| University Medical Center Surgical Hospital | El Paso | $70.24 | $351.21 |
| William P Clements Jr University Hospital | Dallas | $76.50 | $102 |
| Harris Health Ben Taub Hospital | Houston | $102.04 | $901 |
| Harris Health Lyndon B Johnson Hospital | Houston | $102.04 | $901 |
| UTHealth East Texas Quitman | Quitman | $104.13 | $1,041.35 |
| UTHealth East Texas Pittsburg | Pittsburg | $109.17 | $1,091.74 |
| University Medical Center of El Paso | El Paso | $115.86 | $579.28 |
| UTHealth East Texas Tyler | Tyler | $128.40 | $1,284 |
| CHRISTUS Santa Rosa Hospital - Westover Hills | San Antonio | $156.09 | $473 |
| UTHealth East Texas North Campus | Tyler | $177.20 | $1,772 |
| UTHealth East Texas Athens | Athens | $181.40 | $1,814 |
| University Health Dialysis Medical Center | San Antonio | $182.25 | $729 |
| University Health Dialysis South | San Antonio | $182.25 | $729 |
| University Health Dialysis Southeast | San Antonio | $182.25 | $729 |
| University Health Dialysis West at Texas Diabetes Institute | San Antonio | $182.25 | $729 |
| University Health System Children's Kidney Center | San Antonio | $182.25 | $729 |
| University Hospital | San Antonio | $182.25 | $729 |
| UTHealth East Texas Carthage | Carthage | $184.70 | $1,847 |
| Ascension Seton Hays (Ascension Seton) | Kyle | $191.25 | $531.25 |
| Ascension Seton Smithville (Ascension Seton) | Smithville | $191.25 | $531.25 |
| Ascension Seton Edgar B. Davis (Ascension Seton) | Luling | $224.55 | $623.75 |
| Ascension Seton Highland Lakes (Ascension Seton) | Burnet | $224.55 | $623.75 |
| UTHealth East Texas Jacksonville | Jacksonville | $241.30 | $2,413 |
| Ascension Seton Medical Center Austin (Ascension Seton) | Austin | $256.95 | $713.75 |
| Ascension Seton Northwest (Ascension Seton) | Austin | $256.95 | $713.75 |
| Ascension Seton Southwest (Ascension Seton) | 1826 Austin | $256.95 | $713.75 |
| Dell Seton Medical Center at The University of Texas (Ascension Seton) | Austin | $256.95 | $713.75 |
| Ascension Providence | Waco | $261.27 | $725.75 |
| Covenant Hospital Levelland | Levelland | $270.06 | $643 |
| UTHealth East Texas Henderson | Henderson | $295.10 | $2,951 |
| BSA Hospital | Amarillo | $330.50 | $3,305 |
| Harrington Cancer Center | Amarillo | $330.50 | $3,305 |
| St. Joseph Health Regional Hospital | Bryan | $360.33 | $1,739 |
| St. Joseph Health College Station Hospital | College Station | $362.59 | $1,739 |
| Dell Children's Medical Center (Ascension Seton) | Austin | $371.88 | $531.25 |
| Dell Children's Medical Center North Campus (Ascension Seton) | Austin | $371.88 | $531.25 |
| Covenant Hospital Plainview | Plainview | $375.06 | $893 |
| Methodist Celina Medical Center | Celina | $377.70 | $1,259 |
| Methodist Dallas Medical Center | Dallas | $377.70 | $1,259 |
| Methodist Mansfield Medical Center | Mansfield | $377.70 | $1,259 |
| Methodist Midlothian Medical Center | Midlothian | $377.70 | $1,259 |
| Methodist Richardson Medical Center | Richardson | $377.70 | $1,259 |
| Methodist Richardson Medical Center Campus for Continuing Care | Richardson | $377.70 | $1,259 |
| Methodist Southlake Medical Center | Southlake | $377.70 | $1,259 |
| St. Joseph Health Madison Hospital | Madisonville | $409.71 | $1,739 |
