| University Medical Center of El Paso | El Paso | $21.64 | $108.20 |
| University Medical Center Surgical Hospital | El Paso | $23.70 | $118.50 |
| UTHealth East Texas North Campus | Tyler | $33.50 | $335 |
| UTHealth East Texas Quitman | Quitman | $40.30 | $403 |
| UTHealth East Texas Pittsburg | Pittsburg | $42.25 | $422.50 |
| Harris Health Ben Taub Hospital | Houston | $84.49 | $438 |
| Harris Health Lyndon B Johnson Hospital | Houston | $84.49 | $438 |
| UTHealth East Texas Jacksonville | Jacksonville | $91.20 | $912 |
| UTHealth East Texas Carthage | Carthage | $97.30 | $973 |
| CHRISTUS Santa Rosa Hospital - Westover Hills | San Antonio | $106.26 | $322 |
| UTHealth East Texas Athens | Athens | $108.20 | $1,082 |
| UTHealth East Texas Henderson | Henderson | $108.80 | $1,088 |
| UTHealth East Texas Rehabilitation Center | Tyler | $108.80 | $1,088 |
| UTHealth East Texas Tyler | Tyler | $108.80 | $1,088 |
| CHRISTUS Health - West Beaumont | Beaumont | $110.88 | $336 |
| CHRISTUS Hospital - Orange | Orange | $110.88 | $336 |
| CHRISTUS Southeast Texas - MidCounty | Port Arthur | $110.88 | $336 |
| CHRISTUS Southeast Texas Orthopedic Specialty Center | Port Arthur | $110.88 | $336 |
| CHRISTUS Southeast Texas St. Elizabeth | Beaumont | $110.88 | $336 |
| Methodist Celina Medical Center | Celina | $122.40 | $408 |
| Methodist Dallas Medical Center | Dallas | $122.40 | $408 |
| Methodist Mansfield Medical Center | Mansfield | $122.40 | $408 |
| Methodist Midlothian Medical Center | Midlothian | $122.40 | $408 |
| Methodist Richardson Medical Center | Richardson | $122.40 | $408 |
| Methodist Richardson Medical Center Campus for Continuing Care | Richardson | $122.40 | $408 |
| Methodist Southlake Medical Center | Southlake | $122.40 | $408 |
| BSA Hospital | Amarillo | $124.30 | $1,243 |
| Harrington Cancer Center | Amarillo | $124.30 | $1,243 |
| Ascension Providence | Waco | $134.37 | $373.25 |
| Covenant Hospital Levelland | Levelland | $147 | $350 |
| Ascension Seton Edgar B. Davis (Ascension Seton) | Luling | $168.48 | $468 |
| Ascension Seton Hays (Ascension Seton) | Kyle | $175.23 | $486.75 |
| Ascension Seton Smithville (Ascension Seton) | Smithville | $175.23 | $486.75 |
| Covenant Hospital Plainview | Plainview | $179.76 | $428 |
| St. Luke's Health Memorial Livingston | Livingston | $194.30 | $1,295.27 |
| St. Luke's Health Memorial Lufkin | Lufkin | $194.30 | $1,295.27 |
| St. Luke's Health Memorial San Augustine | San Augustine | $194.30 | $1,295.27 |
| Ascension Seton Highland Lakes (Ascension Seton) | Burnet | $210.60 | $585 |
| William P Clements Jr University Hospital | Dallas | $226.50 | $453 |
| University Health Dialysis Medical Center | San Antonio | $232.75 | $931 |
| University Health Dialysis South | San Antonio | $232.75 | $931 |
| University Health Dialysis Southeast | San Antonio | $232.75 | $931 |
| University Health Dialysis West at Texas Diabetes Institute | San Antonio | $232.75 | $931 |
| University Health System Children's Kidney Center | San Antonio | $232.75 | $931 |
| University Hospital | San Antonio | $232.75 | $931 |
