| CHRISTUS Santa Rosa Hospital - Westover Hills | San Antonio | $20.79 | $63 |
| Covenant Hospital Levelland | Levelland | $23.10 | $55 |
| Covenant Hospital Plainview | Plainview | $23.10 | $55 |
| UTHealth East Texas Quitman | Quitman | $36.27 | $362.70 |
| UTHealth East Texas Pittsburg | Pittsburg | $38.02 | $380.25 |
| William P Clements Jr University Hospital | Dallas | $42 | $56 |
| University Medical Center of El Paso | El Paso | $56.14 | $280.70 |
| BSA Hospital | Amarillo | $56.70 | $567 |
| Harrington Cancer Center | Amarillo | $56.70 | $567 |
| Harris Health Ben Taub Hospital | Houston | $57 | $245 |
| Harris Health Lyndon B Johnson Hospital | Houston | $57 | $245 |
| UTHealth East Texas North Campus | Tyler | $59.80 | $598 |
| University Medical Center Surgical Hospital | El Paso | $67.66 | $338.30 |
| UTHealth East Texas Athens | Athens | $75.80 | $758 |
| UTHealth East Texas Carthage | Carthage | $80.30 | $803 |
| UTHealth East Texas Tyler | Tyler | $81 | $810 |
| UTHealth East Texas Jacksonville | Jacksonville | $85.50 | $855 |
| UTHealth East Texas Rehabilitation Center | Tyler | $86.40 | $864 |
| Ascension Seton Smithville (Ascension Seton) | Smithville | $89.10 | $247.50 |
| University Health Dialysis Medical Center | San Antonio | $111.75 | $447 |
| University Health Dialysis South | San Antonio | $111.75 | $447 |
| University Health Dialysis Southeast | San Antonio | $111.75 | $447 |
| University Health Dialysis West at Texas Diabetes Institute | San Antonio | $111.75 | $447 |
| University Health System Children's Kidney Center | San Antonio | $111.75 | $447 |
| University Hospital | San Antonio | $111.75 | $447 |
| Ascension Providence | Waco | $120.15 | $333.75 |
| St. Joseph Health Regional Hospital | Bryan | $130.96 | $632 |
| St. Joseph Health College Station Hospital | College Station | $131.78 | $632 |
| UTHealth East Texas Henderson | Henderson | $141.90 | $1,419 |
| St. Joseph Health Madison Hospital | Madisonville | $148.90 | $632 |
| St. Joseph Health Burleson Hospital | Caldwell | $150.17 | $632 |
| Ascension Seton Hays (Ascension Seton) | Kyle | $154.35 | $428.75 |
| Ascension Seton Medical Center Austin (Ascension Seton) | Austin | $154.35 | $428.75 |
| Ascension Seton Northwest (Ascension Seton) | Austin | $154.35 | $428.75 |
| Ascension Seton Southwest (Ascension Seton) | 1826 Austin | $154.35 | $428.75 |
| Ascension Seton Williamson (Ascension Seton) | Round Rock | $154.35 | $428.75 |
| Dell Seton Medical Center at The University of Texas (Ascension Seton) | Austin | $154.35 | $428.75 |
| Longview Regional Medical Center | Longview | $170.98 | $633.25 |
| Dell Children's Medical Center (Ascension Seton) | Austin | $173.25 | $247.50 |
| Dell Children's Medical Center North Campus (Ascension Seton) | Austin | $173.25 | $247.50 |
| St. Luke's Health Memorial Livingston | Livingston | $176.85 | $1,179 |
| St. Luke's Health Memorial Lufkin | Lufkin | $176.85 | $1,179 |
| St. Luke's Health Memorial San Augustine | San Augustine | $176.85 | $1,179 |
| Parkland Health | Dallas | $180.80 | $452 |
| Methodist Celina Medical Center | Celina | $189.30 | $631 |
| Methodist Dallas Medical Center | Dallas | $189.30 | $631 |
