| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Howard Young Medical Center Inc Of Woodruff Wisconsin | 240 Maple Street, Woodruff | J3101 | $51 [source] | 3 years ago |
| Ascension Calumet Hospital | 614 Memorial Dr, Chilton | J3101 | $171 [source] | 3 years ago |
| Midwest Orthopedic Specialty Hospital, Llc | 10101 S 27Th St, Franklin | J3101 | $262 [source] | 3 years ago |
| Orthopaedic Hospital Of Wisconsin | 475 W River Woods Pkwy, Milwaukee | J3101 | $383 [source] | 3 years ago |
| Chippewa Valley Hospital & Oakview Care Center, Inc. | 1220 3Rd Ave W, Durand | J3101 | $8,856 [source] | 3 years ago |
| Prairie Ridge Health | 1515 Park Ave, Columbus | J3101 | $10,907 [source] | 3 years ago |