| Longview Regional Medical Center | Longview | $268.79 | $995.50 |
| Parkland Health | Dallas | $282 | $705 |
| Covenant Health Emergency Center - Milwaukee Ave | Lubbock | $284.76 | $678 |
| Covenant Health Emergency Center - Quaker Ave | Lubbock | $284.76 | $678 |
| Covenant Medical Center | Lubbock | $284.76 | $678 |
| Ascension Seton Cedar Park Hospital | Cedar Park | $313.72 | $871.45 |
| Baylor Scott & White All Saints Medical Center - Fort Worth | Fort Worth | $332 | $553.34 |
| Baylor Scott & White Heart and Vascular Hospital - Dallas | Dallas | $332 | $553.34 |
| Baylor Scott & White Heart and Vascular Hospital - Waxahachie | Waxahachie | $332 | $553.34 |
| Baylor Scott & White Medical Center - Centennial | Frisco | $332 | $553.34 |
| Baylor Scott & White Medical Center - Frisco at PGA Parkway | Frisco | $332 | $553.34 |
| Baylor Scott & White Medical Center - Grapevine | Grapevine | $332 | $553.34 |
| Baylor Scott & White Medical Center - Irving | Irving | $332 | $553.34 |
| Baylor Scott & White Medical Center - Lake Pointe | Rowlett | $332 | $553.34 |
| Baylor Scott & White Medical Center - McKinney | McKinney | $332 | $553.34 |
| Baylor Scott & White Medical Center - Plano | Plano | $332 | $553.34 |
| Baylor Scott & White Medical Center - Waxahachie | Waxahachie | $332 | $553.34 |
| Baylor Scott & White the Heart Hospital - Denton | Denton | $332 | $553.34 |
| Baylor Scott & White the Heart Hospital - McKinney | McKinney | $332 | $553.34 |
| Baylor Scott & White the Heart Hospital - Plano | Plano | $332 | $553.34 |
| Baylor University Medical Center | Dallas | $332 | $553.34 |
| Shannon Medical Center | San Angelo | $333.50 | $667 |
| Shannon Medical Center Big Spring | Big Spring | $333.50 | $667 |
| Shannon Medical Center South | San Angelo | $333.50 | $667 |
| Shannon Medical Center St John's Campus | San Angelo | $333.50 | $667 |
| Shannon River Crest Hospital | San Angelo | $333.50 | $667 |
| Dell Children's Medical Center (Ascension Seton) | Austin | $340.73 | $486.75 |
| Dell Children's Medical Center North Campus (Ascension Seton) | Austin | $340.73 | $486.75 |
| JPS Health Network | Fort Worth | $352.20 | $587 |
| Trinity Spring North | Fort Worth | $352.20 | $587 |
| Baylor Scott & White Continuing Care Hospital | Temple | $361.74 | $602.90 |
| Baylor Scott & White McLane Children's Medical Center | Temple | $361.74 | $602.90 |
| Baylor Scott & White Medical Center - Brenham | Brenham | $361.74 | $602.90 |
| Baylor Scott & White Medical Center - College Station | College Station | $361.74 | $602.90 |
| Baylor Scott & White Medical Center - Marble Falls | Marble Falls | $361.74 | $602.90 |
| Baylor Scott & White Medical Center - Temple | Temple | $361.74 | $602.90 |
| Baylor Scott & White Medical Center Hillcrest | Waco | $361.74 | $602.90 |
| Baylor Scott & White Pavilion - Temple | Temple | $361.74 | $602.90 |
| Ascension Seton Medical Center Austin (Ascension Seton) | Austin | $367.29 | $1,020.25 |
| Ascension Seton Northwest (Ascension Seton) | Austin | $367.29 | $1,020.25 |
| Ascension Seton Southwest (Ascension Seton) | 1826 Austin | $367.29 | $1,020.25 |
