Excessive production of non-esterified fatty acids (NEFA) and β-hydroxybutyrate (BHBA) are indicative of a poor adaptive response to negative energy balance in early lactation dairy cattle, and numerous studies have reported on the detrimental effects of elevated NEFA and BHBA on early lactation immune function, milk production, and subsequent health events. Due to ease of measurement and quantification, the negative effects of elevated blood BHBA concentrations and resulting diagnosis of hyperketonemia (HYK; BHBA> 1.2 mmol/L) are better documented than those for elevated blood NEFA concentrations. Although the incidence of HYK in early lactation has been reported to range from 40 to 60%, there are few published reports on the economic impact of HYK. The cost of HYK as ascribed to direct consequences of the impact of this condition on milk production, treatment and culling (reported here as the component cost) is important, as is the cost of other diseases attributed to HYK (i.e. the increase in disease risk associated with HYK). The total cost, the sum of the component cost of HYK as well as the additional disease-attributed costs, is important to emphasize the impact of management and prevention of HYK. The objective of this study was to use deterministic models to estimate the direct and indirect costs associated with: 1) the component cost per case of HYK, and 2) the total cost per case of HYK when accounting for the costs related to HYK-attributable displaced abomasa (DA) and metritis cases.