| St. Joseph Health Burleson Hospital | Caldwell | $413.19 | $1,739 |
| Covenant Health Emergency Center - Milwaukee Ave | Lubbock | $459.06 | $1,093 |
| Covenant Health Emergency Center - Quaker Ave | Lubbock | $459.06 | $1,093 |
| Covenant Medical Center | Lubbock | $459.06 | $1,093 |
| Medical City Green Oaks Hospital | Dallas | $478.53 | $478.53 |
| JPS Health Network | Fort Worth | $492 | $820 |
| Trinity Spring North | Fort Worth | $492 | $820 |
| Longview Regional Medical Center | Longview | $532.71 | $1,973 |
| Baylor Scott & White Emergency Medical Center - Cedar Park | Cedar Park | $541.18 | $901.96 |
| Baylor Scott & White Medical Center - Austin | Austin | $541.18 | $901.96 |
| Baylor Scott & White Medical Center - Buda | Buda | $541.18 | $901.96 |
| Baylor Scott & White Medical Center - Lakeway | Lakeway | $541.18 | $901.96 |
| Baylor Scott & White Medical Center - Pflugerville | Pflugerville | $541.18 | $901.96 |
| Baylor Scott & White Medical Center - Round Rock | Round Rock | $541.18 | $901.96 |
| Baylor Scott & White Medical Center - Taylor | Taylor | $541.18 | $901.96 |
| Ascension Seton Cedar Park Hospital | Cedar Park | $586.43 | $1,628.97 |
| St. Luke's Health Memorial Livingston | Livingston | $605.55 | $4,037 |
| St. Luke's Health Memorial Lufkin | Lufkin | $605.55 | $4,037 |
| St. Luke's Health Memorial San Augustine | San Augustine | $605.55 | $4,037 |
| CHRISTUS Health - West Beaumont | Beaumont | $615.78 | $1,866 |
| CHRISTUS Hospital - Orange | Orange | $615.78 | $1,866 |
| CHRISTUS Southeast Texas - MidCounty | Port Arthur | $615.78 | $1,866 |
| CHRISTUS Southeast Texas Orthopedic Specialty Center | Port Arthur | $615.78 | $1,866 |
| CHRISTUS Southeast Texas St. Elizabeth | Beaumont | $615.78 | $1,866 |
| Parkland Health | Dallas | $658.80 | $1,647 |
| Baylor Scott & White Continuing Care Hospital | Temple | $673.78 | $1,122.97 |
| Baylor Scott & White McLane Children's Medical Center | Temple | $673.78 | $1,122.97 |
| Baylor Scott & White Medical Center - Brenham | Brenham | $673.78 | $1,122.97 |
| Baylor Scott & White Medical Center - College Station | College Station | $673.78 | $1,122.97 |
| Baylor Scott & White Medical Center - Marble Falls | Marble Falls | $673.78 | $1,122.97 |
| Baylor Scott & White Medical Center - Temple | Temple | $673.78 | $1,122.97 |
| Baylor Scott & White Medical Center Hillcrest | Waco | $673.78 | $1,122.97 |
| Baylor Scott & White Pavilion - Temple | Temple | $673.78 | $1,122.97 |
| Cook Children's Medical Center | Fort Worth | $713.46 | $951.28 |
| Cook Children's Medical Center - Prosper | Prosper | $713.46 | $951.28 |
| Shannon Medical Center | San Angelo | $786 | $1,572 |
| Shannon Medical Center Big Spring | Big Spring | $786 | $1,572 |
| Shannon Medical Center South | San Angelo | $786 | $1,572 |
| Shannon Medical Center St John's Campus | San Angelo | $786 | $1,572 |
| Shannon River Crest Hospital | San Angelo | $786 | $1,572 |
| Baylor Scott & White All Saints Medical Center - Fort Worth | Fort Worth | $791.89 | $1,319.82 |
| Baylor Scott & White Heart and Vascular Hospital - Dallas | Dallas | $791.89 | $1,319.82 |
| Baylor Scott & White Heart and Vascular Hospital - Waxahachie | Waxahachie | $791.89 | $1,319.82 |