| Dell Seton Medical Center at The University of Texas (Ascension Seton) | Austin | $367.29 | $1,020.25 |
| United Regional Health Care System | Wichita Falls | $393.21 | $444.30 |
| Texas Health Arlington Memorial Hospital | Arlington | $404.40 | $674 |
| Texas Health Center for Diagnostics and Surgery Plano | Plano | $404.40 | $674 |
| Texas Health Harris Methodist Hospital Alliance | Fort Worth | $404.40 | $674 |
| Texas Health Harris Methodist Hospital Azle | Azle | $404.40 | $674 |
| Texas Health Harris Methodist Hospital Cleburne | Cleburne | $404.40 | $674 |
| Texas Health Harris Methodist Hospital Fort Worth | Fort Worth | $404.40 | $674 |
| Texas Health Harris Methodist Hospital Hurst-Euless-Bedford | Bedford | $404.40 | $674 |
| Texas Health Harris Methodist Hospital Southlake | Southlake | $404.40 | $674 |
| Texas Health Harris Methodist Hospital Southwest Fort Worth | Fort Worth | $404.40 | $674 |
| Texas Health Harris Methodist Hospital Stephenville | Stephenville | $404.40 | $674 |
| Texas Health Heart & Vascular Hospital Arlington | Arlington | $404.40 | $674 |
| Texas Health Hospital Clearfork | Fort Worth | $404.40 | $674 |
| Texas Health Hospital Frisco | Frisco | $404.40 | $674 |
| Texas Health Hospital Rockwall | Rockwall | $404.40 | $674 |
| Texas Health Presbyterian Hospital Allen | Allen | $404.40 | $674 |
| Texas Health Presbyterian Hospital Dallas | Dallas | $404.40 | $674 |
| Texas Health Presbyterian Hospital Denton | Denton | $404.40 | $674 |
| Texas Health Presbyterian Hospital Flower Mound | Flower Mound | $404.40 | $674 |
| Texas Health Presbyterian Hospital Kaufman | Kaufman | $404.40 | $674 |
| Texas Health Presbyterian Hospital Plano | Plano | $404.40 | $674 |
| Texas Health Specialty Hospital Fort Worth | Fort Worth | $404.40 | $674 |
| Baylor Scott & White Emergency Medical Center - Cedar Park | Cedar Park | $433.76 | $722.94 |
| Baylor Scott & White Medical Center - Austin | Austin | $433.76 | $722.94 |
| Baylor Scott & White Medical Center - Buda | Buda | $433.76 | $722.94 |
| Baylor Scott & White Medical Center - Lakeway | Lakeway | $433.76 | $722.94 |
| Baylor Scott & White Medical Center - Pflugerville | Pflugerville | $433.76 | $722.94 |
| Baylor Scott & White Medical Center - Round Rock | Round Rock | $433.76 | $722.94 |
| Baylor Scott & White Medical Center - Taylor | Taylor | $433.76 | $722.94 |
| Cook Children's Medical Center | Fort Worth | $438.39 | $584.52 |
| Cook Children's Medical Center - Prosper | Prosper | $438.39 | $584.52 |
| Texas Children's Hospital | Houston | $447.56 | $668 |
| Texas Children's Hospital North Austin Campus | Austin | $447.56 | $668 |
| Texas Children's Hospital The Woodlands | The Woodlands | $447.56 | $668 |
| Texas Children's Hospital West Campus | Houston | $447.56 | $668 |
| Hendrick Medical Center | Abilene | $489.69 | $979.37 |
| Hendrick Medical Center South | Abilene | $489.69 | $979.37 |
| Medical Center Hospital | Odessa | $501 | $501 |
| Hendrick Medical Center Brownwood | Brownwood | $501.42 | $1,002.84 |
| Houston Methodist Emergency Care Center at Kirby | Houston | $507.50 | $1,015 |
| Houston Methodist Emergency Care Center at Voss | Houston | $507.50 | $1,015 |
