| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Upland Hills Health | 800 Compassion Way, Dodgeville | J9217 | $246 [source] | 4 years ago |
| Ascension Calumet Hospital | 614 Memorial Dr, Chilton | J9217 | $331 [source] | 4 years ago |
| Midwest Orthopedic Specialty Hospital, Llc | 10101 S 27Th St, Franklin | J9217 | $483 [source] | 4 years ago |
| Orthopaedic Hospital Of Wisconsin | 475 W River Woods Pkwy, Milwaukee | J9217 | $702 [source] | 4 years ago |
| Aspirus Medford Hospital | 135 S Gibson St, Medford | J9217 | $1,314 [source] | 4 years ago |
| Aspirus Riverview Hospital | 410 Dewey St, Wisconsin Rapids | J9217 | $1,314 [source] | 4 years ago |
| Aspirus Langlade Hospital | 110 E 5Th Ave, Antigo | J9217 | $1,314 [source] | 4 years ago |
| Aspirus Wausau Hospital | 333 Pine Ridge Blvd, Wausau | J9217 | $1,314 [source] | 4 years ago |
| Aspirus Divine Savior Hospital | 2817 New Pinery Rd, Portage | J9217 | $1,314 [source] | 4 years ago |
| Prairie Ridge Health | 1515 Park Ave, Columbus | J9217 | $1,571 [source] | 4 years ago |
| Aurora Sheboygan Memorial Medical Center | 2629 N 7Th St, Sheboygan | J9217 | $1,836 [source] | 4 years ago |
| Aurora Baycare | 1160 Kepler Dr, Green Bay | J9217 | $1,854 [source] | 4 years ago |
| Aurora Medical Center Of Manitowoc County | 5000 Memorial Dr, Two Rivers | J9217 | $1,875 [source] | 4 years ago |
| Aurora Sinai Medical Center | 945 N 12Th St, Milwaukee | J9217 | $1,923 [source] | 4 years ago |
| Aurora St Luke's South Shore | 5900 S Lake Dr, Cudahy | J9217 | $1,937 [source] | 4 years ago |
| Aurora West Allis Medical Center | 8901 W Lincoln Ave, Milwaukee | J9217 | $1,939 [source] | 4 years ago |
| Aurora St. Luke's Medical Center | 2900 W Oklahoma Ave, Milwaukee | J9217 | $1,943 [source] | 4 years ago |
| Aurora Medical Center Bay Area | 3003 University Dr, Marinette | J9217 | $1,951 [source] | 4 years ago |
| Watertown Regional Medical Center | 125 Hospital Drive, Watertown | J9217 | $2,139 [source] | 4 years ago |
| Aurora Medical Center Of Oshkosh | 855 N Westhaven Dr, Oshkosh | J9217 | $2,186 [source] | 4 years ago |
| Aurora Lakeland Medical Center | W3930 County Road Nn, Elkhorn | J9217 | $2,650 [source] | 4 years ago |
| Aurora Medical Center Burlington | 252 Mchenry St, Burlington | J9217 | $2,658 [source] | 4 years ago |
| Aurora Medical Center Grafton | 975 Port Washington Road, Grafton | J9217 | $2,710 [source] | 4 years ago |
| Aurora Medical Center Kenosha | 10400 75Th St, Kenosha | J9217 | $2,848 [source] | 4 years ago |
| Aurora Medical Center Summit | 36500 Aurora Dr, Oconomowoc | J9217 | $2,852 [source] | 4 years ago |
| Aurora Medical Center Of Washington County | 1032 E Sumner St, Hartford | J9217 | $3,493 [source] | 4 years ago |
| Chippewa Valley Hospital & Oakview Care Center, Inc. | 1220 3Rd Ave W, Durand | J9217 | $8,314 [source] | 4 years ago |