| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Ascension Ne Wisconsin-St Elizabeth Campus | 1506 S Oneida St, Appleton | G0102 | $15 [source] | 3 years ago |
| Ascension Calumet Hospital | 614 Memorial Dr, Chilton | G0102 | $24 [source] | 3 years ago |
| Howard Young Medical Center Inc Of Woodruff Wisconsin | 240 Maple Street, Woodruff | G0102 | $25 [source] | 3 years ago |
| Aspirus Riverview Hospital | 410 Dewey St, Wisconsin Rapids | G0102 | $43 [source] | 3 years ago |
| Aspirus Wausau Hospital | 333 Pine Ridge Blvd, Wausau | G0102 | $43 [source] | 3 years ago |
| Prairie Ridge Health | 1515 Park Ave, Columbus | G0102 | $57 [source] | 3 years ago |
| Aspirus Divine Savior Hospital | 2817 New Pinery Rd, Portage | G0102 | $58 [source] | 3 years ago |
| Chippewa Valley Hospital & Oakview Care Center, Inc. | 1220 3Rd Ave W, Durand | G0102 | $68 [source] | 3 years ago |