| Houston Methodist Emergency Care Center in Pearland | Houston | $507.50 | $1,015 |
| Houston Methodist Hospital | Houston | $507.50 | $1,015 |
| Children's Medical Center of Dallas | Dallas | $568.50 | $758 |
| Children's Medical Center of Plano | Plano | $568.50 | $758 |
| Midland County Hospital District | Midland | $572.25 | $763 |
| Midland Memorial Hospital | Midland | $572.25 | $763 |
| Covenant Children's Hospital | Lubbock | $598.08 | $1,424 |
| Covenant Specialty Hospital | Lubbock | $598.08 | $1,424 |
| Memorial Hermann Greater Heights Hospital | Houston | $630.96 | $1,971.75 |
| Memorial Hermann Katy Hospital | Katy | $630.96 | $1,971.75 |
| Memorial Hermann Memorial City Medical Center | Houston | $630.96 | $1,971.75 |
| Memorial Hermann Northeast Hospital | Humble | $630.96 | $1,971.75 |
| Memorial Hermann Pearland Hospital | Pearland | $630.96 | $1,971.75 |
| Memorial Hermann Rehabilitation Hospital-Katy | Katy | $630.96 | $1,971.75 |
| Memorial Hermann Southeast Hospital | Houston | $630.96 | $1,971.75 |
| Memorial Hermann Southwest Hospital | Houston | $630.96 | $1,971.75 |
| Memorial Hermann Sugar Land Hospital | Sugar Land | $630.96 | $1,971.75 |
| Memorial Hermann The Woodlands Medical Center | The Woodlands | $630.96 | $1,971.75 |
| TIRR Memorial Hermann | Houston | $630.96 | $1,971.75 |
| St. David's Surgical Hospital | Austin | $707 | $707 |
| Houston Methodist Baytown Hospital | Baytown | $732 | $1,464 |
| Houston Methodist Clear Lake Hospital | Nassau Bay | $732 | $1,464 |
| Houston Methodist Continuing Care Hospital | Katy | $732 | $1,464 |
| Houston Methodist Cypress Hospital | Cypress | $732 | $1,464 |
| Houston Methodist Emergency Care Center at Cinco Ranch | Houston | $732 | $1,464 |
| Houston Methodist Emergency Care Center in Cypress | Houston | $732 | $1,464 |
| Houston Methodist Emergency Care Center in Deer Park | Nassau Bay | $732 | $1,464 |
| Houston Methodist Emergency Care Center in League City | Nassau Bay | $732 | $1,464 |
| Houston Methodist Emergency Care Center in Magnolia | Houston | $732 | $1,464 |
| Houston Methodist Emergency Care Center in Sienna | Houston | $732 | $1,464 |
| Houston Methodist Emergency Care Center in Spring | The Woodlands | $732 | $1,464 |
| Houston Methodist Emergency Care Center in The Woodlands | The Woodlands | $732 | $1,464 |
| Houston Methodist Sugar Land Hospital | Sugar Land | $732 | $1,464 |
| Houston Methodist The Woodlands Hospital | The Woodlands | $732 | $1,464 |
| Houston Methodist West Hospital | Houston | $732 | $1,464 |
| Houston Methodist Willowbrook Hospital | Houston | $732 | $1,464 |
| Children's Memorial Hermann Hospital | Houston | $734.72 | $2,296 |
| Memorial Hermann Cypress Hospital | Cypress | $734.72 | $2,296 |
| Memorial Hermann Imaging Center (Bellaire) | Bellaire | $734.72 | $2,296 |
| Memorial Hermann Imaging Center (Cypress) | Cypress | $734.72 | $2,296 |
| Memorial Hermann Imaging Center (Texas Medical Center) | Houston | $734.72 | $2,296 |
| Memorial Hermann Imaging Center (Upper Kirby) | Houston | $734.72 | $2,296 |
