Texas PPO - Humana

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*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019 Hospital City Provider % Dollars Billed Out of Network* Provider % Dollars Billed Out of Network* Provider % Dollars Billed Out of Network* Provider % Dollars Billed Out of Network* Provider % Dollars Billed Out of Network* Hendrick Medical Center Abilene Hendrick Anesthesia Network 0% Clinical Pathology Associates 0% Radiology Associates of Abilene 0% Falcon Emergency Physicians PLLC; Texas EM-1 Medical Services 0% Service not available 0% Hendrick Medical Center South Abilene EmergenceHealth, Clinical Partners 0% Clinical Pathology Associates 0% West Texas Radiology Group 0% Taylor Emergency Medicine Associates, PA 0% Millennium Neonatology, PLLC 0% Methodist Hospital For Surgery Addison Dallas Anesthesiology Associates PA/US Anesthesia Partners of Texas PA 0% Laboratory Physicians Association 0% Methodist Center for Diagnostic Imaging 0% Town of Addison Emergency Physicians PLLC 0% Service not available 0% Christus Spohn Hospital Alice Alice EmergencHealth 0% None in network 100% Radiology and Imaging of South Texas 0% Guadalupe Emergency Medicine Associates 4% Service not available 0% Texas Health Presbyterian Hospital Allen Allen Allen Anesthesia Associates PA 100% MD Pathology 0% None in network 100% Texas Medicine Resources LLP 28% Pediatrix Medical Group of Texas 0% Big Bend Regional Medical Center Alpine YPS Anesthesia LLC 0% Rio Grande Pathology Services PA 0% Gerhard Moeller, MD 0% Brewster Emergency Medicine Associates PA 0% Service not available 0% Baptist St Anthonys Health System Amarillo US Anesthesia Partners of Texas PA 0% Amarillo Pathology Associates 0% High Plains Radiological Association 0% LHH Emergency Physicians PLLC; Texas EM - 1 Medical Services PA; Amarillo Emergency Physicians LLP 0% Pediatrix Medical Group of Texas of Texas 0% Physicians Surgical Hospitals LLC Amarillo Reg Martin PA, Panhandle Anesthesia Services LLP 0% Amarillo Pathology Associates 0% High Plains Radiological Association 0% Service not available 0% Service not available 0% Physicians Surgical Hospitals LLC Amarillo Anesthesia Services of Amarillo, Anthem Anesthesia, RNC Anethesia, Reg Martin PA, Thane Morgan MD PA 0% Amarillo Pathology Associates 0% High Plains Radiological Association 0% Service not available 0% Service not available 0% Bayside Community Hospital Anahuac US Anesthesia Partners of Texas PA 0% None in network 0% Houston Northwest Radiology Assoc 0% None in network 0% Service not available 0% This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups Current as of October 2021 Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris, Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry, Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood Anesthesiology Pathology Radiology Emergency Physicians Neonatology Texas PPO

Transcript of Texas PPO - Humana

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Hendrick Medical Center Abilene Hendrick Anesthesia Network 0% Clinical Pathology Associates 0% Radiology Associates of Abilene 0%

Falcon Emergency Physicians PLLC; Texas EM-1 Medical Services

0% Service not available 0%

Hendrick Medical Center South Abilene EmergenceHealth, Clinical Partners 0% Clinical Pathology

Associates 0% West Texas Radiology Group 0% Taylor Emergency Medicine Associates, PA 0% Millennium Neonatology,

PLLC 0%

Methodist Hospital For Surgery Addison

Dallas Anesthesiology Associates PA/US Anesthesia Partners of Texas PA

0% Laboratory Physicians Association 0% Methodist Center for Diagnostic

Imaging 0% Town of Addison Emergency Physicians PLLC 0% Service not available 0%

Christus Spohn Hospital Alice Alice EmergencHealth 0% None in network 100% Radiology and Imaging of South Texas 0% Guadalupe Emergency Medicine

Associates 4% Service not available 0%

Texas Health Presbyterian Hospital Allen Allen Allen Anesthesia Associates PA 100% MD Pathology 0% None in network 100% Texas Medicine Resources LLP 28% Pediatrix Medical Group of

Texas 0%

Big Bend Regional Medical Center Alpine YPS Anesthesia LLC 0% Rio Grande Pathology

Services PA 0% Gerhard Moeller, MD 0% Brewster Emergency Medicine Associates PA 0% Service not available 0%

Baptist St Anthonys Health System Amarillo US Anesthesia Partners of Texas PA 0% Amarillo Pathology

Associates   0% High Plains Radiological Association   0%

LHH Emergency Physicians PLLC; Texas EM - 1 Medical Services PA; Amarillo Emergency Physicians LLP

0% Pediatrix Medical Group of Texas of Texas 0%

Physicians Surgical Hospitals LLC Amarillo Reg Martin PA, Panhandle Anesthesia

Services LLP 0% Amarillo Pathology Associates   0% High Plains Radiological Association

  0% Service not available 0% Service not available 0%

Physicians Surgical Hospitals LLC Amarillo

Anesthesia Services of Amarillo, Anthem Anesthesia, RNC Anethesia, Reg Martin PA, Thane Morgan MD PA

0% Amarillo Pathology Associates   0% High Plains Radiological Association

  0% Service not available 0% Service not available 0%

Bayside Community Hospital Anahuac US Anesthesia Partners of Texas PA 0% None in network 0% Houston Northwest Radiology Assoc 0% None in network 0% Service not available 0%