| Baylor Scott & White Medical Center - Centennial | Frisco | $791.89 | $1,319.82 |
| Baylor Scott & White Medical Center - Frisco at PGA Parkway | Frisco | $791.89 | $1,319.82 |
| Baylor Scott & White Medical Center - Grapevine | Grapevine | $791.89 | $1,319.82 |
| Baylor Scott & White Medical Center - Irving | Irving | $791.89 | $1,319.82 |
| Baylor Scott & White Medical Center - Lake Pointe | Rowlett | $791.89 | $1,319.82 |
| Baylor Scott & White Medical Center - McKinney | McKinney | $791.89 | $1,319.82 |
| Baylor Scott & White Medical Center - Plano | Plano | $791.89 | $1,319.82 |
| Baylor Scott & White Medical Center - Waxahachie | Waxahachie | $791.89 | $1,319.82 |
| Baylor Scott & White the Heart Hospital - Denton | Denton | $791.89 | $1,319.82 |
| Baylor Scott & White the Heart Hospital - McKinney | McKinney | $791.89 | $1,319.82 |
| Baylor Scott & White the Heart Hospital - Plano | Plano | $791.89 | $1,319.82 |
| Baylor University Medical Center | Dallas | $791.89 | $1,319.82 |
| Texas Health Arlington Memorial Hospital | Arlington | $861.45 | $1,435.75 |
| Texas Health Center for Diagnostics and Surgery Plano | Plano | $861.45 | $1,435.75 |
| Texas Health Harris Methodist Hospital Alliance | Fort Worth | $861.45 | $1,435.75 |
| Texas Health Harris Methodist Hospital Azle | Azle | $861.45 | $1,435.75 |
| Texas Health Harris Methodist Hospital Cleburne | Cleburne | $861.45 | $1,435.75 |
| Texas Health Harris Methodist Hospital Fort Worth | Fort Worth | $861.45 | $1,435.75 |
| Texas Health Harris Methodist Hospital Hurst-Euless-Bedford | Bedford | $861.45 | $1,435.75 |
| Texas Health Harris Methodist Hospital Southlake | Southlake | $861.45 | $1,435.75 |
| Texas Health Harris Methodist Hospital Southwest Fort Worth | Fort Worth | $861.45 | $1,435.75 |
| Texas Health Harris Methodist Hospital Stephenville | Stephenville | $861.45 | $1,435.75 |
| Texas Health Heart & Vascular Hospital Arlington | Arlington | $861.45 | $1,435.75 |
| Texas Health Hospital Clearfork | Fort Worth | $861.45 | $1,435.75 |
| Texas Health Hospital Frisco | Frisco | $861.45 | $1,435.75 |
| Texas Health Hospital Rockwall | Rockwall | $861.45 | $1,435.75 |
| Texas Health Presbyterian Hospital Allen | Allen | $861.45 | $1,435.75 |
| Texas Health Presbyterian Hospital Dallas | Dallas | $861.45 | $1,435.75 |
| Texas Health Presbyterian Hospital Denton | Denton | $861.45 | $1,435.75 |
| Texas Health Presbyterian Hospital Flower Mound | Flower Mound | $861.45 | $1,435.75 |
| Texas Health Presbyterian Hospital Kaufman | Kaufman | $861.45 | $1,435.75 |
| Texas Health Presbyterian Hospital Plano | Plano | $861.45 | $1,435.75 |
| Texas Health Specialty Hospital Fort Worth | Fort Worth | $861.45 | $1,435.75 |
| Medical Center Hospital | Odessa | $918 | $918 |
| United Regional Health Care System | Wichita Falls | $934.56 | $1,056 |
| Hendrick Medical Center Brownwood | Brownwood | $952.92 | $1,905.84 |
| Midland County Hospital District | Midland | $986.25 | $1,315 |
| Midland Memorial Hospital | Midland | $986.25 | $1,315 |
| Houston Methodist Emergency Care Center at Kirby | Houston | $996 | $1,992 |
| Houston Methodist Emergency Care Center at Voss | Houston | $996 | $1,992 |
| Houston Methodist Emergency Care Center in Pearland | Houston | $996 | $1,992 |
