| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Howard Young Medical Center Inc Of Woodruff Wisconsin | 240 Maple Street, Woodruff | J3304 | $21 [source] | 4 years ago |
| Aspirus Divine Savior Hospital | 2817 New Pinery Rd, Portage | J3304 | $24 [source] | 4 years ago |
| Ascension Calumet Hospital | 614 Memorial Dr, Chilton | J3304 | $26 [source] | 4 years ago |
| Midwest Orthopedic Specialty Hospital, Llc | 10101 S 27Th St, Franklin | J3304 | $41 [source] | 4 years ago |
| Chippewa Valley Hospital & Oakview Care Center, Inc. | 1220 3Rd Ave W, Durand | J3304 | $57 [source] | 4 years ago |
| Orthopaedic Hospital Of Wisconsin | 475 W River Woods Pkwy, Milwaukee | J3304 | $58 [source] | 4 years ago |