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Permian Regional Medical Center Andrews PRMC Anesthesia Service 0% Community Pathology

Associates 0% High Plains Radiological Associates 0% Concord Medical Group of Texas PLLC 0% Service not available 0%

UTMB Angleton Danbury Angleton UTMB Faculty Group Practice 0% UTMB Faculty Group Practice 0% UTMB Faculty Group Practice 0% Envision Physician Services 0% UTMB Faculty Group Practice 0%

Anson General Hospital Anson Service not available 0% Service not available 0% Radiology Associates of Abilene 0% Concord Medical Group; Concord Medical Group of Texas 0% Service not available 0%

Wise Health Emergency Center Argyle Service not available 31% Service not available 0% Service not available 100% Icare Urgent Care/Synergy

Emergency Consultants PLLC 0% Service not available 0%

Wise Health Surgical Hospital Argyle None in network 31% None in network 0% None in network 100% None in network 0% None in network 0%

Baylor Scott & White Orthopedic and Spine Hospital

Arlington US Anesthesia Partners of Texas PA 0% Arlington Pathology Association 5.01(a) Corp 0% American Radiology Consultants

LLC 0% Rush Creek Emergency Physicians PLLC 0% Service not available 0%

Medical City Arlington Arlington US Anesthesia Partners of Texas PA 0% Ameripath 5 01 A Corporation 0% Medical Imaging of Dallas 86% Questcare Medical Services PLLC 0% Sheridan Healthcare of Texas

PA 0%

Texas Health Arlington Memorial Hospital Arlington US Anesthesia Partners of Texas PA 0%

Ameripath 5 01 A Corporation/Arlington Pathology Association 5.01(a) Corp

100% Radiology Associates of North Texas PA 0% Texas Medicine Resources LLP 5% Pediatrix Medical Group of

Texas 0%

Texas Health Heart and Vascular Hospital Arlington Arlington US Anesthesia Partners of Texas PA 0% Arlington Pathology

Association 5.01(a) Corp 0% None in network 0% None in network 0% Service not available 0%

USMD Hospital at Arlington LP Arlington US Anesthesia Partners of Texas PA 0% Arlington Pathology

Association 5.01(a) Corp 0% Radiology Associates of North Texas PA 0% Burbot Emergency Physicians

PLLC 0% Service not available 0%

Stonewall Memorial Hospital Aspermont Service not available 0% Service not available 0% Radiology Partners 0% Frederic K. Passmann, MD 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Christus St Michael Hospital Atlanta Atlanta Independent Anesthesia of

Texarkana LLP 0% Ameripath 5 01 A Corporation 0% Radiology Consultants LLP 12% None in network 0% Service not available 0%

Baylor Emergency Medical Center at Aubrey Aubrey Service not available 0% Service not available 0% Service not available 0%

Century Integrated Partners Inc/Questcare Medical Services PLLC/Legacy Er And Urgent Care

0% Service not available 0%

Arise Austin Medical Center Austin Westlake Anesthesia Group 0% Clinical Pathology Associates 0% RadPartners 0% Service not available 0% Service not available 0%

Ascension Medical Center Austin Austin US Anesthesia Partners of Texas PA;

Seton Family of Doctors 0% Clinical Pathology Labs 0% Austin Radiological Association PA 0%Travis County Emergency Physicians; Seton Family of Doctors

0% Pediatrix Medical Group of Texas of Texas 0%

Ascension Seton Northwest Austin US Anesthesia Partners of Texas PA 0%Austin Pathology Associates PA; Clinical Pathology Associates

0% Austin Radiological Association PA 0%

Travis County Emergency Physicians; Third Coast Emergency Physicians - Southwest PA

0% Pediatrix Medical Group of Texas of Texas 0%

Ascension Seton Southwest Austin US Anesthesia Partners of Texas PA 0% Clinical Pathology Labs 0% Austin Radiological Association PA 0%

Travis County Emergency Physicians; Third Coast Emergency Physicians - Southwest PA

0% Service not available 0%

Baylor Scott and White Medical Center Austin Austin Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0%

Dell Childrens Medical Center Austin US Anesthesia Partners of Texas PA 0%

Austin Pathology Associates PA; Clinical Pathology Associates; Travis Pathology Associates

0% Austin Radiological Association PA 0% Travis County Emergency Physicians; Bcep PA 0% Pediatrix Medical Group of

Texas of Texas 0%

Dell Seton Medical Center at University of Texas Austin US Anesthesia Partners of Texas PA 0% Clinical Pathology

Associates 0% Austin Radiological Association PA 0% Travis County Emergency Physicians 0% Pediatrix Medical Group of

Texas of Texas 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Heart Hospital of Austin, a Campus of St David's Medical Ctr

Austin Cardiovascular Anesthesiology; Scott and White Clinic 0%

Austin Pathology Associates PA; Travis Pathology Associates

0% Austin Radiological Association PA 0% Longhorn Emergency Medical Associates PA 0% Service not available 0%

North Austin Medical Center Austin Austin Anesthesiology Group PLLC 0%Austin Pathology Associates PA; Clinical Pathology Associates

0% Austin Radiological Association PA 0% Longhorn Emergency Medical Associates PA 0% Pediatrix Medical Group of

Texas of Texas 0%

South Austin Hospital Austin Austin Anesthesiology Group PLLC 0%Austin Pathology Associates PA; Travis Pathology Associates