| Methodist Mansfield Medical Center | Mansfield | $189.30 | $631 |
| Methodist Midlothian Medical Center | Midlothian | $189.30 | $631 |
| Methodist Richardson Medical Center | Richardson | $189.30 | $631 |
| Methodist Richardson Medical Center Campus for Continuing Care | Richardson | $189.30 | $631 |
| Methodist Southlake Medical Center | Southlake | $189.30 | $631 |
| Texas Health Arlington Memorial Hospital | Arlington | $205.35 | $342.25 |
| Texas Health Center for Diagnostics and Surgery Plano | Plano | $205.35 | $342.25 |
| Texas Health Harris Methodist Hospital Alliance | Fort Worth | $205.35 | $342.25 |
| Texas Health Harris Methodist Hospital Azle | Azle | $205.35 | $342.25 |
| Texas Health Harris Methodist Hospital Cleburne | Cleburne | $205.35 | $342.25 |
| Texas Health Harris Methodist Hospital Fort Worth | Fort Worth | $205.35 | $342.25 |
| Texas Health Harris Methodist Hospital Hurst-Euless-Bedford | Bedford | $205.35 | $342.25 |
| Texas Health Harris Methodist Hospital Southlake | Southlake | $205.35 | $342.25 |
| Texas Health Harris Methodist Hospital Southwest Fort Worth | Fort Worth | $205.35 | $342.25 |
| Texas Health Harris Methodist Hospital Stephenville | Stephenville | $205.35 | $342.25 |
| Texas Health Heart & Vascular Hospital Arlington | Arlington | $205.35 | $342.25 |
| Texas Health Hospital Clearfork | Fort Worth | $205.35 | $342.25 |
| Texas Health Hospital Frisco | Frisco | $205.35 | $342.25 |
| Texas Health Hospital Rockwall | Rockwall | $205.35 | $342.25 |
| Texas Health Presbyterian Hospital Allen | Allen | $205.35 | $342.25 |
| Texas Health Presbyterian Hospital Dallas | Dallas | $205.35 | $342.25 |
| Texas Health Presbyterian Hospital Denton | Denton | $205.35 | $342.25 |
| Texas Health Presbyterian Hospital Flower Mound | Flower Mound | $205.35 | $342.25 |
| Texas Health Presbyterian Hospital Kaufman | Kaufman | $205.35 | $342.25 |
| Texas Health Presbyterian Hospital Plano | Plano | $205.35 | $342.25 |
| Texas Health Specialty Hospital Fort Worth | Fort Worth | $205.35 | $342.25 |
| United Regional Health Care System | Wichita Falls | $228.68 | $258.40 |
| Ascension Seton Edgar B. Davis (Ascension Seton) | Luling | $242.91 | $674.75 |
| Ascension Seton Highland Lakes (Ascension Seton) | Burnet | $242.91 | $674.75 |
| Ascension Seton Cedar Park Hospital | Cedar Park | $245.04 | $680.68 |
| Behavioral Medicine at Renaissance | Edinburg | $247.51 | $247.51 |
| Doctors Hospital at Renaissance | Edinburg | $247.51 | $247.51 |
| Rehab Center at Renaissance | Edinburg | $247.51 | $247.51 |
| Womens Hospitalat Renaissance | Edinburg | $247.51 | $247.51 |
| DHR Health Brownsville | Brownsville | $259.89 | $259.89 |
| Covenant Health Emergency Center - Milwaukee Ave | Lubbock | $274.26 | $653 |
| Covenant Health Emergency Center - Quaker Ave | Lubbock | $274.26 | $653 |
| Covenant Medical Center | Lubbock | $274.26 | $653 |
| Baylor Scott & White All Saints Medical Center - Fort Worth | Fort Worth | $282.80 | $471.33 |
| Baylor Scott & White Heart and Vascular Hospital - Dallas | Dallas | $282.80 | $471.33 |
| Baylor Scott & White Heart and Vascular Hospital - Waxahachie | Waxahachie | $282.80 | $471.33 |
| Baylor Scott & White Medical Center - Centennial | Frisco | $282.80 | $471.33 |
