| BSA Hospital | Amarillo | $7.10 | $71 |
| Harrington Cancer Center | Amarillo | $7.10 | $71 |
| South Texas Health System Edinburg | Edinburg | $9 | $12 |
| South Texas Health System Heart | McAllen | $9 | $12 |
| South Texas Health System McAllen | McAllen | $9 | $12 |
| Harris Health Ben Taub Hospital | Houston | $9.71 | $111 |
| Harris Health Lyndon B Johnson Hospital | Houston | $9.71 | $111 |
| Texas Health Presbyterian Hospital Allen | Allen | $11.25 | $18.75 |
| UTHealth East Texas Tyler | Tyler | $16 | $160 |
| UTHealth East Texas Rehabilitation Center | Tyler | $16.50 | $165 |
| University Medical Center Surgical Hospital | El Paso | $17.58 | $87.92 |
| University Medical Center of El Paso | El Paso | $17.58 | $87.92 |
| UTHealth East Texas North Campus | Tyler | $17.60 | $176 |
| University Health Dialysis Medical Center | San Antonio | $27 | $108 |
| University Health Dialysis South | San Antonio | $27 | $108 |
| University Health Dialysis Southeast | San Antonio | $27 | $108 |
| University Health Dialysis West at Texas Diabetes Institute | San Antonio | $27 | $108 |
| University Health System Children's Kidney Center | San Antonio | $27 | $108 |
| University Hospital | San Antonio | $27 | $108 |
| Methodist Dallas Medical Center | Dallas | $30.60 | $102 |
| Methodist Mansfield Medical Center | Mansfield | $30.60 | $102 |
| Methodist Richardson Medical Center | Richardson | $30.60 | $102 |
| Methodist Richardson Medical Center Campus for Continuing Care | Richardson | $30.60 | $102 |
| UTHealth East Texas Quitman | Quitman | $31.17 | $311.75 |
| UTHealth East Texas Pittsburg | Pittsburg | $31.27 | $312.73 |
| CHRISTUS Santa Rosa Hospital - Westover Hills | San Antonio | $32.34 | $98 |
| St. Joseph Health Regional Hospital | Bryan | $34.19 | $165 |
| St. Joseph Health College Station Hospital | College Station | $34.41 | $165 |
| UTHealth East Texas Athens | Athens | $37.70 | $377 |
| JPS Health Network | Fort Worth | $37.80 | $63 |
| Trinity Spring North | Fort Worth | $37.80 | $63 |
| Ascension Providence | Waco | $38.43 | $106.75 |
| St. Joseph Health Madison Hospital | Madisonville | $38.88 | $165 |
| UMC Children's Hospital | Lubbock | $39 | $39 |
| UMC Health & Wellness Hospital | Lubbock | $39 | $39 |
| University Medical Center | Lubbock | $39 | $39 |
| St. Joseph Health Burleson Hospital | Caldwell | $39.21 | $165 |
| Ascension Seton Edgar B. Davis (Ascension Seton) | Luling | $41.58 | $115.50 |
| Ascension Seton Highland Lakes (Ascension Seton) | Burnet | $41.58 | $115.50 |
| UTHealth East Texas Carthage | Carthage | $43.70 | $437 |
| UTHealth East Texas Henderson | Henderson | $44.40 | $444 |
| Memorial Hermann Greater Heights Hospital | Houston | $46.88 | $146.50 |
| Memorial Hermann Katy Hospital | Katy | $46.88 | $146.50 |
| Memorial Hermann Memorial City Medical Center | Houston | $46.88 | $146.50 |
| Memorial Hermann Northeast Hospital | Humble | $46.88 | $146.50 |
| Memorial Hermann Pearland Hospital | Pearland | $46.88 | $146.50 |
| Memorial Hermann Rehabilitation Hospital-Katy | Katy | $46.88 | $146.50 |
| Memorial Hermann Southeast Hospital | Houston | $46.88 | $146.50 |