0% Austin Radiological Association PA 0% Longhorn Emergency Medical Associates PA 0% Pediatrix Medical Group of

Texas of Texas 0%

St Davids Hospital Austin Austin Anesthesiology Group PLLC 0% Clinical Pathology Associates 0% Austin Radiological Association PA 0% TeamHealth ER 0% Pediatrix Medical Group of

Texas of Texas 0%

St Davids Surgical Hospital Austin Austin Anesthesiology Group PLLC 0% Austin Pathology Associates PA 0% Austin Radiological Association PA 0% TeamHealth ER 0% Pediatrix Medical Group of

Texas of Texas 0%

Texas Health Harris Methodist Hospital Azle Azle Northstar Anesthesia PA 0% None in network 0% None in network 0% Texas Medicine Resources LLP 0% Service not available 0%

Ballinger Memorial Hospital Ballinger Service not available 0% LabCorp 0% Concord Radiology 0% Ballinger Memorial Hospital 0% Service not available 0%

Ascension Seton Bastrop Bastrop Service not available 0% Clinical Pathology Associates 0% Austin Radiological Association PA 0% Emergency Service Partners 0% Service not available 0%

Matagorda Regional Medical Center Bay City None in network 0% Community Pathology

Associates 0% Singleton Associates 0%Bay Prairie Emergency Physicians PLLC & Texas EM-1 Medical Services PA(Emcare)

0% Service not available 0%

Houston Methodist Baytown Hospital Baytown US Anesthesia Partners of Texas PA 0% Methodist Pathology

Associates 0% Houston Radiology Associated 0% San Jacinto Emergency Physicians 100% Texas Childrens Physician

Group 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Baptist Beaumont Hospital Beaumont None in network 90% Diagnostic Pathology Associates 0% Coastal Imaging Associates, 0% none in network 100% Doshi Neonatal Associates

PLLC 0%

Christus Hospital St Elizabeth Hospital Beaumont Huang Xisong, MD, Guoxin Wu, MD 100% Beaumont Pathology

Associates PA 0% Radiology Associates, Southeast Texas Imaging 0% Sound Physicians Emergency

Medicine of Texas, PLLC 0% Pediatrix Medical Group of Texas 0%

Texas Health Harris Methodist Hospital Hurst Euless Bedford

Bedford US Anesthesia Partners of Texas PA 0% ProPath Associates 0% None in network 83% Texas Medicine Resources LLP 0% Pediatrix Medical Group of Texas 0%

Christus Spohn Hospital Beeville Beeville EmergencHealth 0% None in network 0% Radiology and Imaging of South

Texas 0% Guadalupe Emergency Medicine Associates 8% Service not available 0%

Bellville Medical Center Bellville Performance Anesthesia Services LLC 0% Brazos Valley Pathology 0% Bryan Radiology Associates 0% Concord Medical Group of Texas 0% Service not available 0%

Scenic Mountain Medical Center Big Spring Scenic Mountain Anesthesia Services 0% Ameripath 0% High Plains Radiology 0% Concord Medical Group of Texas 0% Service not available 0%

Methodist Boerne Emergency Center Boerne Service not available 5% South Texas Pathology

Associates 0% South Texas Radiology Group 0%Texas EM-I Medical Services,Floyd Ridge Emergency Physicians

0% Service not available 3%

Golden Plains Community Hospital Borger Golden Plains Community Hospital 0% Amarillo Pathology

Associates   0% RFC Radiology Associates 0% None in network 0% Service not available 0%

Heart of Texas Memorial Hosp Brady Heart of Texas Memorial Hospital 0% Service not available 0% Community Radiology Associates 0% Victoria Emergency Partners 100% Service not available 0%

Stephens Memorial Hospital Breckenridge Robert T. Laird, CRNA 0% Clinical Pathology Associates 0% Stonewall Memorial Hospital 0% Concord Medical Group of Texas

PLLC 0% Service not available 0%

Baylor Scott and White Medical Center Brenham Brenham Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Century Integrated Partners Inc 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Brownfield Regional Medical Center Brownfield Brownfield Regional Medical Center 0% Ameripath Lubbock 0% High Plains Radiology 0% Concord Medical Group of Texas 0% Service not available 0%

Valley Baptist Medical Center Brownsville Brownsville None in network 100% Pathology Associates of

South Texas 100% Valley Radiology and Associates 0% Travis County Emergency Physicians 100% Brownsville Associates in

Neonatology 0%

Valley Regional Medical Center Brownsville Northstar Anesthesia PA 0% Mid Valley Pathology 100% Singleton Associates 0% TX-I Medical Services 0% Brownsville Associates in

Neonatology 0%

Brownwood Regional Medical Center Brownwood Clinical Partners PA 0% Community Pathology

Associates 0% Singleton Associates PA 0% Texas EM-I Medical Services PA 0% Service not available 0%

CHI St Joseph Health Regional Hospital Bryan None in network 0%

Austin Pathology Associates PA; Brazos Valley Pathology; CHI St Joseph Health Urology Associates

0% Bryan Radiology Associates 0% Bryan Emergency Physicians 0% Pediatrix Medical Group of Texas of Texas 0%

The Physicians Centre Bryan YPS Anesthesia 0%Brazos Valley Pathology PA; Austin Pathology Associates PA

0% Bryan Radiology Associates 0% None in network 0% Service not available 0%

Baylor Scott and White Medical Center Buda Buda Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Service not available 0%