| Baylor Scott & White Medical Center - Frisco at PGA Parkway | Frisco | $282.80 | $471.33 |
| Baylor Scott & White Medical Center - Grapevine | Grapevine | $282.80 | $471.33 |
| Baylor Scott & White Medical Center - Irving | Irving | $282.80 | $471.33 |
| Baylor Scott & White Medical Center - Lake Pointe | Rowlett | $282.80 | $471.33 |
| Baylor Scott & White Medical Center - McKinney | McKinney | $282.80 | $471.33 |
| Baylor Scott & White Medical Center - Plano | Plano | $282.80 | $471.33 |
| Baylor Scott & White Medical Center - Waxahachie | Waxahachie | $282.80 | $471.33 |
| Baylor Scott & White the Heart Hospital - Denton | Denton | $282.80 | $471.33 |
| Baylor Scott & White the Heart Hospital - McKinney | McKinney | $282.80 | $471.33 |
| Baylor Scott & White the Heart Hospital - Plano | Plano | $282.80 | $471.33 |
| Baylor University Medical Center | Dallas | $282.80 | $471.33 |
| Hendrick Medical Center Brownwood | Brownwood | $283.96 | $567.92 |
| Baylor Scott & White Continuing Care Hospital | Temple | $290.31 | $483.85 |
| Baylor Scott & White McLane Children's Medical Center | Temple | $290.31 | $483.85 |
| Baylor Scott & White Medical Center - Brenham | Brenham | $290.31 | $483.85 |
| Baylor Scott & White Medical Center - College Station | College Station | $290.31 | $483.85 |
| Baylor Scott & White Medical Center - Marble Falls | Marble Falls | $290.31 | $483.85 |
| Baylor Scott & White Medical Center - Temple | Temple | $290.31 | $483.85 |
| Baylor Scott & White Medical Center Hillcrest | Waco | $290.31 | $483.85 |
| Baylor Scott & White Pavilion - Temple | Temple | $290.31 | $483.85 |
| Houston Methodist Emergency Care Center at Kirby | Houston | $290.50 | $581 |
| Houston Methodist Emergency Care Center at Voss | Houston | $290.50 | $581 |
| Houston Methodist Emergency Care Center in Pearland | Houston | $290.50 | $581 |
| Houston Methodist Hospital | Houston | $290.50 | $581 |
| Medical City Children's Hospital | Garland | $291.76 | $291.76 |
| Medical City Dallas Hospital | Garland | $291.76 | $291.76 |
| Medical City ER Garland | Garland | $291.76 | $291.76 |
| Baylor Scott & White Emergency Medical Center - Cedar Park | Cedar Park | $295.43 | $492.39 |
| Baylor Scott & White Medical Center - Austin | Austin | $295.43 | $492.39 |
| Baylor Scott & White Medical Center - Buda | Buda | $295.43 | $492.39 |
| Baylor Scott & White Medical Center - Lakeway | Lakeway | $295.43 | $492.39 |
| Baylor Scott & White Medical Center - Pflugerville | Pflugerville | $295.43 | $492.39 |
| Baylor Scott & White Medical Center - Round Rock | Round Rock | $295.43 | $492.39 |
| Baylor Scott & White Medical Center - Taylor | Taylor | $295.43 | $492.39 |
| Cook Children's Medical Center - Prosper | Prosper | $296.92 | $395.89 |
| CHRISTUS Health - West Beaumont | Beaumont | $301.95 | $915 |
| CHRISTUS Hospital - Orange | Orange | $301.95 | $915 |
| CHRISTUS Southeast Texas - MidCounty | Port Arthur | $301.95 | $915 |
| CHRISTUS Southeast Texas Orthopedic Specialty Center | Port Arthur | $301.95 | $915 |
| CHRISTUS Southeast Texas St. Elizabeth | Beaumont | $301.95 | $915 |
| Texas Children's Hospital | Houston | $307.53 | $459 |
