| 
                Monongahela Valley Hospital
                1163 Country Club Road Monongahela, PA 15063
                         $85 –         $108
               | 
            
            
            
              | 
                The Washington Hospital
                155 Wilson Ave Washington, PA 15301
                        $108 –         $131
               | 
            
            
            
              | 
                Saint Vincent Hospital
                232 W 25th St Erie, PA 16544
                        $108 –         $131
               | 
            
            
            
              | 
                Heritage Valley Beaver Hospital
                25 Heckel Rd Mc Kees Rocks, PA 15136
                        $108 –         $131
               | 
            
            
            
              | 
                Heritage Valley Beaver
                1000 Dutch Ridge Rd Beaver, PA 15009
                        $108 –         $131
               | 
            
            
            
              | 
                Heritage Valley Beaver Hospital
                1000 Dutch Ridge Rd Beaver, PA 15009
                        $108 –         $131
               | 
            
            
            
              | 
                Suburban Community Hospital
                2701 Dekalb Pike East Norriton, PA 19401
                        $108 –         $131
               | 
            
            
            
              | 
                Fox Chase Cancer Center
                333 Cottman Ave Philadelphia, PA 19111
                        $108 –         $131
               | 
            
            
            
              | 
                Temple University Hospital – Main Campus
                3401 N Broad St Philadelphia, PA 19140
                        $108 –         $131
               | 
            
            
            
              | 
                Whs - Greene
                350 Bonar Ave Waynesburg, PA 15370
                        $108 –         $131
               | 
            
            
            
              | 
                Lower Bucks Hospital
                501 Bath Rd Bristol, PA 19007
                        $108 –         $131
               | 
            
            
            
              | 
                Delaware County Memorial Hospital
                501 N Lansdowne Ave Drexel Hill, PA 19026
                        $108 –         $131
               | 
            
            
            
              | 
                Roxborough Memorial Hospital
                5800 Ridge Ave Philadelphia, PA 19128
                        $108 –         $131
               | 
            
            
            
              | 
                Penn Medicine Chester County Hospital
                701 E Marshall St West Chester, PA 19380
                        $108 –         $131
               | 
            
            
            
              | 
                Heritage Valley Sewickley
                720 Blackburn Rd Sewickley, PA 15143
                        $108 –         $131
               | 
            
            
            
              | 
                Temple University Hospital – Jeanes Campus
                7600 Central Ave Philadelphia, PA 19111
                        $108 –         $131
               | 
            
            
            
              | 
                Punxsutawney Area Hospital
                81 Hillcrest Dr Punxsutawney, PA 15767
                        $108 –         $131
               | 
            
            
            
              | 
                Pennsylvania Hospital
                800 Spruce St Phila, PA 19107
                        $131 –         $154
               | 
            
            
            
              | 
                Penn Presbyterian Medical Center
                51 N 39th St Philadelphia, PA 19104
                        $131 –         $154
               | 
            
            
            
              | 
                Physicians Care Surgical Hospital
                454 Enterprise Dr Royersford, PA 19468
                        $131 –         $154
               | 
            
            
            
              | 
                Albert Einstein Medical Center
                5501 Old York Rd Phila, PA 19141
                        $131 –         $177
               | 
            
            
            
              | 
                Penn Medicine Lancaster General Hospital
                555 N Duke St Lancaster, PA 17602
                        $131 –         $154
               | 
            
            
            
              | 
                Einstein Medical Center Montgomery
                559 W Germantown Pike East Norriton, PA 19403
                        $131 –         $177
               | 
            
            
            
              | 
                Hospital of the University of Pennsylvania
                3400 Spruce St Philadelphia, PA 19104
                        $131 –         $154
               | 
            
            
            
              | 
                Conemaugh Miners Medical Center
                290 Haida Avenue Hastings, PA 16646
                        $131 –         $154
               | 
            
            
            
              | 
                St. Clair Hospital
                1000 Bower Hill Rd Pittsburgh, PA 15243
                        $131 –         $154
               | 
            
            
            
              | 
                ACMH Hospital
                1 Nolte Dr Kittanning, PA 16201
                        $154 –         $177
               | 
            
            
            
              | 
                Canonsburg Hospital
                100 Medical Boulevard Canonsburg, PA 15317
                        $154 –         $177
               | 
            
            
            
              | 
                Conemaugh Memorial Medical Center
                1086 Franklin St Johnstown, PA 15905
                        $154 –         $177
               | 
            
            
            
              | 
                Allegheny Valley Hospital
                1301 Carlisle Street Natrona Heights, PA 15065
                        $154 –         $177
               | 
            
            
            
              | 
                Jefferson Hospital
                565 Coal Valley Rd Clairton, PA 15025
                        $154 –         $177
               | 
            
            
            
              | 
                Grove City Medical Center
                631 N Broad Street Ext Grove City, PA 16127
                        $154 –         $177
               | 
            
            
            
              | 
                Allegheny General Hospital
                320 E North Ave Pittsburgh, PA 15212
                        $177 –         $200
               | 
            
            
            
              | 
                Forbes Hospital
                2570 Haymaker Road Monroeville, PA 15146
                        $177 –         $200
               | 
            
            
            
              | 
                JC Blair Memorial Hospital
                1225 Warm Springs Ave Huntingdon, PA 16652
                        $177 –         $200
               | 
            
            
            
              | 
                Clarion Hospital
                1 Hospital Dr Clarion, PA 16214
                        $177 –         $200
               | 
            
            
            
              | 
                Nason Hospital
                105 Nason Dr Roaring Spring, PA 16673
                        $223 –         $246
               | 
            
            
            
              | 
                Highlands Hospital
                401 E Murphy Ave Connellsville, PA 15425
                        $223 –         $246
               | 
            
            
            
              | 
                Indiana Regional Medical Center
                835 Hospital Rd Indiana, PA 15701
                        $223 –         $246
               | 
            
            
            
              | 
                Excela Latrobe Hospital
                One Mellon Way Latrobe, PA 15650
                        $246 –         $269
               | 
            
            
            
              | 
                Excela Westmoreland Hospital
                532 W Pittsburgh St Greensburg, PA 15601
                        $246 –         $269
               | 
            
            
            
              | 
                Excela Frick Hospital
                508 S Church St Mt Pleasant, PA 15666
                        $246 –         $269
               | 
            
            
            
              | 
                Brandywine Hospital
                201 Reeceville Rd Coatesville, PA 19320
                        $246 –         $269
               | 
            
            
            
              | 
                Pottstown Hospital
                1600 E High St Pottstown, PA 19464
                        $269 –         $298
               | 
            
            
            
              | 
                Jennersville Hospital
                1015 W Baltimore Pike West Grove, PA 19390
                        $269 –         $298
               | 
            
            
            
              | 
                West Penn Hospital
                4800 Friendship Avenue Pittsburgh, PA 15224
                        $269 –         $298
               | 
            
            
            
              | 
                Upmc Pinnacle Community Osteopathic
                4300 Londonderry Rd Harrisburg, PA 17109
                        $269 –         $298
               | 
            
            
            
              | 
                Wayne Memorial Hospital
                601 Park St Honesdale, PA 18431
                        $269 –         $298
               |