Baylor Emergency Medical Center Burleson

Dallas Anesthesiology Associates PA/US Anesthesia Partners of Texas PA

0% Service not available 0% Service not available 0% West Village Emergency Physicians PLLC 100% Service not available 0%

Texas Health Huguley Hospital Ft Worth South Burleson Northstar Anesthesia PA 0% Huguley Pathology

Consultants PA 0% Radiology Associates of North Texas PA 0% None in network 100% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Ascension Seton Highland Lakes Burnet YPS Anesthesia LLC 0%

Austin Pathology Associates PA; Travis Pathology Associates

0% Austin Radiological Association PA 0%

Travis County Emergency Physicians; Third Coast Emergency Physicians - Southwest PA

0% Service not available 0%

CHI St Joseph Health Burleson Hospital Caldwell Service not available 0% Austin Pathology

Associates PA 0% Bryan Radiology Associates 0%Burleson St Joseph's Health; Brazos Valley Emergency Physicians

0% Service not available 0%

Hemphill County Hospital Canadian Service not available 0% North Texas Pathology 0% High Plains Radiological Association   0% Southwest Medical Associates 0% Service not available 0%

Cedar Park Regional Medical Center Cedar Park US Anesthesia Partners of Texas PA 0% Brazos Valley Pathology,

PA 0% Austin Radiological Association PA 0% Travis County Emergency Physicians 0% Service not available 0%

Childress Regional Medical Center Childress None in network 0% None in network 0% High Plains Radiological Association

  0% Childress Regional Medical Center Physicians 0% Service not available 0%

Texas Health Harris Methodist Hospital Cleburne Cleburne US Anesthesia Partners of Texas PA 0% None in network 0% None in network 100% Texas Medicine Resources LLP 0% Pediatrix Medical Group of

Texas of Texas 0%

Goodall-Witcher Hospital Clifton YPS Anesthesia LLC 0% Central Texas Pathology Lab 0% Radiology Consultants of Texas 0% None in network 0% Service not available 0%

Baylor Scott and White Medical Center College Station

College Station Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0%

CHI St Joseph Health College Station Hospital College Station None in network 0% Austin Pathology

Associates PA 0% Bryan Radiology Associates 0%

Travis County Emergency Physicians; Third Coast Emergency Physicians - Southwest PA

0% Texas Childrens Physician Group 0%

Baylor Emergency Medical Center at Colleyville Colleyville Service not available 0% Service not available 0% Service not available 0% None in network 100% Service not available 0%

Mitchell County Hospital Colorado City None in network 0% Clinical Pathology Associates 0% Garvish Radiology 0% Mitchell County Hospital District 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Columbus Community Hospital Columbus Huffman Anesthesia 0% None in network 0% Bryan Radiology Associates 0% Concord Medical Group of Texas 0% Service not available 0%

Comanche County Medical Center Comanche YPS Anesthesia LLC 0% Clinical Pathology

Associates 0% Radiology Associates of Abilene PA 0% Concord Medical Group PLLC 0% Service not available 0%

Aspire Hospital LLC Conroe Service not available 0% Service not Available 0% Bryan Radiology Associates 42% Service not Available 0% Service not available 0%

HCA Houston Conroe Conroe North Houston Anesthesiology 0% North Houston Pathology Associates 0% Inpatient Consultants of Texas,

PLLC (IPC) 0% Compass Point Emergency Physicians, PLLC(Emcare) 0% Pediatrix Medical Group of

Texas 0%

Bay Area Medical Center Corpus Christi US Anesthesia Partners of Texas PA 0% Pathology Associates of Corpus Christi 0% Radiology Associates 0% TX-1 Medical Services, Oxbow

Emergency Physicians 0% Neonatology Consultants of Corpus Christi 0%

Christus Spohn Hospital South Corpus Christi Bay Area Anesthesia Associates,

EmergencHealth 0% Pathology Associates of Corpus Christi 0% Radiology and Imaging of South

Texas 0% Conner Emergency Medicine Associates 0% Childrens Physician Services

of South Texas 0%

Christus Spohn Memorial Hospital Corpus Christi Service not available 11% Pathology Associates of

Corpus Christi 17% Radiology and Imaging of South Texas 0% Conner Emergency Medicine

Associates 0% Service not available 0%

Christus Spohn Shoreline Hospital Corpus Christi EmergencHealth 0% Pathology Associates of

Corpus Christi 0% Radiology and Imaging of South Texas 0% Conner Emergency Medicine

Associates 0% Service not available 0%

Corpus Christi Medical Center Northwest Regional Corpus Christi Service not available 0% Service not available 15% Service not available 0% TX-1 Medical Services, Oxbow

Emergency Physicians 0% Service not available 0%

Doctors Regional Medical Center Corpus Christi US Anesthesia Partners of Texas PA 0% Pathology Associates of

Corpus Christi 0% Radiology Associates 0% TX-1 Medical Services, Oxbow Emergency Physicians 0% Service not available 0%

Driscoll Childrens Hospital Corpus Christi Childrens Physician Services of South Texas 0% Childrens Physician

Services of South Texas 29% Childrens Physician Services of South Texas 0% Nueces Emergency Medicine

Associates 0% Neonatology Consultants of Corpus Christi 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

South Texas Surgical Hospital Corpus ChristiGulf Shore Anesthesia, Bay Area Anesthesia Associates, Clinical Associates

