| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Eastern Maine Medical Center | 489 State St, Bangor | J0490 | $69 [source] | 4 years ago |
| Sebasticook Valley Health | 447 N Main St, Pittsfield | J0490 | $88 [source] | 4 years ago |
| Northern Light Blue Hill Hospital | 57 Water Street, Blue Hill | J0490 | $126 [source] | 4 years ago |
| Northern Light Maine Coast Hospital | 50 Union St, Ellsworth | J0490 | $147 [source] | 4 years ago |
| Eastern Maine Healthcare Systems Inland Hospital | 200 Kennedy Memorial Dr, Waterville | J0490 | $206 [source] | 4 years ago |
| Northern Light A.r. Gould Hospital | 140 Academy St, Presque Isle | J0490 | $251 [source] | 4 years ago |