| Houston Methodist Hospital | Houston | $996 | $1,992 |
| Children's Memorial Hermann Hospital | Houston | $1,009.04 | $3,153.25 |
| Memorial Hermann Cypress Hospital | Cypress | $1,009.04 | $3,153.25 |
| Memorial Hermann Greater Heights Hospital | Houston | $1,009.04 | $3,153.25 |
| Memorial Hermann Imaging Center (Bellaire) | Bellaire | $1,009.04 | $3,153.25 |
| Memorial Hermann Imaging Center (Cypress) | Cypress | $1,009.04 | $3,153.25 |
| Memorial Hermann Imaging Center (Texas Medical Center) | Houston | $1,009.04 | $3,153.25 |
| Memorial Hermann Imaging Center (Upper Kirby) | Houston | $1,009.04 | $3,153.25 |
| Memorial Hermann Katy Hospital | Katy | $1,009.04 | $3,153.25 |
| Memorial Hermann Memorial City Medical Center | Houston | $1,009.04 | $3,153.25 |
| Memorial Hermann Northeast Hospital | Humble | $1,009.04 | $3,153.25 |
| Memorial Hermann Pearland Hospital | Pearland | $1,009.04 | $3,153.25 |
| Memorial Hermann Rehabilitation Hospital-Katy | Katy | $1,009.04 | $3,153.25 |
| Memorial Hermann Rockets Orthopedic Hospital | Bellaire | $1,009.04 | $3,153.25 |
| Memorial Hermann Southeast Hospital | Houston | $1,009.04 | $3,153.25 |
| Memorial Hermann Southwest Hospital | Houston | $1,009.04 | $3,153.25 |
| Memorial Hermann Sugar Land Hospital | Sugar Land | $1,009.04 | $3,153.25 |
| Memorial Hermann The Woodlands Medical Center | The Woodlands | $1,009.04 | $3,153.25 |
| Memorial Hermann-Texas Medical Center | Houston | $1,009.04 | $3,153.25 |
| TIRR Memorial Hermann | Houston | $1,009.04 | $3,153.25 |
| Texas Children's Hospital | Houston | $1,015.05 | $1,515 |
| Texas Children's Hospital North Austin Campus | Austin | $1,015.05 | $1,515 |
| Texas Children's Hospital The Woodlands | The Woodlands | $1,015.05 | $1,515 |
| Texas Children's Hospital West Campus | Houston | $1,015.05 | $1,515 |
| Covenant Children's Hospital | Lubbock | $1,051.26 | $2,503 |
| Covenant Specialty Hospital | Lubbock | $1,051.26 | $2,503 |
| Children's Medical Center of Dallas | Dallas | $1,092.75 | $1,457 |
| Children's Medical Center of Plano | Plano | $1,092.75 | $1,457 |
| Hendrick Medical Center | Abilene | $1,096.61 | $2,193.22 |
| Hendrick Medical Center South | Abilene | $1,096.61 | $2,193.22 |
| South Austin Medical Center | Bastrop | $1,303 | $1,303 |
| St. David's Emergency Center - Bastrop | Bastrop | $1,303 | $1,303 |
| St. David's Emergency Center - Bee Cave | Bastrop | $1,303 | $1,303 |
| St. David's Emergency Center – South Lamar | Bastrop | $1,303 | $1,303 |
| North Austin Medical Center | Austin | $1,319 | $1,319 |
| St. David's Emergency Center Pflugerville | Austin | $1,319 | $1,319 |
| St. David's Emergency Center – Anderson Mill | Austin | $1,319 | $1,319 |
| St. David's Emergency Center – Arboretum | Austin | $1,319 | $1,319 |
| St. David's Emergency Center – Wells Branch | Austin | $1,319 | $1,319 |
| Heart Hospital of Austin | Austin | $1,410 | $1,410 |
| Heart Hospital of Austin at St. Davids Round Rock | Round Rock | $1,410 | $1,410 |
| St. David's Emergency Center – Manor | Manor | $1,410 | $1,410 |
| St. David's Emergency Center – Mueller | Manor | $1,410 | $1,410 |
| St. David's Emergency Center – Riverside | Manor | $1,410 | $1,410 |