| Memorial Hermann Rockets Orthopedic Hospital | Bellaire | $734.72 | $2,296 |
| Memorial Hermann-Texas Medical Center | Houston | $734.72 | $2,296 |
| UMC Children's Hospital | Lubbock | $843 | $843 |
| UMC Health & Wellness Hospital | Lubbock | $843 | $843 |
| University Medical Center | Lubbock | $843 | $843 |
| Medical City Argyle Hospital | Argyle | $860.86 | $860.86 |
| Medical City Denton Hospital | Denton | $860.86 | $860.86 |
| Medical City ER Argyle | Denton | $860.86 | $860.86 |
| Behavioral Medicine at Renaissance | Edinburg | $871.73 | $871.73 |
| Doctors Hospital at Renaissance | Edinburg | $871.73 | $871.73 |
| Rehab Center at Renaissance | Edinburg | $871.73 | $871.73 |
| Womens Hospitalat Renaissance | Edinburg | $871.73 | $871.73 |
| DHR Health Brownsville | Brownsville | $915.32 | $915.32 |
| Medical City Children's Hospital | Garland | $980.08 | $980.08 |
| Medical City Dallas Hospital | Garland | $980.08 | $980.08 |
| Medical City ER Garland | Garland | $980.08 | $980.08 |
| Medical City Heart Hospital | Dallas | $980.08 | $980.08 |
| Medical City Spine Hospital | Dallas | $980.08 | $980.08 |
| Medical City Frisco Hospital | Frisco | $985.50 | $985.50 |
| Medical City ER White Settlement | Fort Worth | $1,193.66 | $1,193.66 |
| Medical City Fort Worth Hospital | Fort Worth | $1,193.66 | $1,193.66 |
| Heart Hospital of Austin | Austin | $1,227 | $1,227 |
| St. David's Georgetown | Georgetown | $1,227 | $1,227 |
| Round Rock Medical Center | Leander | $1,229 | $1,229 |
| St. David's Emergency Center - Leander | Leander | $1,229 | $1,229 |
| Methodist Childrens Hospital | San Antonio | $1,248.21 | $1,248.21 |
| Methodist ER Alamo Heights | San Antonio | $1,248.21 | $1,248.21 |
| Methodist ER Boerne | San Antonio | $1,248.21 | $1,248.21 |
| Methodist ER Bulverde | Spring Branch | $1,248.21 | $1,248.21 |
| Methodist ER City Base | San Antonio | $1,248.21 | $1,248.21 |
| Methodist ER Converse | San Antonio | $1,248.21 | $1,248.21 |
| Methodist ER De Zavala Rd | San Antonio | $1,248.21 | $1,248.21 |
| Methodist ER Helotes | San Antonio | $1,248.21 | $1,248.21 |
| Methodist ER Legacy Trails | San Antonio | $1,248.21 | $1,248.21 |
| Methodist ER Nacogdoches | San Antonio | $1,248.21 | $1,248.21 |
| Methodist ER Westover Hills | San Antonio | $1,248.21 | $1,248.21 |
| Methodist Hospital | San Antonio | $1,248.21 | $1,248.21 |
| Methodist Hospital Atascosa | Jourdanton | $1,248.21 | $1,248.21 |
| Methodist Hospital Landmark | San Antonio | $1,248.21 | $1,248.21 |
| Methodist Hospital Stone Oak | Spring Branch | $1,248.21 | $1,248.21 |
| Methodist Stone Oak Rehabilitation Hospital | San Antonio | $1,248.21 | $1,248.21 |
| Metropolitan Methodist Hospital | San Antonio | $1,248.21 | $1,248.21 |
| New Braunfels ER | San Antonio | $1,248.21 | $1,248.21 |
| Northeast Methodist Hospital | San Antonio | $1,248.21 | $1,248.21 |
| Medical City Decatur Behavioral Health | Decatur | $1,286.57 | $1,286.57 |
| Medical City Decatur Hospital | Decatur | $1,286.57 | $1,286.57 |
| Medical City Las Colinas Hospital | Irving | $1,385.48 | $1,385.48 |
| ER 24/7 Edinburg | Edinburg | $1,385.70 | $1,385.70 |