| Texas Children's Hospital North Austin Campus | Austin | $307.53 | $459 |
| Texas Children's Hospital The Woodlands | The Woodlands | $307.53 | $459 |
| Texas Children's Hospital West Campus | Houston | $307.53 | $459 |
| JPS Health Network | Fort Worth | $317.40 | $529 |
| Trinity Spring North | Fort Worth | $317.40 | $529 |
| UMC Children's Hospital | Lubbock | $318 | $318 |
| UMC Health & Wellness Hospital | Lubbock | $318 | $318 |
| University Medical Center | Lubbock | $318 | $318 |
| Medical Center Hospital | Odessa | $330 | $330 |
| Children's Memorial Hermann Hospital | Houston | $332.40 | $1,038.75 |
| Memorial Hermann Cypress Hospital | Cypress | $332.40 | $1,038.75 |
| Memorial Hermann Greater Heights Hospital | Houston | $332.40 | $1,038.75 |
| Memorial Hermann Imaging Center (Bellaire) | Bellaire | $332.40 | $1,038.75 |
| Memorial Hermann Imaging Center (Cypress) | Cypress | $332.40 | $1,038.75 |
| Memorial Hermann Imaging Center (Texas Medical Center) | Houston | $332.40 | $1,038.75 |
| Memorial Hermann Imaging Center (Upper Kirby) | Houston | $332.40 | $1,038.75 |
| Memorial Hermann Katy Hospital | Katy | $332.40 | $1,038.75 |
| Memorial Hermann Memorial City Medical Center | Houston | $332.40 | $1,038.75 |
| Memorial Hermann Northeast Hospital | Humble | $332.40 | $1,038.75 |
| Memorial Hermann Pearland Hospital | Pearland | $332.40 | $1,038.75 |
| Memorial Hermann Rehabilitation Hospital-Katy | Katy | $332.40 | $1,038.75 |
| Memorial Hermann Rockets Orthopedic Hospital | Bellaire | $332.40 | $1,038.75 |
| Memorial Hermann Southeast Hospital | Houston | $332.40 | $1,038.75 |
| Memorial Hermann Southwest Hospital | Houston | $332.40 | $1,038.75 |
| Memorial Hermann Sugar Land Hospital | Sugar Land | $332.40 | $1,038.75 |
| Memorial Hermann The Woodlands Medical Center | The Woodlands | $332.40 | $1,038.75 |
| Memorial Hermann-Texas Medical Center | Houston | $332.40 | $1,038.75 |
| TIRR Memorial Hermann | Houston | $332.40 | $1,038.75 |
| Hendrick Medical Center | Abilene | $342.72 | $685.44 |
| Hendrick Medical Center South | Abilene | $342.72 | $685.44 |
| Midland County Hospital District | Midland | $344.25 | $459 |
| Midland Memorial Hospital | Midland | $344.25 | $459 |
| Shannon Medical Center | San Angelo | $366.50 | $733 |
| Shannon Medical Center Big Spring | Big Spring | $366.50 | $733 |
| Shannon Medical Center South | San Angelo | $366.50 | $733 |
| Shannon Medical Center St John's Campus | San Angelo | $366.50 | $733 |
| Shannon River Crest Hospital | San Angelo | $366.50 | $733 |
| Covenant Children's Hospital | Lubbock | $375.90 | $895 |
| Covenant Specialty Hospital | Lubbock | $375.90 | $895 |
| HCA Houston ER 24/7 - Fairmont | Pasadena | $380.12 | $380.12 |
| HCA Houston ER 24/7 - North Channel | Pasadena | $380.12 | $380.12 |
| HCA Houston Southeast | Pasadena | $380.12 | $380.12 |
| Children's Medical Center of Dallas | Dallas | $413.25 | $551 |
| Children's Medical Center of Plano | Plano | $413.25 | $551 |
| Medical City ER White Settlement | Fort Worth | $442.90 | $442.90 |
| Medical City Fort Worth Hospital | Fort Worth | $442.90 | $442.90 |
| Methodist Hospital Hill Country | Fredericksburg | $444.73 | $444.73 |