| Memorial Hermann Southwest Hospital | Houston | $46.88 | $146.50 |
| Memorial Hermann Sugar Land Hospital | Sugar Land | $46.88 | $146.50 |
| Memorial Hermann The Woodlands Medical Center | The Woodlands | $46.88 | $146.50 |
| TIRR Memorial Hermann | Houston | $46.88 | $146.50 |
| Methodist Celina Medical Center | Celina | $47.40 | $158 |
| Methodist Midlothian Medical Center | Midlothian | $47.40 | $158 |
| Methodist Southlake Medical Center | Southlake | $47.40 | $158 |
| UTHealth East Texas Jacksonville | Jacksonville | $47.90 | $479 |
| Covenant Health Emergency Center - Milwaukee Ave | Lubbock | $50.82 | $121 |
| Covenant Health Emergency Center - Quaker Ave | Lubbock | $50.82 | $121 |
| Covenant Medical Center | Lubbock | $50.82 | $121 |
| William P Clements Jr University Hospital | Dallas | $51 | $68 |
| Covenant Hospital Levelland | Levelland | $52.08 | $124 |
| Texas Health Harris Methodist Hospital Fort Worth | Fort Worth | $53.25 | $88.75 |
| Texas Health Harris Methodist Hospital Hurst-Euless-Bedford | Bedford | $53.25 | $88.75 |
| Texas Health Presbyterian Hospital Flower Mound | Flower Mound | $53.25 | $88.75 |
| Texas Health Presbyterian Hospital Plano | Plano | $53.25 | $88.75 |
| Children's Memorial Hermann Hospital | Houston | $57.28 | $179 |
| Memorial Hermann Cypress Hospital | Cypress | $57.28 | $179 |
| Memorial Hermann Imaging Center (Bellaire) | Bellaire | $57.28 | $179 |
| Memorial Hermann Imaging Center (Cypress) | Cypress | $57.28 | $179 |
| Memorial Hermann Imaging Center (Texas Medical Center) | Houston | $57.28 | $179 |
| Memorial Hermann Imaging Center (Upper Kirby) | Houston | $57.28 | $179 |
| Memorial Hermann Rockets Orthopedic Hospital | Bellaire | $57.28 | $179 |
| Memorial Hermann-Texas Medical Center | Houston | $57.28 | $179 |
| Covenant Hospital Plainview | Plainview | $57.54 | $137 |
| St. Luke's Health Memorial Livingston | Livingston | $57.90 | $386 |
| St. Luke's Health Memorial Lufkin | Lufkin | $57.90 | $386 |
| St. Luke's Health Memorial San Augustine | San Augustine | $57.90 | $386 |
| Ascension Seton Hays (Ascension Seton) | Kyle | $60.75 | $168.75 |
| Ascension Seton Smithville (Ascension Seton) | Smithville | $63.27 | $175.75 |
| Dell Seton Medical Center at The University of Texas (Ascension Seton) | Austin | $63.27 | $175.75 |
| Parkland Health | Dallas | $66 | $165 |
| Ascension Seton Medical Center Austin (Ascension Seton) | Austin | $70.20 | $195 |
| Ascension Seton Northwest (Ascension Seton) | Austin | $70.20 | $195 |
| Ascension Seton Southwest (Ascension Seton) | 1826 Austin | $70.20 | $195 |
| Baylor Scott & White Continuing Care Hospital | Temple | $89.75 | $149.58 |
| Baylor Scott & White McLane Children's Medical Center | Temple | $89.75 | $149.58 |
| Baylor Scott & White Medical Center - Brenham | Brenham | $89.75 | $149.58 |
| Baylor Scott & White Medical Center - College Station | College Station | $89.75 | $149.58 |
| Baylor Scott & White Medical Center - Marble Falls | Marble Falls | $89.75 | $149.58 |
| Baylor Scott & White Medical Center - Temple | Temple | $89.75 | $149.58 |