0% Pathology Associates of Corpus Christi 0% Radiology Associates, Radiology

and Imaging of South Texas 0% None in network 0% Service not available 0%

The Heart Hospital Corpus Christi US Anesthesia Partners of Texas PA 0% Pathology Associates of Corpus Christi 15% Radiology Associates 0% TX-1 Medical Services, Oxbow

Emergency Physicians 0% Service not available 0%

Navarro Regional Hospital Corsicana Northstar Anesthesia PA 0% Ameripath 5 01 A Corporation 0% Radiology Associates of North

Texas PA 0%Comprehensive Hospitalist Services of Texas PLLC/Navarro Emergency Physicians PLLC

0% Medical Associates of Navarro County 0%

Crane Memorial Hospital Crane Crane Rural Health Clinic 0% Midland Pathology Associates 0% RadPartners 0% Concord Medical Group of Texas

PLLC, Crane Memorial Hospital 0% Service not available 0%

Crockett Medical Center Crockett None in network 0% None in network 0% Bryan Radiology Associates 0% Concord Medical Group of Texas PLLC 0% Service not available 0%

Crosbyton Clinic Hospital Crosbyton Service not available 0% Service not available 0% John Garvish MD 0% Steve B Alley, MD 0% Service not available 0%

Cuero Regional Hospital Cuero AM Anesthesia Services of South Texas 72% None in network 100% None in network 0% None in network 87% Service not available 0%

HCA Houston Healthcare North Cypress Cypress US Anesthesia Partners of Texas PA 0%

JS Wilkensfield and Associates, Gulf Pathology Associates, Community Pathology Associates

0% West Houston Radiology 0% None in network 0% Service not available 0%

Memorial Hermann Cypress Hospital Cypress Texans Anesthesia Associates 0% Memorial Pathology

Consultants 0% Synergy Radiology Associates 0% Memorial Hermann Emergency Physicians 0% UT Physicians 0%

Coon Memorial Hospital Dalhart High Country Community Rural Health Clinic 0% LabCorp 0% High Plains Radiology 0% None in network 0% Service not available 0%

Baylor Heart and Vascular Hospital Dallas US Anesthesia Partners of Texas PA 0% Ameripath 5 01 A

Corporation 0% American Radiology Consultants LLC 54% Service not available 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Baylor Scott & White Medical Center Uptown Dallas Dallas Anesthesiology Associates PA

Allen Anesthesia Associates PA 0% Pathologist Bio Medical Laboratories PLLC 0% American Radiology Consultants

LLC 54% West Village Emergency Physicians PLLC 0% Service not available 0%

Baylor University Medical Center Dallas US Anesthesia Partners of Texas PA,

Pinnacle Anesthesia 0% Pathologist Bio Medical Laboratories PLLC 71% American Radiology Consultants

LLC 34% Century Integrated Partners Inc 0% Pediatrix Medical Group of Texas of Texas 0%

Childrens Medical Center of Dallas Dallas

Anesthesiologist for Childrens/University of Texas Southwestern

0% UT Southwestern Medical Center 2% UT Southwestern Medical Center 0%

Pediatric Emergency Medicine Group LLP/UT Southwestern Medical Center

0% UT Southwestern Medical Center 0%

Medical City Childrens Dallas Dallas Anesthesiology Associates PA 11% MCD Pathology LLP 0% Radiology Associates of North Texas PA 4% Questcare Medical Services PLLC 0% Pediatrix Medical Group of

Texas of Texas 0%

Medical City Dallas DallasDallas Anesthesiology Associates PA/US Anesthesia Partners of Texas PA

11% MCD Pathology LLP 0%Radiology Associates of North Texas PA/Radiology Consultants of North Dallas PA

4% Questcare Medical Services PLLC 0% Pediatrix Medical Group of Texas of Texas 0%

Medical City Heart and Spine Hospital Dallas US Anesthesia Partners of Texas PA 11% None in network 0% None in network 4% Questcare Medical Services PLLC 0% None in network 0%

Methodist Charlton Medical Center Dallas US Anesthesia Partners of Texas PA 0% Laboratory Physicians

Association 0%Radiological Consultants Association/Radiology Associates of North Texas PA

0% Texas Physician Resources LLP 0% Service not available 0%

Methodist Dallas Medical Center Dallas US Anesthesia Partners of Texas PA 0% Laboratory Physicians

Association 0%Radiological Consultants Association/Radiology Associates of North Texas PA

0% Texas Physician Resources LLP 0% Pediatrix Medical Group of Texas of Texas 0%

North Central Surgical Center DallasDallas Anesthesiology Associates PA/US Anesthesia Partners of Texas PA

43% None in network 0% None in network 0% NP Emergency Physicians PLLC 0% None in network 0%

Texas Health Presbyterian Hospital Dallas Dallas US Anesthesia Partners of Texas PA 0% North Dallas Pathology

Services PA 0% None in network 0% Texas Medicine Resources LLP 0% Pediatrix Medical Group of Texas of Texas 0%

Texas Institute for Surgery at Texas Health Presbyterian Dal

Dallas US Anesthesia Partners of Texas PA 0% None in network 0% Radiology Associates of North Texas PA 0% None in network 0% None in network 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

UT Southwestern University Hospital Dallas University of Texas Southwestern

Medical Center 0% University of Texas Southwestern 0% University of Texas Southwestern 2% UT Southwestern Medical Center 0% University of Texas