| St. David's Georgetown | Georgetown | $1,410 | $1,410 |
| St. David's Medical Center | Manor | $1,410 | $1,410 |
| St. David's Rehabilitation Hospital | Austin | $1,410 | $1,410 |
| St. David's Surgical Hospital | Austin | $1,417 | $1,417 |
| UMC Children's Hospital | Lubbock | $1,500 | $1,500 |
| UMC Health & Wellness Hospital | Lubbock | $1,500 | $1,500 |
| University Medical Center | Lubbock | $1,500 | $1,500 |
| Behavioral Medicine at Renaissance | Edinburg | $1,733.11 | $1,733.11 |
| Doctors Hospital at Renaissance | Edinburg | $1,733.11 | $1,733.11 |
| Rehab Center at Renaissance | Edinburg | $1,733.11 | $1,733.11 |
| Womens Hospitalat Renaissance | Edinburg | $1,733.11 | $1,733.11 |
| Medical City ER White Settlement | Fort Worth | $1,764.21 | $1,764.21 |
| Medical City Fort Worth Hospital | Fort Worth | $1,764.21 | $1,764.21 |
| DHR Health Brownsville | Brownsville | $1,819.77 | $1,819.77 |
| Medical City Frisco Hospital | Frisco | $1,836.46 | $1,836.46 |
| Medical City Plano Hospital | Plano | $1,836.46 | $1,836.46 |
| Medical City Sachse Hospital | Sachse | $1,836.46 | $1,836.46 |
| Medical City Surgical Hospital Alliance | Fort Worth | $1,957.18 | $1,957.18 |
| Medical City Children's Hospital | Garland | $2,005.65 | $2,005.65 |
| Medical City Dallas Hospital | Garland | $2,005.65 | $2,005.65 |
| Medical City ER Garland | Garland | $2,005.65 | $2,005.65 |
| Medical City Heart Hospital | Dallas | $2,005.65 | $2,005.65 |
| Medical City Spine Hospital | Dallas | $2,005.65 | $2,005.65 |
| Houston Methodist Baytown Hospital | Baytown | $2,034 | $4,068 |
| Houston Methodist Clear Lake Hospital | Nassau Bay | $2,034 | $4,068 |
| Houston Methodist Continuing Care Hospital | Katy | $2,034 | $4,068 |
| Houston Methodist Cypress Hospital | Cypress | $2,034 | $4,068 |
| Houston Methodist Emergency Care Center at Cinco Ranch | Houston | $2,034 | $4,068 |
| Houston Methodist Emergency Care Center in Cypress | Houston | $2,034 | $4,068 |
| Houston Methodist Emergency Care Center in Deer Park | Nassau Bay | $2,034 | $4,068 |
| Houston Methodist Emergency Care Center in League City | Nassau Bay | $2,034 | $4,068 |
| Houston Methodist Emergency Care Center in Magnolia | Houston | $2,034 | $4,068 |
| Houston Methodist Emergency Care Center in Sienna | Houston | $2,034 | $4,068 |
| Houston Methodist Emergency Care Center in Spring | The Woodlands | $2,034 | $4,068 |
| Houston Methodist Emergency Care Center in The Woodlands | The Woodlands | $2,034 | $4,068 |
| Houston Methodist Sugar Land Hospital | Sugar Land | $2,034 | $4,068 |
| Houston Methodist The Woodlands Hospital | The Woodlands | $2,034 | $4,068 |
| Houston Methodist West Hospital | Houston | $2,034 | $4,068 |
| Houston Methodist Willowbrook Hospital | Houston | $2,034 | $4,068 |
| South Texas Health System Edinburg | Edinburg | $2,128.50 | $2,838 |
| South Texas Health System Heart | McAllen | $2,128.50 | $2,838 |
| South Texas Health System McAllen | McAllen | $2,128.50 | $2,838 |
| Round Rock Medical Center | Leander | $2,245 | $2,245 |
| St. David's Emergency Center - Leander | Leander | $2,245 | $2,245 |
| Medical City North Hills Hospital | North Richland Hills | $2,497.39 | $2,497.39 |
| Medical City Alliance Hospital | Fort Worth | $2,828.86 | $2,828.86 |