| Baylor Scott & White Medical Center Hillcrest | Waco | $89.75 | $149.58 |
| Baylor Scott & White Pavilion - Temple | Temple | $89.75 | $149.58 |
| Longview Regional Medical Center | Longview | $93.02 | $344.50 |
| Hendrick Medical Center Brownwood | Brownwood | $94.75 | $189.50 |
| Texas Children's Hospital | Houston | $99.16 | $148 |
| Texas Children's Hospital North Austin Campus | Austin | $99.16 | $148 |
| Texas Children's Hospital The Woodlands | The Woodlands | $99.16 | $148 |
| Texas Children's Hospital West Campus | Houston | $99.16 | $148 |
| Texas Health Arlington Memorial Hospital | Arlington | $113.55 | $189.25 |
| Texas Health Center for Diagnostics and Surgery Plano | Plano | $113.55 | $189.25 |
| Texas Health Harris Methodist Hospital Alliance | Fort Worth | $113.55 | $189.25 |
| Texas Health Harris Methodist Hospital Azle | Azle | $113.55 | $189.25 |
| Texas Health Harris Methodist Hospital Cleburne | Cleburne | $113.55 | $189.25 |
| Texas Health Harris Methodist Hospital Southlake | Southlake | $113.55 | $189.25 |
| Texas Health Harris Methodist Hospital Southwest Fort Worth | Fort Worth | $113.55 | $189.25 |
| Texas Health Harris Methodist Hospital Stephenville | Stephenville | $113.55 | $189.25 |
| Texas Health Heart & Vascular Hospital Arlington | Arlington | $113.55 | $189.25 |
| Texas Health Hospital Clearfork | Fort Worth | $113.55 | $189.25 |
| Texas Health Hospital Frisco | Frisco | $113.55 | $189.25 |
| Texas Health Hospital Rockwall | Rockwall | $113.55 | $189.25 |
| Texas Health Presbyterian Hospital Dallas | Dallas | $113.55 | $189.25 |
| Texas Health Presbyterian Hospital Denton | Denton | $113.55 | $189.25 |
| Texas Health Specialty Hospital Fort Worth | Fort Worth | $113.55 | $189.25 |
| Baylor Scott & White All Saints Medical Center - Fort Worth | Fort Worth | $115.97 | $193.28 |
| Baylor Scott & White Heart and Vascular Hospital - Dallas | Dallas | $115.97 | $193.28 |
| Baylor Scott & White Heart and Vascular Hospital - Waxahachie | Waxahachie | $115.97 | $193.28 |
| Baylor Scott & White Medical Center - Centennial | Frisco | $115.97 | $193.28 |
| Baylor Scott & White Medical Center - Frisco at PGA Parkway | Frisco | $115.97 | $193.28 |
| Baylor Scott & White Medical Center - Grapevine | Grapevine | $115.97 | $193.28 |
| Baylor Scott & White Medical Center - Irving | Irving | $115.97 | $193.28 |
| Baylor Scott & White Medical Center - Lake Pointe | Rowlett | $115.97 | $193.28 |
| Baylor Scott & White Medical Center - McKinney | McKinney | $115.97 | $193.28 |
| Baylor Scott & White Medical Center - Plano | Plano | $115.97 | $193.28 |
| Baylor Scott & White Medical Center - Waxahachie | Waxahachie | $115.97 | $193.28 |
| Baylor Scott & White the Heart Hospital - Denton | Denton | $115.97 | $193.28 |
| Baylor Scott & White the Heart Hospital - McKinney | McKinney | $115.97 | $193.28 |
| Baylor Scott & White the Heart Hospital - Plano | Plano | $115.97 | $193.28 |
| Baylor University Medical Center | Dallas | $115.97 | $193.28 |
| Dell Children's Medical Center (Ascension Seton) | Austin | $123.03 | $175.75 |
