| Hospital | Address | Code | Price | Last Updated |
|---|---|---|---|---|
| River Falls Area Hospital | , River Falls | G0399 | $16 [source] | 3 years ago |
| Chippewa Valley Hospital & Oakview Care Center, Inc. | 1220 3Rd Ave W, Durand | G0399 | $438 [source] | 3 years ago |
| Ascension Calumet Hospital | 614 Memorial Dr, Chilton | G0399 | $557 [source] | 3 years ago |
| Tomah Memorial Hospital | 501 Gopher Dr, Tomah | G0399 | $689 [source] | 3 years ago |
| Aspirus Riverview Hospital | 410 Dewey St, Wisconsin Rapids | G0399 | $745 [source] | 3 years ago |
| Aspirus Wausau Hospital | 333 Pine Ridge Blvd, Wausau | G0399 | $745 [source] | 3 years ago |
| Aurora Sheboygan Memorial Medical Center | 2629 N 7Th St, Sheboygan | G0399 | $925 [source] | 3 years ago |
| Aurora Lakeland Medical Center | W3930 County Road Nn, Elkhorn | G0399 | $925 [source] | 3 years ago |
| Aurora Sinai Medical Center | 945 N 12Th St, Milwaukee | G0399 | $925 [source] | 3 years ago |
| Aurora Baycare | 1160 Kepler Dr, Green Bay | G0399 | $925 [source] | 3 years ago |
| Aurora Medical Center Of Manitowoc County | 5000 Memorial Dr, Two Rivers | G0399 | $925 [source] | 3 years ago |
| Aurora Medical Center Summit | 36500 Aurora Dr, Oconomowoc | G0399 | $925 [source] | 3 years ago |
| Aurora Medical Center Bay Area | 3003 University Dr, Marinette | G0399 | $925 [source] | 3 years ago |
| Aurora St. Luke's Medical Center | 2900 W Oklahoma Ave, Milwaukee | G0399 | $925 [source] | 3 years ago |
| Aurora Medical Center Of Washington County | 1032 E Sumner St, Hartford | G0399 | $925 [source] | 3 years ago |
| Aurora Medical Center Of Oshkosh | 855 N Westhaven Dr, Oshkosh | G0399 | $925 [source] | 3 years ago |
| Aurora Medical Center Kenosha | 10400 75Th St, Kenosha | G0399 | $925 [source] | 3 years ago |