| Medical City ER Haslet | Fort Worth | $2,828.86 | $2,828.86 |
| Medical City ER Saginaw | Fort Worth | $2,828.86 | $2,828.86 |
| Medical City Arlington Hospital | Arlington | $2,936.75 | $2,936.75 |
| Medical City ER Grand Prarie | Arlington | $2,936.75 | $2,936.75 |
| Medical City ER Red Oak | Arlington | $2,936.75 | $2,936.75 |
| Medical City Lewisville Hospital | Lewisville | $3,054.19 | $3,054.19 |
| Methodist Childrens Hospital | San Antonio | $3,060.11 | $3,060.11 |
| Methodist ER Alamo Heights | San Antonio | $3,060.11 | $3,060.11 |
| Methodist ER Boerne | San Antonio | $3,060.11 | $3,060.11 |
| Methodist ER Bulverde | Spring Branch | $3,060.11 | $3,060.11 |
| Methodist ER City Base | San Antonio | $3,060.11 | $3,060.11 |
| Methodist ER Converse | San Antonio | $3,060.11 | $3,060.11 |
| Methodist ER De Zavala Rd | San Antonio | $3,060.11 | $3,060.11 |
| Methodist ER Helotes | San Antonio | $3,060.11 | $3,060.11 |
| Methodist ER Legacy Trails | San Antonio | $3,060.11 | $3,060.11 |
| Methodist ER Nacogdoches | San Antonio | $3,060.11 | $3,060.11 |
| Methodist ER Westover Hills | San Antonio | $3,060.11 | $3,060.11 |
| Methodist Hospital | San Antonio | $3,060.11 | $3,060.11 |
| Methodist Hospital Atascosa | Jourdanton | $3,060.11 | $3,060.11 |
| Methodist Hospital Hill Country | Fredericksburg | $3,060.11 | $3,060.11 |
| Methodist Hospital Landmark | San Antonio | $3,060.11 | $3,060.11 |
| Methodist Hospital Stone Oak | Spring Branch | $3,060.11 | $3,060.11 |
| Methodist Hospital Westover Hills | San Antonio | $3,060.11 | $3,060.11 |
| Methodist Rehabilitation Hospital Texsan | San Antonio | $3,060.11 | $3,060.11 |
| Methodist Specialty & Transplant Hospital | San Antonio | $3,060.11 | $3,060.11 |
| Methodist Stone Oak Rehabilitation Hospital | San Antonio | $3,060.11 | $3,060.11 |
| Methodist Texsan Hospital | San Antonio | $3,060.11 | $3,060.11 |
| Metropolitan Methodist Hospital | San Antonio | $3,060.11 | $3,060.11 |
| New Braunfels ER | San Antonio | $3,060.11 | $3,060.11 |
| Northeast Methodist Hospital | San Antonio | $3,060.11 | $3,060.11 |
| Medical City Weatherford Hospital | Weatherford | $3,091.85 | $3,091.85 |
| Medical City Argyle Hospital | Argyle | $3,122.31 | $3,122.31 |
| Medical City Decatur Behavioral Health | Decatur | $3,122.31 | $3,122.31 |
| Medical City Decatur Hospital | Decatur | $3,122.31 | $3,122.31 |
| Medical City Denton Hospital | Denton | $3,122.31 | $3,122.31 |
| Medical City ER Argyle | Denton | $3,122.31 | $3,122.31 |
| HCA Houston ER 24/7 - Fairmont | Pasadena | $3,192.21 | $3,192.21 |
| HCA Houston ER 24/7 - North Channel | Pasadena | $3,192.21 | $3,192.21 |
| HCA Houston Rehabilitation Hospital Southeast | Pasadena | $3,192.21 | $3,192.21 |
| HCA Houston Southeast | Pasadena | $3,192.21 | $3,192.21 |
| Medical City Las Colinas Hospital | Irving | $3,764.75 | $3,764.75 |
| Medical City ER Stonebridge | McKinney | $3,814.55 | $3,814.55 |
| Medical City McKinney Hospital | McKinney | $3,814.55 | $3,814.55 |
| ER 24/7 Edinburg | Edinburg | $4,184.46 | $4,184.46 |
| ER 24/7 McAllen | Edinburg | $4,184.46 | $4,184.46 |
| ER 24/7 Mission | Edinburg | $4,184.46 | $4,184.46 |
| ER 24/7 San Juan | Edinburg | $4,184.46 | $4,184.46 |