| Dell Children's Medical Center North Campus (Ascension Seton) | Austin | $123.03 | $175.75 |
| Medical City Children's Hospital | Garland | $124.23 | $124.23 |
| Medical City Dallas Hospital | Garland | $124.23 | $124.23 |
| Medical City ER Garland | Garland | $124.23 | $124.23 |
| Baylor Scott & White Emergency Medical Center - Cedar Park | Cedar Park | $128.92 | $214.87 |
| Baylor Scott & White Medical Center - Austin | Austin | $128.92 | $214.87 |
| Baylor Scott & White Medical Center - Buda | Buda | $128.92 | $214.87 |
| Baylor Scott & White Medical Center - Lakeway | Lakeway | $128.92 | $214.87 |
| Baylor Scott & White Medical Center - Pflugerville | Pflugerville | $128.92 | $214.87 |
| Baylor Scott & White Medical Center - Round Rock | Round Rock | $128.92 | $214.87 |
| Baylor Scott & White Medical Center - Taylor | Taylor | $128.92 | $214.87 |
| CHRISTUS Health - West Beaumont | Beaumont | $130.35 | $395 |
| CHRISTUS Hospital - Orange | Orange | $130.35 | $395 |
| CHRISTUS Southeast Texas - MidCounty | Port Arthur | $130.35 | $395 |
| CHRISTUS Southeast Texas Orthopedic Specialty Center | Port Arthur | $130.35 | $395 |
| CHRISTUS Southeast Texas St. Elizabeth | Beaumont | $130.35 | $395 |
| Texas Health Presbyterian Hospital Kaufman | Kaufman | $133.20 | $222 |
| Midland County Hospital District | Midland | $135 | $180 |
| Midland Memorial Hospital | Midland | $135 | $180 |
| Shannon Medical Center | San Angelo | $137 | $274 |
| Shannon Medical Center Big Spring | Big Spring | $137 | $274 |
| Shannon Medical Center South | San Angelo | $137 | $274 |
| Shannon Medical Center St John's Campus | San Angelo | $137 | $274 |
| Shannon River Crest Hospital | San Angelo | $137 | $274 |
| United Regional Health Care System | Wichita Falls | $147.13 | $166.25 |
| Medical Center Hospital | Odessa | $149 | $149 |
| Cook Children's Medical Center - Prosper | Prosper | $151.49 | $201.99 |
| Medical City Mental Health and Wellness Center Frisco | Frisco | $156.46 | $156.46 |
| Medical City Green Oaks Hospital | Dallas | $168.98 | $168.98 |
| Medical City Mental Health and Wellness Center - Alliance | Fort Worth | $168.98 | $168.98 |
| Ascension Seton Cedar Park Hospital | Cedar Park | $184.67 | $512.98 |
| Children's Medical Center of Dallas | Dallas | $191.25 | $255 |
| Children's Medical Center of Plano | Plano | $191.25 | $255 |
| Hendrick Medical Center | Abilene | $193.55 | $387.10 |
| Hendrick Medical Center South | Abilene | $193.55 | $387.10 |
| Behavioral Medicine at Renaissance | Edinburg | $200 | $200 |
| Doctors Hospital at Renaissance | Edinburg | $200 | $200 |
| Rehab Center at Renaissance | Edinburg | $200 | $200 |
| Womens Hospitalat Renaissance | Edinburg | $200 | $200 |
| Houston Methodist Emergency Care Center at Kirby | Houston | $205.50 | $411 |
| Houston Methodist Emergency Care Center at Voss | Houston | $205.50 | $411 |
| Houston Methodist Emergency Care Center in Pearland | Houston | $205.50 | $411 |
| Houston Methodist Hospital | Houston | $205.50 | $411 |
| DHR Health Brownsville | Brownsville | $210 | $210 |
| Houston Methodist Baytown Hospital | Baytown | $248 | $496 |
