| The Washington Hospital
                155 Wilson Ave Washington, PA 15301
                         $36 –          $91 | 
            
            
              | Whs - Greene
                350 Bonar Ave Waynesburg, PA 15370
                         $36 –          $91 | 
            
            
              | Pottstown Hospital
                1600 E High St Pottstown, PA 19464
                         $91 –         $146 | 
            
            
              | Conemaugh Memorial Medical Center
                1086 Franklin St Johnstown, PA 15905
                        $146 –         $201 | 
            
            
              | Monongahela Valley Hospital
                1163 Country Club Road Monongahela, PA 15063
                        $146 –         $201 | 
            
            
              | Heritage Valley Beaver
                1000 Dutch Ridge Rd Beaver, PA 15009
                        $146 –         $201 | 
            
            
              | Heritage Valley Beaver Hospital
                1000 Dutch Ridge Rd Beaver, PA 15009
                        $146 –         $201 | 
            
            
              | Heritage Valley Beaver Hospital
                25 Heckel Rd Mc Kees Rocks, PA 15136
                        $146 –         $201 | 
            
            
              | Heritage Valley Sewickley
                720 Blackburn Rd Sewickley, PA 15143
                        $146 –         $201 | 
            
            
              | Butler Memorial Hospital
                911 E Brady St Butler, PA 16001
                        $146 –         $201 | 
            
            
              | Temple University Hospital – Jeanes Campus
                7600 Central Ave Philadelphia, PA 19111
                        $201 –         $256 | 
            
            
              | Lower Bucks Hospital
                501 Bath Rd Bristol, PA 19007
                        $201 –         $256 | 
            
            
              | Delaware County Memorial Hospital
                501 N Lansdowne Ave Drexel Hill, PA 19026
                        $201 –         $256 | 
            
            
              | Roxborough Memorial Hospital
                5800 Ridge Ave Philadelphia, PA 19128
                        $201 –         $256 | 
            
            
              | Forbes Hospital
                2570 Haymaker Road Monroeville, PA 15146
                        $201 –         $256 | 
            
            
              | Suburban Community Hospital
                2701 Dekalb Pike East Norriton, PA 19401
                        $201 –         $256 | 
            
            
              | Fox Chase Cancer Center
                333 Cottman Ave Philadelphia, PA 19111
                        $201 –         $256 | 
            
            
              | Temple University Hospital – Main Campus
                3401 N Broad St Philadelphia, PA 19140
                        $201 –         $256 | 
            
            
              | Physicians Care Surgical Hospital
                454 Enterprise Dr Royersford, PA 19468
                        $256 –         $311 | 
            
            
              | Saint Vincent Hospital
                232 W 25th St Erie, PA 16544
                        $256 –         $311 | 
            
            
              | Grove City Medical Center
                631 N Broad Street Ext Grove City, PA 16127
                        $256 –         $311 | 
            
            
              | Jefferson Hospital
                565 Coal Valley Rd Clairton, PA 15025
                        $256 –         $311 | 
            
            
              | Punxsutawney Area Hospital
                81 Hillcrest Dr Punxsutawney, PA 15767
                        $256 –         $311 | 
            
            
              | Sharon Regional Medical Center
                740 E State St Sharon, PA 16146
                        $256 –         $311 | 
            
            
              | Chestnut Hill Hospital
                8835 Germantown Ave Philadelphia, PA 19118
                        $311 –         $366 | 
            
            
              | Nason Hospital
                105 Nason Dr Roaring Spring, PA 16673
                        $311 –         $366 | 
            
            
              | Albert Einstein Medical Center
                5501 Old York Rd Phila, PA 19141
                        $311 –         $366 | 
            
            
              | Einstein Medical Center Montgomery
                559 W Germantown Pike East Norriton, PA 19403
                        $311 –         $366 | 
            
            
              | Clarion Hospital
                1 Hospital Dr Clarion, PA 16214
                        $311 –         $366 | 
            
            
              | ACMH Hospital
                1 Nolte Dr Kittanning, PA 16201
                        $311 –         $366 | 
            
            
              | St. Clair Hospital
                1000 Bower Hill Rd Pittsburgh, PA 15243
                        $366 –         $421 | 
            
            
              | St. Luke’s Sacred Heart Campus
                421 W Chew St Allentown, PA 18102
                        $366 –         $421 | 
            
            
              | Upmc Pinnacle Community Osteopathic
                4300 Londonderry Rd Harrisburg, PA 17109
                        $366 –         $421 | 
            
            
              | Excela Westmoreland Hospital
                532 W Pittsburgh St Greensburg, PA 15601
                        $366 –         $421 | 
            
            
              | Excela Latrobe Hospital
                One Mellon Way Latrobe, PA 15650
                        $366 –         $421 | 
            
            
              | Meadville Medical Center
                751 Liberty St Meadville, PA 16335
                        $421 –         $476 | 
            
            
              | Indiana Regional Medical Center
                835 Hospital Rd Indiana, PA 15701
                        $476 –         $534 | 
            
            
              | West Penn Hospital
                4800 Friendship Avenue Pittsburgh, PA 15224
                        $476 –         $534 | 
            
            
              | WellSpan York Hospital
                1001 South George Street York, PA 17405
                        $476 –         $534 |