| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Atrium Health Behavioral Health | 501 Billingsley Road , Charlotte | G0104 | $329 [source] | 3 years ago |
| Carolinas Rehabilitation | 1100 Blythe Blvd. , Charlotte | G0104 | $329 [source] | 3 years ago |
| Adventhealth Hendersonville | 100 Hospital Dr, Hendersonville | G0104 | $521 [source] | 3 years ago |
| Harris Regional Hospital | 68 Hospital Road, Sylva | G0104 | $678 [source] | 3 years ago |
| Carolinas Medical Center | 1000 Blythe Blvd. , Charlotte | G0104 | $756 [source] | 3 years ago |
| Atrium Health Lincoln | 433 Mcalister Road , Lincolnton | G0104 | $756 [source] | 3 years ago |
| Cone Health Moses Cone Hospital | 1121 North Church St Entrance A, Greensboro | G0104 | $770 [source] | 3 years ago |
| Cone Health Penn Nursing Center | 618 S Main St, Reidsville | G0104 | $1,047 [source] | 3 years ago |
| Moses Cone Hospital | 1131D N Church St, Greensboro | G0104 | $1,047 [source] | 3 years ago |
| Cone Health Behavioral Health Hospital | 700 Walter Reed Dr, Greensboro | G0104 | $1,047 [source] | 3 years ago |
| Cone Health Wesley Long Hospital | 2400 W Friendly Ave, Greensboro | G0104 | $1,047 [source] | 3 years ago |
| Cone Health Alamance Regional Medical Center | 1240 Huffman Mill Rd, Burlington | G0104 | $1,047 [source] | 3 years ago |
| Atrium Health Cabarrus | 920 Church Street North , Concord | G0104 | $1,457 [source] | 3 years ago |
| Atrium Health Mercy | 2001 Vail Ave. , Charlotte | G0104 | $1,472 [source] | 3 years ago |
| Atrium Health University | 8800 N. Tryon St. , Charlotte | G0104 | $1,472 [source] | 3 years ago |
| Atrium Health Cleveland | 201 E. Grover St. , Shelby | G0104 | $1,472 [source] | 3 years ago |
| Atrium Health Stanly | 301 Yadkin St. , Albemarle | G0104 | $1,472 [source] | 3 years ago |
| Atrium Health Union | 600 Hospital Drive , Monroe | G0104 | $1,472 [source] | 3 years ago |
| Atrium Health Pineville | 10628 Park Road , Charlotte | G0104 | $1,472 [source] | 3 years ago |
| Atrium Health Anson | 2301 Us Hwy 74 W. , Wadesboro | G0104 | $1,555 [source] | 3 years ago |
| Person Memorial Hospital | 615 Ridge Road, Roxboro | G0104 | $2,215 [source] | 3 years ago |