| Houston Methodist Clear Lake Hospital | Nassau Bay | $248 | $496 |
| Houston Methodist Continuing Care Hospital | Katy | $248 | $496 |
| Houston Methodist Cypress Hospital | Cypress | $248 | $496 |
| Houston Methodist Emergency Care Center at Cinco Ranch | Houston | $248 | $496 |
| Houston Methodist Emergency Care Center in Cypress | Houston | $248 | $496 |
| Houston Methodist Emergency Care Center in Deer Park | Nassau Bay | $248 | $496 |
| Houston Methodist Emergency Care Center in League City | Nassau Bay | $248 | $496 |
| Houston Methodist Emergency Care Center in Magnolia | Houston | $248 | $496 |
| Houston Methodist Emergency Care Center in Sienna | Houston | $248 | $496 |
| Houston Methodist Emergency Care Center in Spring | The Woodlands | $248 | $496 |
| Houston Methodist Emergency Care Center in The Woodlands | The Woodlands | $248 | $496 |
| Houston Methodist Sugar Land Hospital | Sugar Land | $248 | $496 |
| Houston Methodist The Woodlands Hospital | The Woodlands | $248 | $496 |
| Houston Methodist West Hospital | Houston | $248 | $496 |
| Houston Methodist Willowbrook Hospital | Houston | $248 | $496 |
| Cook Children's Medical Center | Fort Worth | $272.01 | $362.68 |
| Medical City Lewisville Hospital | Lewisville | $313.51 | $313.51 |
| Covenant Children's Hospital | Lubbock | $315.84 | $752 |
| Covenant Specialty Hospital | Lubbock | $315.84 | $752 |
| Medical City Weatherford Hospital | Weatherford | $401.98 | $401.98 |
| Heart Hospital of Austin | Austin | $440 | $440 |
| Heart Hospital of Austin at St. Davids Round Rock | Round Rock | $440 | $440 |
| St. David's Emergency Center – Manor | Manor | $440 | $440 |
| St. David's Emergency Center – Mueller | Manor | $440 | $440 |
| St. David's Emergency Center – Riverside | Manor | $440 | $440 |
| St. David's Medical Center | Manor | $440 | $440 |
| St. David's Rehabilitation Hospital | Austin | $440 | $440 |
| Methodist Childrens Hospital | San Antonio | $481.45 | $481.45 |
| Methodist ER Boerne | San Antonio | $481.45 | $481.45 |
| Methodist ER Converse | San Antonio | $481.45 | $481.45 |
| Methodist ER De Zavala Rd | San Antonio | $481.45 | $481.45 |
| Methodist ER Helotes | San Antonio | $481.45 | $481.45 |
| Methodist ER Legacy Trails | San Antonio | $481.45 | $481.45 |
| Methodist ER Nacogdoches | San Antonio | $481.45 | $481.45 |
| Methodist ER Westover Hills | San Antonio | $481.45 | $481.45 |
| Methodist Hospital | San Antonio | $481.45 | $481.45 |
| Methodist Hospital Hill Country | Fredericksburg | $481.45 | $481.45 |
| Methodist Rehabilitation Hospital Texsan | San Antonio | $481.45 | $481.45 |
| Methodist Texsan Hospital | San Antonio | $481.45 | $481.45 |
| New Braunfels ER | San Antonio | $481.45 | $481.45 |
| Northeast Methodist Hospital | San Antonio | $481.45 | $481.45 |
| HCA Houston ER 24/7 - Cypress/fm 1960 | Houston | $487.91 | $487.91 |
| HCA Houston ER 24/7 – Jersey Village | Houston | $487.91 | $487.91 |
| HCA Houston Tomball | Houston | $487.91 | $487.91 |
| Methodist ER Alamo Heights | San Antonio | $506.90 | $506.90 |
| Methodist ER Bulverde | Spring Branch | $506.90 | $506.90 |
| Methodist ER City Base | San Antonio | $506.90 | $506.90 |
