| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Ascension Calumet Hospital | 614 Memorial Dr, Chilton | J0702 | $10 [source] | 4 years ago |
| Aspirus Medford Hospital | 135 S Gibson St, Medford | J0702 | $16 [source] | 4 years ago |
| Aspirus Divine Savior Hospital | 2817 New Pinery Rd, Portage | J0702 | $16 [source] | 4 years ago |
| Aspirus Riverview Hospital | 410 Dewey St, Wisconsin Rapids | J0702 | $16 [source] | 4 years ago |
| Aspirus Langlade Hospital | 110 E 5Th Ave, Antigo | J0702 | $16 [source] | 4 years ago |
| Aspirus Wausau Hospital | 333 Pine Ridge Blvd, Wausau | J0702 | $16 [source] | 4 years ago |
| Aurora Medical Center Bay Area | 3003 University Dr, Marinette | J0702 | $16 [source] | 4 years ago |
| Orthopaedic Hospital Of Wisconsin | 475 W River Woods Pkwy, Milwaukee | J0702 | $22 [source] | 4 years ago |
| Essentia Health St. Mary's Hospital-Superior | 3500 Tower Ave, Superior | J0702 | $25 [source] | 4 years ago |
| Chippewa Valley Hospital & Oakview Care Center, Inc. | 1220 3Rd Ave W, Durand | J0702 | $42 [source] | 4 years ago |
| Aurora Baycare | 1160 Kepler Dr, Green Bay | J0702 | $43 [source] | 4 years ago |
| Aurora Medical Center Of Manitowoc County | 5000 Memorial Dr, Two Rivers | J0702 | $44 [source] | 4 years ago |
| Aurora Medical Center Summit | 36500 Aurora Dr, Oconomowoc | J0702 | $53 [source] | 4 years ago |
| Aurora West Allis Medical Center | 8901 W Lincoln Ave, Milwaukee | J0702 | $55 [source] | 4 years ago |
| Aurora Medical Center Grafton | 975 Port Washington Road, Grafton | J0702 | $57 [source] | 4 years ago |
| Aurora St Luke's South Shore | 5900 S Lake Dr, Cudahy | J0702 | $59 [source] | 4 years ago |
| Aurora Lakeland Medical Center | W3930 County Road Nn, Elkhorn | J0702 | $67 [source] | 4 years ago |
| Aurora Medical Center Burlington | 252 Mchenry St, Burlington | J0702 | $67 [source] | 4 years ago |
| Aurora Medical Center Of Oshkosh | 855 N Westhaven Dr, Oshkosh | J0702 | $71 [source] | 4 years ago |
| Aurora Sinai Medical Center | 945 N 12Th St, Milwaukee | J0702 | $75 [source] | 4 years ago |
| Aurora St. Luke's Medical Center | 2900 W Oklahoma Ave, Milwaukee | J0702 | $76 [source] | 4 years ago |
| Aurora Medical Center Kenosha | 10400 75Th St, Kenosha | J0702 | $79 [source] | 4 years ago |
| Aurora Sheboygan Memorial Medical Center | 2629 N 7Th St, Sheboygan | J0702 | $81 [source] | 4 years ago |
| Prairie Ridge Health | 1515 Park Ave, Columbus | J0702 | $87 [source] | 4 years ago |
| Aurora Medical Center Of Washington County | 1032 E Sumner St, Hartford | J0702 | $108 [source] | 4 years ago |
| Watertown Regional Medical Center | 125 Hospital Drive, Watertown | J0702 | $139 [source] | 4 years ago |
| Upland Hills Health | 800 Compassion Way, Dodgeville | J0702 | $225 [source] | 4 years ago |