| Medical City Frisco Hospital | Frisco | $460.65 | $460.65 |
| Medical City Plano Hospital | Plano | $460.65 | $460.65 |
| Medical City Sachse Hospital | Sachse | $460.65 | $460.65 |
| Medical City Green Oaks Hospital | Dallas | $594.86 | $594.86 |
| Medical City Mental Health and Wellness Center - Alliance | Fort Worth | $594.86 | $594.86 |
| Medical City Mental Health and Wellness Center Frisco | Frisco | $594.86 | $594.86 |
| South Texas Health System McAllen | McAllen | $613.50 | $818 |
| Medical City Argyle Hospital | Argyle | $695.50 | $695.50 |
| Medical City Decatur Behavioral Health | Decatur | $695.50 | $695.50 |
| Medical City Decatur Hospital | Decatur | $695.50 | $695.50 |
| Medical City Denton Hospital | Denton | $695.50 | $695.50 |
| Medical City ER Argyle | Denton | $695.50 | $695.50 |
| North Austin Medical Center | Austin | $704 | $704 |
| St. David's Emergency Center Pflugerville | Austin | $704 | $704 |
| St. David's Emergency Center – Anderson Mill | Austin | $704 | $704 |
| St. David's Emergency Center – Arboretum | Austin | $704 | $704 |
| St. David's Emergency Center – Wells Branch | Austin | $704 | $704 |
| St. David's Surgical Hospital | Austin | $704 | $704 |
| South Austin Medical Center | Bastrop | $735 | $735 |
| St. David's Emergency Center - Bastrop | Bastrop | $735 | $735 |
| St. David's Emergency Center - Bee Cave | Bastrop | $735 | $735 |
| St. David's Emergency Center – South Lamar | Bastrop | $735 | $735 |
| ER 24/7 Edinburg | Edinburg | $777.52 | $777.52 |
| ER 24/7 McAllen | Edinburg | $777.52 | $777.52 |
| ER 24/7 Mission | Edinburg | $777.52 | $777.52 |
| ER 24/7 San Juan | Edinburg | $777.52 | $777.52 |
| Rio Grande Regional Hospital | Edinburg | $777.52 | $777.52 |
| Houston Methodist Baytown Hospital | Baytown | $790.50 | $1,581 |
| Houston Methodist Clear Lake Hospital | Nassau Bay | $790.50 | $1,581 |
| Houston Methodist Continuing Care Hospital | Katy | $790.50 | $1,581 |
| Houston Methodist Cypress Hospital | Cypress | $790.50 | $1,581 |
| Houston Methodist Emergency Care Center at Cinco Ranch | Houston | $790.50 | $1,581 |
| Houston Methodist Emergency Care Center in Cypress | Houston | $790.50 | $1,581 |
| Houston Methodist Emergency Care Center in Deer Park | Nassau Bay | $790.50 | $1,581 |
| Houston Methodist Emergency Care Center in League City | Nassau Bay | $790.50 | $1,581 |
| Houston Methodist Emergency Care Center in Magnolia | Houston | $790.50 | $1,581 |
| Houston Methodist Emergency Care Center in Sienna | Houston | $790.50 | $1,581 |
| Houston Methodist Emergency Care Center in Spring | The Woodlands | $790.50 | $1,581 |
| Houston Methodist Emergency Care Center in The Woodlands | The Woodlands | $790.50 | $1,581 |
| Houston Methodist Sugar Land Hospital | Sugar Land | $790.50 | $1,581 |
| Houston Methodist The Woodlands Hospital | The Woodlands | $790.50 | $1,581 |
| Houston Methodist West Hospital | Houston | $790.50 | $1,581 |
| Houston Methodist Willowbrook Hospital | Houston | $790.50 | $1,581 |
| Medical City Weatherford Hospital | Weatherford | $803.37 | $803.37 |
| South Texas Health System Edinburg | Edinburg | $869.25 | $1,159 |
| South Texas Health System Heart | McAllen | $869.25 | $1,159 |