Southwestern 0%

UT Southwestern University Hospital Dallas University of Texas Southwestern

Medical Center 0% University of Texas Southwestern 0% University of Texas Southwestern 0% UT Southwestern Medical Center 0% Service not available 0%

Wise Regional Health System Decatur None in network 0% Ameripath 5 01 A Corporation 0% None in network 100% Wise Emergency Medicine

Associates PA 0% Service not available 0%

Val Verde Regional Medical Center Del Rio None in network 100% Pathology Associates of

San Antonio LLP 0% South Texas Radiology Group 0% Victoria Emergency Associates 32% Service not available 0%

Texoma Medical Center DenisonUS Anesthesia Partners of Texas PA/Pinnacle Anesthesia Consultants PA

0% None in network 0% Sherman Radiology Associates 100% None in network 68% Millennium Neo Texoma PLLC 0%

Baylor Scott and White The Heart Hospital Denton Denton US Anesthesia Partners of Texas PA 0% None in network 0% None in network 100% Century Integrated Partners Inc 0% Service not available 0%

Medical City Denton Denton US Anesthesia Partners of Texas PA 0% Affiliated Pathology Services PC 0% None in network 71%

Century Integrated Partners Inc/Questcare Medical Services PLLC

0% Sheridan Healthcare of Texas PA 0%

Texas Health Presbyterian Hospital Denton Denton Metropolitan Anesthesia Consultants

LLP 0% Ameripath 5 01 A Corporation 0% None in network 100% Texas Medicine Resources LLP 0% Pediatrix Medical Group of

Texas of Texas 0%

Yoakum County Hospital Denver City

Shanna Barker CRNA; Mary Alice Hardie CRNA; Mark Allen Hornsby CRNA; Mayme Alicia Matthews CRNA; Jeffrey White CRNA

0% Ameripath Lubbock 0% Lubbock Diagnostic Radiology 0% Lone Star Emergency Associates 0% Service not available 0%

Plains Memorial Hospital Dimmitt Service not available 0% Ameripath of Lubbock 0% High Plains Radiological Association   0% David Ward MD PA 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Moore County Hospital Dumas Stella Tan, MD; Manisha Wagle MD 0% Amarillo Pathology Associates   0% High Plains Radiological Associates,

John Garvish 0% Moore County Hospital, Sound Physicians; Memorial Hospital 0% Service not available 0%

Rice Medical Center Eagle Lake YPS Anesthesia Services, Rice Medical Associates 0% None in network 0% Singleton Associates 0% Rice Medical Associates 0% Service not available 0%

Fort Duncan Regional Medical Center Eagle Pass Access Provider Group 0% Pathology Reference Labs 0% Maverick County Rural Radiologist

PA 100% Maverick Emergency Medicine Associates 0% Service not available 0%

Eastland Memorial Hospital Eastland YPS Anesthesia LLC; Hendrick Provider Network 0% Clinical Pathology

Associates 0% Radiology Associates of Abilene 0% Concord Medical Group 0% Service not available 0%

Concho County Hospital Eden Service not available 0% Service not available 0% Singleton Associates 0% Monte Horne MD 0% Service not available 0%

Cornerstone Regional Hospital LP Edinburg None in network 0% RGV Pathology Consultants 0% Edinburg Radiology 0% Ivan Melendez MD 0% Service not available 0%

Doctors Hospital At Renaissance Edinburg McAllen Anesthesia Consultants 0% Valley Pathology 32% Renaissance Radiology Associates 36% Renaissance Emergency

Physicians 0% Neonatology Consultants of South Texas 0%

STHS Edinburg Childrens Hospital Edinburg Premier Anesthesia of Huntsville LLC 0% RGV Pathology Consultants 0% RFC Radiology Associates 3% Edinburg Emergency Medicine

Associates PA 0% Pediatrix Medical Group of Texas 0%

STHS Edinburg Regional Medical Center Edinburg Premier Anesthesia of Huntsville LLC 0% RGV Pathology Consultants 0% RFC Radiology Associates 3% Edinburg Emergency Medicine

Associates PA 0% Pediatrix Medical Group of Texas 0%

The Womens Hospital At Renaissance Edinburg McAllen Anesthesia Consultants 0% Valley Pathology 32% Renaissance Radiology Associates 36% Renaissance Emergency

Physicians 0% Neonatology Consultants of South Texas 0%

Jackson Healthcare Center Edna Satinder Judge, MD 0% None in network 0% None in network 0% Jackson County ER 52% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

El Campo Memorial Hospital El Campo None in network 0% Community Pathology Associates 0% Concord Radiology 0% Concord Medical Group of Texas 100% Service not available 0%

Del Sol Medical Center El Paso West Star Anesthesia Services PA 0% Rio Grande Pathology Services PA 0% Imaging Advantage 0% Emergency Services of Texas PA 0% Pediatrix Medical Group of

Texas of Texas 0%

East El Paso Physicians Medical Center Llc El Paso None in network 0% Rio Grande Pathology

Services PA 0% Synergy Radiology Associates 0% Patriot Emergency Physicians PLLC 0% Service not available 0%

Las Palmas Medical Center El Paso West Star Anesthesia Services; Anesthesia Consultants Associated 90% Desert Pathology Services,

P.A. 43% Imaging Advantage 40% Emergency Services of Texas PA 0% Pediatrix Medical Group of Texas of Texas 0%

The Hospitals of Providence East Campus El Paso EPMed PA 0% Pathology Associates of El