| ER 24/7 McAllen | Edinburg | $1,385.70 | $1,385.70 |
| ER 24/7 Mission | Edinburg | $1,385.70 | $1,385.70 |
| ER 24/7 San Juan | Edinburg | $1,385.70 | $1,385.70 |
| Rio Grande Regional Hospital | Edinburg | $1,385.70 | $1,385.70 |
| North Austin Medical Center | Austin | $1,412 | $1,412 |
| St. David's Emergency Center Pflugerville | Austin | $1,412 | $1,412 |
| St. David's Emergency Center – Anderson Mill | Austin | $1,412 | $1,412 |
| St. David's Emergency Center – Arboretum | Austin | $1,412 | $1,412 |
| St. David's Emergency Center – Wells Branch | Austin | $1,412 | $1,412 |
| Medical City ER Stonebridge | McKinney | $1,447.85 | $1,447.85 |
| Medical City McKinney Hospital | McKinney | $1,447.85 | $1,447.85 |
| Medical City Arlington Hospital | Arlington | $1,473.04 | $1,473.04 |
| Medical City ER Grand Prarie | Arlington | $1,473.04 | $1,473.04 |
| Medical City ER Red Oak | Arlington | $1,473.04 | $1,473.04 |
| Medical City Plano Hospital | Plano | $1,473.06 | $1,473.06 |
| Medical City Sachse Hospital | Sachse | $1,473.06 | $1,473.06 |
| South Austin Medical Center | Bastrop | $1,577 | $1,577 |
| St. David's Emergency Center - Bastrop | Bastrop | $1,577 | $1,577 |
| St. David's Emergency Center - Bee Cave | Bastrop | $1,577 | $1,577 |
| St. David's Emergency Center – South Lamar | Bastrop | $1,577 | $1,577 |
| South Texas Health System Behavioral | Edinburg | $1,755 | $2,340 |
| South Texas Health System Edinburg | Edinburg | $1,755 | $2,340 |
| South Texas Health System Heart | McAllen | $1,755 | $2,340 |
| South Texas Health System McAllen | McAllen | $1,755 | $2,340 |
| Medical City Lewisville Hospital | Lewisville | $2,017.81 | $2,017.81 |
| HCA Houston ER 24/7 - Mission Bend | Houston | $2,066 | $2,066 |
| HCA Houston ER 24/7 - Stafford | Houston | $2,066 | $2,066 |
| HCA Houston ER 24/7 - Westchase | Houston | $2,066 | $2,066 |
| HCA Houston West | Houston | $2,066 | $2,066 |
| HCA Houston ER 24/7 - Fry Road | Houston | $2,116 | $2,116 |
| HCA Houston ER 24/7 - Towne Lake | Houston | $2,116 | $2,116 |
| HCA Houston ER 24/7 Copperfield | Houston | $2,116 | $2,116 |
| HCA Houston ER 24/7 Willowbrook | Houston | $2,116 | $2,116 |
| HCA Houston North Cypress | Houston | $2,116 | $2,116 |
| HCA Houston ER 24/7 - Cypress/fm 1960 | Houston | $2,175.42 | $2,175.42 |
| HCA Houston ER 24/7 – Jersey Village | Houston | $2,175.42 | $2,175.42 |
| HCA Houston Tomball | Houston | $2,175.42 | $2,175.42 |
| HCA Houston ER 24/7 Bellaire | Houston | $2,246.70 | $2,246.70 |
| HCA Houston ER 24/7 Heights | Houston | $2,246.70 | $2,246.70 |
| HCA Houston ER 24/7 Memorial City | Houston | $2,246.70 | $2,246.70 |
| HCA Houston ER 24/7 Montrose | Houston | $2,246.70 | $2,246.70 |
| HCA Houston Medical Center | Houston | $2,246.70 | $2,246.70 |
| ER 24/7 Brownsville | Brownsville | $2,279.38 | $2,279.38 |
| ER 24/7 Harlingen | Brownsville | $2,279.38 | $2,279.38 |
| Valley Regional Medical Center | Brownsville | $2,279.38 | $2,279.38 |
| HCA Houston ER 24/7 Fallbrook | Houston | $2,302.60 | $2,302.60 |
| HCA Houston ER 24/7 Spring | Houston | $2,302.60 | $2,302.60 |
| HCA Houston Northwest | Houston | $2,302.60 | $2,302.60 |
