Office visit, new patient (high complexity, ~60 min) (99205) range across 3 matching MRF lines |
$210.90–$380.76 | $370–$668 | varies |
| Office consultation (low complexity, ~30 min) (99243) range across 3 matching MRF lines |
$104.88–$243.39 | $184–$427 | varies |
| Office consultation (moderate complexity, ~40 min) (99244) range across 3 matching MRF lines |
$140.22–$360.24 | $246–$632 | varies |
| Preventive visit, new patient (age 18–39) (99385) range across 3 matching MRF lines |
$100.32–$212.61 | $176–$373 | varies |
| Preventive visit, new patient (age 40–64) (99386) range across 3 matching MRF lines |
$106.59–$240.54 | $187–$422 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.
As a Critical Access Hospital, Medicare pays this facility about 101% of its own costs. The × Medicare column compares the cash price against that cost-based benchmark, not a standard rate.
More prices at this hospital
- Imaging: 206 codes with posted prices and Medicare benchmarks
- Lab & pathology: 605 codes with posted prices and Medicare benchmarks
- Visits & medical services: 204 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 637 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 24 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (UNKNOWN, 19.3 MB) ↓ — captured 2026-09-08
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.