| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Northern Light Blue Hill Hospital | 57 Water Street, Blue Hill | J0690 | $4 [source] | 4 years ago |
| Charles A Dean Memorial Hospital | 364 Pritham Ave, Greenville | J0690 | $15 [source] | 4 years ago |
| Eastern Maine Medical Center | 489 State St, Bangor | J0690 | $16 [source] | 4 years ago |
| Sebasticook Valley Health | 447 N Main St, Pittsfield | J0690 | $25 [source] | 4 years ago |
| Northern Light A.r. Gould Hospital | 140 Academy St, Presque Isle | J0690 | $25 [source] | 4 years ago |
| Northern Light Maine Coast Hospital | 50 Union St, Ellsworth | J0690 | $26 [source] | 4 years ago |
| Eastern Maine Healthcare Systems Inland Hospital | 200 Kennedy Memorial Dr, Waterville | J0690 | $27 [source] | 4 years ago |
| Mercy Hospital | 144 State St, Portland | J0690 | $46 [source] | 4 years ago |