| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Howard Young Medical Center Inc Of Woodruff Wisconsin | 240 Maple Street, Woodruff | G0397 | $76 [source] | 3 years ago |
| Ascension Calumet Hospital | 614 Memorial Dr, Chilton | G0397 | $117 [source] | 3 years ago |
| Ascension Ne Wisconsin-St Elizabeth Campus | 1506 S Oneida St, Appleton | G0397 | $120 [source] | 3 years ago |
| Chippewa Valley Hospital & Oakview Care Center, Inc. | 1220 3Rd Ave W, Durand | G0397 | $209 [source] | 3 years ago |