| Round Rock Medical Center | Leander | $892 | $892 |
| St. David's Emergency Center - Leander | Leander | $892 | $892 |
| Medical City Heart Hospital | Dallas | $908.39 | $908.39 |
| Medical City Spine Hospital | Dallas | $908.39 | $908.39 |
| Methodist Childrens Hospital | San Antonio | $945.08 | $945.08 |
| Methodist ER Alamo Heights | San Antonio | $945.08 | $945.08 |
| Methodist ER Boerne | San Antonio | $945.08 | $945.08 |
| Methodist ER Bulverde | Spring Branch | $945.08 | $945.08 |
| Methodist ER City Base | San Antonio | $945.08 | $945.08 |
| Methodist ER Converse | San Antonio | $945.08 | $945.08 |
| Methodist ER De Zavala Rd | San Antonio | $945.08 | $945.08 |
| Methodist ER Helotes | San Antonio | $945.08 | $945.08 |
| Methodist ER Legacy Trails | San Antonio | $945.08 | $945.08 |
| Methodist ER Nacogdoches | San Antonio | $945.08 | $945.08 |
| Methodist ER Westover Hills | San Antonio | $945.08 | $945.08 |
| Methodist Hospital | San Antonio | $945.08 | $945.08 |
| Methodist Hospital Atascosa | Jourdanton | $945.08 | $945.08 |
| Methodist Hospital Landmark | San Antonio | $945.08 | $945.08 |
| Methodist Hospital Stone Oak | Spring Branch | $945.08 | $945.08 |
| Methodist Hospital Westover Hills | San Antonio | $945.08 | $945.08 |
| Methodist Rehabilitation Hospital Texsan | San Antonio | $945.08 | $945.08 |
| Methodist Specialty & Transplant Hospital | San Antonio | $945.08 | $945.08 |
| Methodist Stone Oak Rehabilitation Hospital | San Antonio | $945.08 | $945.08 |
| Methodist Texsan Hospital | San Antonio | $945.08 | $945.08 |
| Metropolitan Methodist Hospital | San Antonio | $945.08 | $945.08 |
| New Braunfels ER | San Antonio | $945.08 | $945.08 |
| Northeast Methodist Hospital | San Antonio | $945.08 | $945.08 |
| South Texas Health System Behavioral | Edinburg | $999 | $1,332 |
| St. David's Georgetown | Georgetown | $1,138 | $1,138 |
| St. David's Emergency Center – Manor | Manor | $1,181 | $1,181 |
| St. David's Emergency Center – Mueller | Manor | $1,181 | $1,181 |
| St. David's Emergency Center – Riverside | Manor | $1,181 | $1,181 |
| St. David's Medical Center | Manor | $1,181 | $1,181 |
| St. David's Rehabilitation Hospital | Austin | $1,181 | $1,181 |
| Heart Hospital of Austin | Austin | $1,229 | $1,229 |
| Heart Hospital of Austin at St. Davids Round Rock | Round Rock | $1,229 | $1,229 |
| HCA Houston ER 24/7 - Mission Bend | Houston | $1,236 | $1,236 |
| HCA Houston ER 24/7 - Stafford | Houston | $1,236 | $1,236 |
| HCA Houston ER 24/7 - Westchase | Houston | $1,236 | $1,236 |
| HCA Houston West | Houston | $1,236 | $1,236 |
| Medical City Arlington Hospital | Arlington | $1,278.76 | $1,278.76 |
| Medical City ER Grand Prarie | Arlington | $1,278.76 | $1,278.76 |
| Medical City ER Red Oak | Arlington | $1,278.76 | $1,278.76 |
| Medical City North Hills Hospital | North Richland Hills | $1,314.44 | $1,314.44 |
| Medical City Alliance Hospital | Fort Worth | $1,318.27 | $1,318.27 |
| Medical City ER Haslet | Fort Worth | $1,318.27 | $1,318.27 |
| Medical City ER Saginaw | Fort Worth | $1,318.27 | $1,318.27 |
| Medical City Surgical Hospital Alliance | Fort Worth | $1,318.27 | $1,318.27 |
| HCA Houston ER 24/7 - Fort Bend Parkway | Houston | $1,362.86 | $1,362.86 |
