| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Howard Young Medical Center Inc Of Woodruff Wisconsin | 240 Maple Street, Woodruff | J1569 | $35 [source] | 4 years ago |
| Ascension Calumet Hospital | 614 Memorial Dr, Chilton | J1569 | $59 [source] | 4 years ago |
| Midwest Orthopedic Specialty Hospital, Llc | 10101 S 27Th St, Franklin | J1569 | $81 [source] | 4 years ago |
| Orthopaedic Hospital Of Wisconsin | 475 W River Woods Pkwy, Milwaukee | J1569 | $122 [source] | 4 years ago |
| Essentia Health St. Mary's Hospital-Superior | 3500 Tower Ave, Superior | J1569 | $128 [source] | 4 years ago |
| Aurora Baycare | 1160 Kepler Dr, Green Bay | J1569 | $178 [source] | 4 years ago |
| Aurora Medical Center Of Manitowoc County | 5000 Memorial Dr, Two Rivers | J1569 | $181 [source] | 4 years ago |
| Aurora Medical Center Bay Area | 3003 University Dr, Marinette | J1569 | $190 [source] | 4 years ago |
| Aurora Sinai Medical Center | 945 N 12Th St, Milwaukee | J1569 | $224 [source] | 4 years ago |
| Aurora West Allis Medical Center | 8901 W Lincoln Ave, Milwaukee | J1569 | $225 [source] | 4 years ago |
| Aurora St. Luke's Medical Center | 2900 W Oklahoma Ave, Milwaukee | J1569 | $225 [source] | 4 years ago |
| Aurora Medical Center Of Oshkosh | 855 N Westhaven Dr, Oshkosh | J1569 | $229 [source] | 4 years ago |
| Aurora St Luke's South Shore | 5900 S Lake Dr, Cudahy | J1569 | $249 [source] | 4 years ago |
| Aurora Medical Center Grafton | 975 Port Washington Road, Grafton | J1569 | $254 [source] | 4 years ago |
| Aurora Sheboygan Memorial Medical Center | 2629 N 7Th St, Sheboygan | J1569 | $261 [source] | 4 years ago |
| Aurora Lakeland Medical Center | W3930 County Road Nn, Elkhorn | J1569 | $261 [source] | 4 years ago |
| Aurora Medical Center Burlington | 252 Mchenry St, Burlington | J1569 | $261 [source] | 4 years ago |
| Aurora Medical Center Summit | 36500 Aurora Dr, Oconomowoc | J1569 | $262 [source] | 4 years ago |
| Aurora Medical Center Kenosha | 10400 75Th St, Kenosha | J1569 | $286 [source] | 4 years ago |
| Aurora Medical Center Of Washington County | 1032 E Sumner St, Hartford | J1569 | $361 [source] | 4 years ago |
| Adventhealth Durand | 1220 3Rd Ave W, Durand | J1569 | $1,516 [source] | 4 years ago |
| Prairie Ridge Health | 1515 Park Ave, Columbus | J1569 | $5,368 [source] | 4 years ago |