| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Howard Young Medical Center Inc Of Woodruff Wisconsin | 240 Maple Street, Woodruff | G0289 | $112 [source] | 4 years ago |
| Ascension Ne Wisconsin-St Elizabeth Campus | 1506 S Oneida St, Appleton | G0289 | $151 [source] | 4 years ago |
| Ascension Calumet Hospital | 614 Memorial Dr, Chilton | G0289 | $255 [source] | 4 years ago |
| Chippewa Valley Hospital & Oakview Care Center, Inc. | 1220 3Rd Ave W, Durand | G0289 | $279 [source] | 4 years ago |
| Orthopaedic Hospital Of Wisconsin | 475 W River Woods Pkwy, Milwaukee | G0289 | $949 [source] | 4 years ago |
| Ascension St Francis Hospital | 3237 S 16Th St, Milwaukee | G0289 | $1,265 [source] | 4 years ago |
| Ascension Se Wisconsin Hospital-St Joseph Campus | 5000 W Chambers St, Milwaukee | G0289 | $1,265 [source] | 4 years ago |
| Midwest Orthopedic Specialty Hospital, Llc | 10101 S 27Th St, Franklin | G0289 | $1,265 [source] | 4 years ago |
| Ascension All Saints Hospital | 1320 Wisconsin Ave, Racine | G0289 | $1,265 [source] | 4 years ago |
| Prairie Ridge Health | 1515 Park Ave, Columbus | G0289 | $1,460 [source] | 4 years ago |