| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| Hilo Medical Center | 1190 Waianuenue Ave, Hilo | G0399 | $161 [source] | 3 years ago |
| Kona Community Hospital | 79-1019 Haukapila St, Kealakekua | G0399 | $161 [source] | 3 years ago |
| Hale Ho'ola Hamakua | 100 Keokea Pl, Kula | G0399 | $227 [source] | 3 years ago |
| Kau Hospital | 1 Kamani Street, Pahala | G0399 | $227 [source] | 3 years ago |
| Kohala Hospital | 54 383 Hospital Road, Kapaau | G0399 | $227 [source] | 3 years ago |
| The Queen's Medical Center - West O'ahu | 1301 Punchbowl St, Honolulu | G0399 | $1,143 [source] | 3 years ago |
| The Queen's Medical Center | 4800 Kawaihau Rd, Kapaa | G0399 | $1,143 [source] | 3 years ago |