| Rio Grande Regional Hospital | Edinburg | $4,184.46 | $4,184.46 |
| HCA Houston ER 24/7 - Mission Bend | Houston | $4,198 | $4,198 |
| HCA Houston ER 24/7 - Stafford | Houston | $4,198 | $4,198 |
| HCA Houston ER 24/7 - Westchase | Houston | $4,198 | $4,198 |
| HCA Houston West | Houston | $4,198 | $4,198 |
| HCA Houston ER 24/7 Bellaire | Houston | $4,793.42 | $4,793.42 |
| HCA Houston ER 24/7 Heights | Houston | $4,793.42 | $4,793.42 |
| HCA Houston ER 24/7 Memorial City | Houston | $4,793.42 | $4,793.42 |
| HCA Houston ER 24/7 Montrose | Houston | $4,793.42 | $4,793.42 |
| HCA Houston Medical Center | Houston | $4,793.42 | $4,793.42 |
| HCA Houston ER 24/7 - Fort Bend Parkway | Houston | $4,825.98 | $4,825.98 |
| HCA Houston Pearland | Houston | $4,825.98 | $4,825.98 |
| HCA Houston ER 24/7 - Cypress/fm 1960 | Houston | $5,444.87 | $5,444.87 |
| HCA Houston ER 24/7 – Jersey Village | Houston | $5,444.87 | $5,444.87 |
| HCA Houston Tomball | Houston | $5,444.87 | $5,444.87 |
| HCA Houston ER 24/7 - Atascocita | Humble | $5,512.47 | $5,512.47 |
| HCA Houston ER 24/7 - Cleveland | Humble | $5,512.47 | $5,512.47 |
| HCA Houston ER 24/7 - Fall Creek | Humble | $5,512.47 | $5,512.47 |
| HCA Houston ER 24/7 - Fry Road | Houston | $5,512.47 | $5,512.47 |
| HCA Houston ER 24/7 - Towne Lake | Houston | $5,512.47 | $5,512.47 |
| HCA Houston ER 24/7 Copperfield | Houston | $5,512.47 | $5,512.47 |
| HCA Houston ER 24/7 Willowbrook | Houston | $5,512.47 | $5,512.47 |
| HCA Houston Kingwood | Humble | $5,512.47 | $5,512.47 |
| HCA Houston North Cypress | Houston | $5,512.47 | $5,512.47 |
| HCA Houston Conroe | Conroe | $5,589 | $5,589 |
| HCA Houston ER 24/7 Fallbrook | Houston | $5,618.99 | $5,618.99 |
| HCA Houston ER 24/7 Spring | Houston | $5,618.99 | $5,618.99 |
| HCA Houston Northwest | Houston | $5,618.99 | $5,618.99 |
| ER 24/7 Brownsville | Brownsville | $6,122.79 | $6,122.79 |
| ER 24/7 Harlingen | Brownsville | $6,122.79 | $6,122.79 |
| Valley Regional Medical Center | Brownsville | $6,122.79 | $6,122.79 |
| HCA Houston Clear Lake | Alvin | $6,350.87 | $6,350.87 |
| HCA Houston ER 24/7 - Alvin | Alvin | $6,350.87 | $6,350.87 |
| HCA Houston ER 24/7 - Friendswood | Alvin | $6,350.87 | $6,350.87 |
| HCA Houston ER 24/7 - Pearland | Alvin | $6,350.87 | $6,350.87 |
| HCA Houston ER 24/7 - Texas City | Alvin | $6,350.87 | $6,350.87 |
| HCA Houston Mainland | Texas City | $6,350.87 | $6,350.87 |
| CHRISTUS Santa Rosa Hospital - San Marcos | San Marcos | Not published | Not published |
| Medical City Mental Health and Wellness Center - Alliance | Fort Worth | Not published | Not published |
| Northwest Emergency at Eastern, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $2,930 |
| Northwest Emergency at Tascosa, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $2,930 |
| Northwest Emergency at Town Square, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $2,930 |
| Northwest Emergency on Georgia, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $2,930 |
| Northwest Texas Healthcare System | Amarillo | Not published | $2,930 |
| Northwest Texas Healthcare System Behavioral Health | Amarillo | Not published | $3,663 |
| University of Texas MD Anderson Cancer Center | Houston | Not published | $1,082 |