| Medical City Alliance Hospital | Fort Worth | $2,363.39 | $2,363.39 |
| Medical City ER Haslet | Fort Worth | $2,363.39 | $2,363.39 |
| Medical City ER Saginaw | Fort Worth | $2,363.39 | $2,363.39 |
| Medical City Surgical Hospital Alliance | Fort Worth | $2,363.39 | $2,363.39 |
| HCA Houston ER 24/7 - Fort Bend Parkway | Houston | $2,394.66 | $2,394.66 |
| HCA Houston Pearland | Houston | $2,394.66 | $2,394.66 |
| Heart Hospital of Austin at St. Davids Round Rock | Round Rock | $2,435 | $2,435 |
| St. David's Emergency Center – Manor | Manor | $2,435 | $2,435 |
| St. David's Emergency Center – Mueller | Manor | $2,435 | $2,435 |
| St. David's Emergency Center – Riverside | Manor | $2,435 | $2,435 |
| St. David's Medical Center | Manor | $2,435 | $2,435 |
| St. David's Rehabilitation Hospital | Austin | $2,435 | $2,435 |
| Medical City North Hills Hospital | North Richland Hills | $2,440.39 | $2,440.39 |
| Methodist Hospital Hill Country | Fredericksburg | $2,491.54 | $2,491.54 |
| Methodist Hospital Westover Hills | San Antonio | $2,491.54 | $2,491.54 |
| Methodist Rehabilitation Hospital Texsan | San Antonio | $2,491.54 | $2,491.54 |
| Methodist Specialty & Transplant Hospital | San Antonio | $2,491.54 | $2,491.54 |
| Methodist Texsan Hospital | San Antonio | $2,491.54 | $2,491.54 |
| HCA Houston ER 24/7 - Fairmont | Pasadena | $2,536.17 | $2,536.17 |
| HCA Houston ER 24/7 - North Channel | Pasadena | $2,536.17 | $2,536.17 |
| HCA Houston Rehabilitation Hospital Southeast | Pasadena | $2,536.17 | $2,536.17 |
| HCA Houston Southeast | Pasadena | $2,536.17 | $2,536.17 |
| HCA Houston Clear Lake | Alvin | $2,844.19 | $2,844.19 |
| HCA Houston ER 24/7 - Alvin | Alvin | $2,844.19 | $2,844.19 |
| HCA Houston ER 24/7 - Friendswood | Alvin | $2,844.19 | $2,844.19 |
| HCA Houston ER 24/7 - Pearland | Alvin | $2,844.19 | $2,844.19 |
| HCA Houston ER 24/7 - Texas City | Alvin | $2,844.19 | $2,844.19 |
| Medical City Weatherford Hospital | Weatherford | $3,366.18 | $3,366.18 |
| HCA Houston ER 24/7 - Atascocita | Humble | $4,273.19 | $4,273.19 |
| HCA Houston ER 24/7 - Cleveland | Humble | $4,273.19 | $4,273.19 |
| HCA Houston ER 24/7 - Fall Creek | Humble | $4,273.19 | $4,273.19 |
| HCA Houston Kingwood | Humble | $4,273.19 | $4,273.19 |
| HCA Houston Conroe | Conroe | $4,320.50 | $4,320.50 |
| HCA Houston Mainland | Texas City | $5,680.81 | $5,680.81 |
| Medical City Green Oaks Hospital | Dallas | 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 | $408 |
| Northwest Emergency at Tascosa, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $408 |
| Northwest Emergency at Town Square, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $408 |
| Northwest Emergency on Georgia, a Service of Northwest Texas Healthcare System | Amarillo | Not published | $408 |
| Northwest Texas Healthcare System | Amarillo | Not published | $408 |
| Northwest Texas Healthcare System Behavioral Health | Amarillo | Not published | $3,178 |
| Northwest Texas Healthcare System Surgery Center | Amarillo | Not published | $3,178 |
| University of Texas MD Anderson Cancer Center | Houston | Not published | $371 |