Paso PA 0% RadPartners 0% Bluff Creek Emergency Medicine Associates PA 2% Pediatrix Medical Group of

Texas of Texas 0%

The Hospitals of Providence Memorial Campus El Paso BHS Physicians Network Inc 0%

Pathology Associates of El Paso PA; GYN PATH Services Inc

0% Radiology Partners 0%Bluff Creek Emergency Associates PA, Patriot Emergency Physicians PLLC

0% Pediatrix Medical Group of Texas of Texas 0%

The Hospitals of Providence Northeast Campus El Paso Service not available 0% None in network 0% None in network 0% Pearsall Emergency Medicine

Associates, PA 0% Service not available 0%

The Hospitals of Providence Sierra Campus El Paso West Star Anesthesia Services PA;

CRNA Associates INC 27%Pathology Associates of El Paso PA; Sierra Laboratory Associates PA

0% RadPartners 0%Bluff Creek Emergency Medicine Associates PA; Northbank Emergency Physicians

6% Service not available 0%

The Hospitals of Providence Transmountain Campus El Paso Texas Tech University Health

Sciences Center El Paso 93%Texas Tech University Health Sciences Center El Paso

42% RadPartners 0%Texas EM-1 Medical Services PA; Patriot Emergency Physicians PLLC

0% Pediatrix Medical Group of Texas of Texas 0%

University Medical Center Of El Paso El Paso None in network 100%

Texas Tech University Health Sciences Center El Paso; University Medical Center of El Paso

65% Texas Tech University Health Sciences Center El Paso 4% Texas Tech University Health

Sciences Center El Paso 64%

Texas Tech University Health Sciences Center El Paso; Pediatrix Medical Group of Texas of Texas

0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Ennis Regional Medical Center Ennis None in network 0% Lab Direct LLC 0% None in network 0%

Running Buffalo Clover Emergency Physicians PLLC/Texas EM-1 Medical Services PA

0% Service not available 0%

Dallas Medical Center LLC Farmer's Branch Noble Anesthesia Partners PLLC 0% Ameripath 5 01 A

Corporation 0% Medical Imaging of Dallas 0% Live Oak Emergency Physicians PLLC 0% Service not available 0%

Connally Memorial Medical Center Floresville Anesthesia Associates of Seguin 0% Village Oaks Pathology

Services 0% South Texas Radiology Group 0% Victoria Emergency Partners 0% Service not available 0%

Texas Health Presbyterian Hospital Flower Mound Flower Mound US Anesthesia Partners of Texas PA 0% MD Pathology 0% None in network 100% Anesthesiologists for Children 0% Pediatrix Medical Group of

Texas of Texas 0%

Pecos County Memorial Hospital Fort Stockton None in network 0% ProPath Associates 0% MCH ProCare 81% None in network 100% Service not available 0%

Baylor All Saints Medical Center Fort Worth Northstar Anesthesia 0% Tarrant Pathology

Associates 0% Radiology Associates of North Texas PA 0% Century Integrated Partners Inc 0% Pediatrix Medical Group of

Texas 0%

Baylor Scott & White Surgical Hospital Forth Worth Fort Worth Noble Anesthesia Partners PLLC/US

Anesthesia Partners of Texas PA 0% Tarrant Pathology Associates 0% None in network 0% Stockyard Emergency

Physicians PLLC 0% Service not available 0%

Cook Childrens Medical Center Fort Worth Cook Childrens Physician Network 23% Cook Childrens Physician

Network 0% Radiology Associates of North Texas PA 0% Cook Childrens Physician

Network 28% Pediatrix Medical Group of Texas 0%

Medical City Alliance Fort Worth US Anesthesia Partners of Texas PA 0% Ameripath 5 01 A Corporation 0% None in network 92% Questcare Medical Services PLLC 0% Sheridan Healthcare of Texas

PA 100%

Medical City Fort Worth Fort Worth US Anesthesia Partners of Texas PA 0% Ameripath 5 01 A Corporation 0% Radiology Associates of North

Texas PA 0% Questcare Medical Services PLLC 100% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Texas Health Harris Methodist Hospital Alliance Fort Worth US Anesthesia Partners of Texas PA 0% Ameripath 5 01 A

Corporation 100% None in network 100% Texas Medicine Resources LLP 0% Pediatrix Medical Group of Texas 0%

Texas Health Harris Methodist Hospital Fort Worth

Fort Worth US Anesthesia Partners of Texas PA 0% AmeriPath PAT 5 01 A Corp 100% Radiology Associates of North Texas PA 0% Texas Medicine Resources LLP 0% Pediatrix Medical Group of

Texas 0%

Texas Health Harris Methodist Hospital Southwest Fort Worth

Fort Worth US Anesthesia Partners of Texas PA 0% ProPath Associates 0% None in network 0% Texas Medicine Resources LLP 22% Pediatrix Medical Group of Texas 0%

Wise Health System Fort Worth None in network 0% None in network 0% None in network 100% Wise Emergency Medicine Associates PA 0% Service not available 0%

Hill Country Memorial Hospital Fredericksburg US Anesthesia Partners of Texas PA 0% Foundations Inc 0% South Texas Radiology Group 0%

Barons Creek Emergency Physicians, Texas EM-I Medical Services

17% Service not available 0%

Parmer County Community Hospital Friona Service not available 0% Amarillo Pathology

Associates   0% High Plains Radiological Associates 0% Parmer County Community Hospital ER 0% Service not available 0%

