| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Northern Light Blue Hill Hospital | 57 Water Street, Blue Hill | J0692 | $21 [source] | 3 years ago |
| Sebasticook Valley Health | 447 N Main St, Pittsfield | J0692 | $25 [source] | 3 years ago |
| Eastern Maine Medical Center | 489 State St, Bangor | J0692 | $27 [source] | 3 years ago |
| Charles A Dean Memorial Hospital | 364 Pritham Ave, Greenville | J0692 | $31 [source] | 3 years ago |
| Eastern Maine Healthcare Systems Inland Hospital | 200 Kennedy Memorial Dr, Waterville | J0692 | $37 [source] | 3 years ago |
| Northern Light A.r. Gould Hospital | 140 Academy St, Presque Isle | J0692 | $79 [source] | 3 years ago |
| Mercy Hospital | 144 State St, Portland | J0692 | $122 [source] | 3 years ago |