| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Orthopaedic Hospital Of Wisconsin | 475 W River Woods Pkwy, Milwaukee | J0696 | $2 [source] | 3 years ago |
| Essentia Health St. Mary's Hospital-Superior | 3500 Tower Ave, Superior | J0696 | $3 [source] | 3 years ago |
| Aspirus Medford Hospital | 135 S Gibson St, Medford | J0696 | $27 [source] | 3 years ago |
| Aspirus Divine Savior Hospital | 2817 New Pinery Rd, Portage | J0696 | $27 [source] | 3 years ago |
| Aspirus Riverview Hospital | 410 Dewey St, Wisconsin Rapids | J0696 | $27 [source] | 3 years ago |
| Aspirus Langlade Hospital | 110 E 5Th Ave, Antigo | J0696 | $27 [source] | 3 years ago |
| Aspirus Wausau Hospital | 333 Pine Ridge Blvd, Wausau | J0696 | $27 [source] | 3 years ago |
| Aurora Medical Center Of Manitowoc County | 5000 Memorial Dr, Two Rivers | J0696 | $64 [source] | 3 years ago |
| Prairie Ridge Health | 1515 Park Ave, Columbus | J0696 | $74 [source] | 3 years ago |
| Adventhealth Durand | 1220 3Rd Ave W, Durand | J0696 | $91 [source] | 3 years ago |
| Aurora Lakeland Medical Center | W3930 County Road Nn, Elkhorn | J0696 | $92 [source] | 3 years ago |
| Aurora Medical Center Burlington | 252 Mchenry St, Burlington | J0696 | $92 [source] | 3 years ago |
| Aurora St Luke's South Shore | 5900 S Lake Dr, Cudahy | J0696 | $92 [source] | 3 years ago |
| Aurora Baycare | 1160 Kepler Dr, Green Bay | J0696 | $93 [source] | 3 years ago |
| Aurora Medical Center Bay Area | 3003 University Dr, Marinette | J0696 | $94 [source] | 3 years ago |
| Aurora Medical Center Of Washington County | 1032 E Sumner St, Hartford | J0696 | $98 [source] | 3 years ago |
| Aurora Medical Center Summit | 36500 Aurora Dr, Oconomowoc | J0696 | $103 [source] | 3 years ago |
| Aurora West Allis Medical Center | 8901 W Lincoln Ave, Milwaukee | J0696 | $108 [source] | 3 years ago |
| Aurora Medical Center Of Oshkosh | 855 N Westhaven Dr, Oshkosh | J0696 | $110 [source] | 3 years ago |
| Aurora Medical Center Kenosha | 10400 75Th St, Kenosha | J0696 | $110 [source] | 3 years ago |
| Aurora Sinai Medical Center | 945 N 12Th St, Milwaukee | J0696 | $117 [source] | 3 years ago |
| Watertown Regional Medical Center | 125 Hospital Drive, Watertown | J0696 | $117 [source] | 3 years ago |
| Aurora Medical Center Grafton | 975 Port Washington Road, Grafton | J0696 | $119 [source] | 3 years ago |
| Aurora Sheboygan Memorial Medical Center | 2629 N 7Th St, Sheboygan | J0696 | $130 [source] | 3 years ago |
| Aurora St. Luke's Medical Center | 2900 W Oklahoma Ave, Milwaukee | J0696 | $162 [source] | 3 years ago |