| Methodist Hospital Atascosa | Jourdanton | $506.90 | $506.90 |
| Methodist Hospital Landmark | San Antonio | $506.90 | $506.90 |
| Methodist Hospital Stone Oak | Spring Branch | $506.90 | $506.90 |
| Methodist Hospital Westover Hills | San Antonio | $506.90 | $506.90 |
| Methodist Specialty & Transplant Hospital | San Antonio | $506.90 | $506.90 |
| Methodist Stone Oak Rehabilitation Hospital | San Antonio | $506.90 | $506.90 |
| Metropolitan Methodist Hospital | San Antonio | $506.90 | $506.90 |
| Medical City Arlington Hospital | Arlington | $509.78 | $509.78 |
| Medical City ER Grand Prarie | Arlington | $509.78 | $509.78 |
| Medical City ER Red Oak | Arlington | $509.78 | $509.78 |
| South Austin Medical Center | Bastrop | $538 | $538 |
| St. David's Emergency Center - Bastrop | Bastrop | $538 | $538 |
| St. David's Emergency Center - Bee Cave | Bastrop | $538 | $538 |
| St. David's Emergency Center – South Lamar | Bastrop | $538 | $538 |
| HCA Houston ER 24/7 Bellaire | Houston | $566 | $566 |
| HCA Houston ER 24/7 Heights | Houston | $566 | $566 |
| HCA Houston ER 24/7 Memorial City | Houston | $566 | $566 |
| HCA Houston ER 24/7 Montrose | Houston | $566 | $566 |
| HCA Houston Medical Center | Houston | $566 | $566 |
| HCA Houston ER 24/7 - Mission Bend | Houston | $575 | $575 |
| HCA Houston ER 24/7 - Stafford | Houston | $575 | $575 |
| HCA Houston ER 24/7 - Westchase | Houston | $575 | $575 |
| HCA Houston West | Houston | $575 | $575 |
| South Texas Health System Behavioral | Edinburg | $584.25 | $779 |
| HCA Houston ER 24/7 - Atascocita | Humble | $587.65 | $587.65 |
| HCA Houston ER 24/7 - Cleveland | Humble | $587.65 | $587.65 |
| HCA Houston ER 24/7 - Fall Creek | Humble | $587.65 | $587.65 |
| HCA Houston ER 24/7 - Fry Road | Houston | $587.65 | $587.65 |
| HCA Houston ER 24/7 - Towne Lake | Houston | $587.65 | $587.65 |
| HCA Houston ER 24/7 Copperfield | Houston | $587.65 | $587.65 |
| HCA Houston ER 24/7 Willowbrook | Houston | $587.65 | $587.65 |
| HCA Houston Kingwood | Humble | $587.65 | $587.65 |
| HCA Houston North Cypress | Houston | $587.65 | $587.65 |
| Medical City ER White Settlement | Fort Worth | $602.93 | $602.93 |
| Medical City Fort Worth Hospital | Fort Worth | $602.93 | $602.93 |
| St. David's Georgetown | Georgetown | $627 | $627 |
| HCA Houston Conroe | Conroe | $646.51 | $646.51 |
| Round Rock Medical Center | Leander | $664 | $664 |
| St. David's Emergency Center - Leander | Leander | $664 | $664 |
| Medical City North Hills Hospital | North Richland Hills | $693.69 | $693.69 |
| North Austin Medical Center | Austin | $698 | $698 |
| St. David's Emergency Center Pflugerville | Austin | $698 | $698 |
| St. David's Emergency Center – Anderson Mill | Austin | $698 | $698 |
| St. David's Emergency Center – Arboretum | Austin | $698 | $698 |
| St. David's Emergency Center – Wells Branch | Austin | $698 | $698 |
| St. David's Surgical Hospital | Austin | $698 | $698 |
| Medical City Heart Hospital | Dallas | $759.96 | $759.96 |
| Medical City Spine Hospital | Dallas | $759.96 | $759.96 |