| HCA Houston Pearland | Houston | $1,362.86 | $1,362.86 |
| Medical City ER Stonebridge | McKinney | $1,544.92 | $1,544.92 |
| Medical City McKinney Hospital | McKinney | $1,544.92 | $1,544.92 |
| HCA Houston Conroe | Conroe | $1,571.50 | $1,571.50 |
| Medical City Lewisville Hospital | Lewisville | $1,604.95 | $1,604.95 |
| Medical City Las Colinas Hospital | Irving | $1,658.57 | $1,658.57 |
| HCA Houston Rehabilitation Hospital Southeast | Pasadena | $1,698.56 | $1,698.56 |
| HCA Houston ER 24/7 Bellaire | Houston | $1,781.90 | $1,781.90 |
| HCA Houston ER 24/7 Heights | Houston | $1,781.90 | $1,781.90 |
| HCA Houston ER 24/7 Memorial City | Houston | $1,781.90 | $1,781.90 |
| HCA Houston ER 24/7 Montrose | Houston | $1,781.90 | $1,781.90 |
| HCA Houston Medical Center | Houston | $1,781.90 | $1,781.90 |
| HCA Houston ER 24/7 - Cypress/fm 1960 | Houston | $1,920.22 | $1,920.22 |
| HCA Houston ER 24/7 – Jersey Village | Houston | $1,920.22 | $1,920.22 |
| HCA Houston Tomball | Houston | $1,920.22 | $1,920.22 |
| HCA Houston Clear Lake | Alvin | $1,942.31 | $1,942.31 |
| HCA Houston ER 24/7 - Alvin | Alvin | $1,942.31 | $1,942.31 |
| HCA Houston ER 24/7 - Friendswood | Alvin | $1,942.31 | $1,942.31 |
| HCA Houston ER 24/7 - Pearland | Alvin | $1,942.31 | $1,942.31 |
| HCA Houston ER 24/7 - Texas City | Alvin | $1,942.31 | $1,942.31 |
| HCA Houston Mainland | Texas City | $1,942.31 | $1,942.31 |
| ER 24/7 Brownsville | Brownsville | $2,019.57 | $2,019.57 |
| ER 24/7 Harlingen | Brownsville | $2,019.57 | $2,019.57 |
| Valley Regional Medical Center | Brownsville | $2,019.57 | $2,019.57 |
| HCA Houston ER 24/7 Fallbrook | Houston | $2,053.77 | $2,053.77 |
| HCA Houston ER 24/7 Spring | Houston | $2,053.77 | $2,053.77 |
| HCA Houston Northwest | Houston | $2,053.77 | $2,053.77 |
| HCA Houston ER 24/7 - Atascocita | Humble | $2,191.41 | $2,191.41 |
| HCA Houston ER 24/7 - Cleveland | Humble | $2,191.41 | $2,191.41 |
| HCA Houston ER 24/7 - Fall Creek | Humble | $2,191.41 | $2,191.41 |
| HCA Houston ER 24/7 - Fry Road | Houston | $2,191.41 | $2,191.41 |
| HCA Houston ER 24/7 - Towne Lake | Houston | $2,191.41 | $2,191.41 |
| HCA Houston ER 24/7 Copperfield | Houston | $2,191.41 | $2,191.41 |
| HCA Houston ER 24/7 Willowbrook | Houston | $2,191.41 | $2,191.41 |
| HCA Houston Kingwood | Humble | $2,191.41 | $2,191.41 |
| HCA Houston North Cypress | Houston | $2,191.41 | $2,191.41 |
| CHRISTUS Santa Rosa Hospital - San Marcos | San Marcos | Not published | Not published |
| Northwest Emergency at Eastern, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $383 |
| Northwest Emergency at Tascosa, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $383 |
| Northwest Emergency at Town Square, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $383 |
| Northwest Emergency on Georgia, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $383 |
| Northwest Texas Healthcare System | Amarillo | Not published | $383 |
| Northwest Texas Healthcare System Behavioral Health | Amarillo | Not published | $730 |
| Northwest Texas Healthcare System Surgery Center | Amarillo | Not published | $944 |
| University of Texas MD Anderson Cancer Center | Houston | Not published | $365 |