| Medical City Alliance Hospital | Fort Worth | $797.36 | $797.36 |
| Medical City ER Haslet | Fort Worth | $797.36 | $797.36 |
| Medical City ER Saginaw | Fort Worth | $797.36 | $797.36 |
| Medical City Surgical Hospital Alliance | Fort Worth | $797.36 | $797.36 |
| Medical City Frisco Hospital | Frisco | $828.40 | $828.40 |
| Medical City Plano Hospital | Plano | $828.40 | $828.40 |
| Medical City Sachse Hospital | Sachse | $828.40 | $828.40 |
| Medical City Argyle Hospital | Argyle | $1,012.66 | $1,012.66 |
| Medical City Decatur Behavioral Health | Decatur | $1,012.66 | $1,012.66 |
| Medical City Decatur Hospital | Decatur | $1,012.66 | $1,012.66 |
| Medical City Denton Hospital | Denton | $1,012.66 | $1,012.66 |
| Medical City ER Argyle | Denton | $1,012.66 | $1,012.66 |
| ER 24/7 Brownsville | Brownsville | $1,018.09 | $1,018.09 |
| ER 24/7 Harlingen | Brownsville | $1,018.09 | $1,018.09 |
| Valley Regional Medical Center | Brownsville | $1,018.09 | $1,018.09 |
| Medical City Las Colinas Hospital | Irving | $1,063.08 | $1,063.08 |
| HCA Houston ER 24/7 - Fort Bend Parkway | Houston | $1,241.88 | $1,241.88 |
| HCA Houston Pearland | Houston | $1,241.88 | $1,241.88 |
| ER 24/7 Edinburg | Edinburg | $1,280.59 | $1,280.59 |
| ER 24/7 McAllen | Edinburg | $1,280.59 | $1,280.59 |
| ER 24/7 Mission | Edinburg | $1,280.59 | $1,280.59 |
| ER 24/7 San Juan | Edinburg | $1,280.59 | $1,280.59 |
| Rio Grande Regional Hospital | Edinburg | $1,280.59 | $1,280.59 |
| HCA Houston ER 24/7 - Fairmont | Pasadena | $1,321.35 | $1,321.35 |
| HCA Houston ER 24/7 - North Channel | Pasadena | $1,321.35 | $1,321.35 |
| HCA Houston Rehabilitation Hospital Southeast | Pasadena | $1,321.35 | $1,321.35 |
| HCA Houston Southeast | Pasadena | $1,321.35 | $1,321.35 |
| Medical City ER Stonebridge | McKinney | $1,333 | $1,333 |
| Medical City McKinney Hospital | McKinney | $1,333 | $1,333 |
| HCA Houston Clear Lake | Alvin | $1,428.90 | $1,428.90 |
| HCA Houston ER 24/7 - Alvin | Alvin | $1,428.90 | $1,428.90 |
| HCA Houston ER 24/7 - Friendswood | Alvin | $1,428.90 | $1,428.90 |
| HCA Houston ER 24/7 - Pearland | Alvin | $1,428.90 | $1,428.90 |
| HCA Houston ER 24/7 - Texas City | Alvin | $1,428.90 | $1,428.90 |
| HCA Houston Mainland | Texas City | $1,428.90 | $1,428.90 |
| HCA Houston ER 24/7 Fallbrook | Houston | $2,116.78 | $2,116.78 |
| HCA Houston ER 24/7 Spring | Houston | $2,116.78 | $2,116.78 |
| HCA Houston Northwest | Houston | $2,116.78 | $2,116.78 |
| 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 | $136 |
| Northwest Emergency at Tascosa, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $136 |
| Northwest Emergency at Town Square, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $136 |
| Northwest Emergency on Georgia, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $136 |
| Northwest Texas Healthcare System | Amarillo | Not published | $136 |
| Northwest Texas Healthcare System Behavioral Health | Amarillo | Not published | $455 |
| Northwest Texas Healthcare System Surgery Center | Amarillo | Not published | $455 |
| University of Texas MD Anderson Cancer Center | Houston | Not published | $114 |