Baylor Scott and White Medical Center Centennial Frisco Metropolitan Anesthesia Consultants 0% Ameripath 5 01 A

Corporation 0% None in network 97% None in Network 67% Pediatrix Medical Group of Texas of Texas 0%

Baylor Scott and White Medical Center Frisco Frisco US Anesthesia Partners of Texas PA 0% MD Pathology 0% None in network 100% Shawnee Trail Emergency

Physicians 100% Pediatrix Medical Group of Texas of Texas 0%

Medical City Frisco A Medical City Plano Facility Frisco US Anesthesia Partners of Texas PA 45%

Ameripath 5 01 A Corporation/Pathologist Bio Medical Laboratories PLLC

0% Radiology Consultants of North Dallas PA 90% Questcare Medical Services PLLC 27% Sheridan Healthcare of North

Texas PA 68%

Texas Health Hospital Frisco Frisco US Anesthesia Partners of Texas PA 0% None in network 0% None in network 0% Texas Medicine Resources LLP 0% Pediatrix Medical Group of Texas of Texas 0%

North Texas Medical Center Gainesville US Anesthesia Partners of Texas PA 0% None in network 0% Sherman Radiology Associates 0% None in network 100% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

University Of Texas Medical Branch At Galveston Galveston UTMB Faculty Group Practice 47% UTMB Faculty Group

Practice 0% UTMB Faculty Group Practice 0% Envision Physician Services 0% UTMB Faculty Group Practice 0%

St David's Georgetown Hospital Georgetown Northstar Anesthesia PA 0%

Clinical Pathology Associates; Travis Pathology Associates

0% Austin Radiological Association PA 0% Longhorn Emergency Medical Associates PA 0% Pediatrix Medical Group of

Texas of Texas 0%

Glen Rose Medical Center Glen Rose None in network 0% Central Texas Pathology Laboratory PA 0% High Plains Radiological Associates 0% Fossil Rim Emergency Physicians

PLLC 0% Service not available 0%

Memorial Hospital Gonzales Memorial Hospital CRNA 0% None in network 0% None in network 0% Concord Medical Group 46% Service not available 0%

Graham Regional Medical Center Graham YPS Anesthesia LLC 0% Pathology Associates of

North Texas PA 0% None in network 0% Texas Emergency Medicine Group LLP 0% Service not available 0%

Lake Granbury Medical Center Granbury EmergencHealth LLC 0% ProPath Associates 0% Radiology Associates of North

Texas PA 0% None in network 81% Service not available 0%

Baylor Scott and White Emergency Hospital Grand Prairie

Grand Prairie Service not available 0% Service not available 0% Service not available 0% Century Integrated Partners Inc 100% Service not available 0%

Baylor Regional Medical Center At Grapevine Grapevine US Anesthesia Partners of Texas PA 0% Pathologist Bio Medical

Laboratories PLLC 0% Radiology Associates of North Texas PA 0% Century Integrated Partners Inc 0% Pediatrix Medical Group of

Texas 0%

Hunt Regional Medical Center Greenville Northstar Anesthesia PA 0% R Irvin Morgan MD PA Pathology Associates 0% None in network 0% Texas Medicine Resources LLP 0% Texas Neonatology

Associates LLC 0%

Limestone Medical Center Groesbeck None in network 0% Central Texas Pathology Laboratory PA 0% Singleton Associates PA; Central

Texas Radiological Association PA 0% Concord Medical Group of Texas 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Lavaca Medical Center Hallettsville Lavaca Family Health Clinic 0% None in network 0% Bryan Radiology Associates 0% Lavaca Family Health Clinic 100% Service not available 0%

Hamilton General Hospital Hamilton Scott and White Clinic 0% Scott and White Clinic 0% Central Texas Radiological Association PA 0% Scott and White Clinic 0% Service not available 0%

Valley Baptist Medical Center Harlingen None in network 100% Mid Valley Pathology 100% Sunrise Vascular 0% Travis County Emergency Physicians 0%

Neonatology Consultants of Corpus Christi, Childrens Physician Services of South Texas

0%

Haskell Memorial Hospital Haskell None in network 0% None in network 0% Radiology Associates of Abilene PA 0% Concord Medical Group PLLC 0% None in network 0%

Sabine County Hospital Hemphill Service not available 0% Quest Diagnostics SG 0% High Plains Radiological Associates 0% None in network 0% Service not available 0%

Clay County Memorial Hospital Henrietta Clinical Partners PA 0% Pathology Associates of

North Texas PA 0% None in Network 0% Concord Medical Group of Texas PLLC 0% Service not available 0%

Hereford Regional Medical Center Hereford Hereford Health Clinic; Alliance

Regional Health Network 0% Amarillo Pathology Associates 0% High Plains Radiological 0% Concord Medical Group of Texas

PLLC 0% Service not available 0%

Hill Regional Hospital Hillsboro None in network 0% Central Texas Pathology Laboratory PA 0% None in Network 100% None in network 0% Service not available 0%

Medina Regional Hospital Hondo Medina Regional Hospital 32% Village Oaks Pathology Services 0% South Texas Radiology Group 0% Victoria Emergency Associates 0% Service not available 0%

The Hospitals of Providence Horizon City Campus Horizon City US Anesthesia Partners of Texas PA 0% Pathology Associates of El

Paso PA 0% Providence Imaging Consultants PA 0% Pearsall Emergency Medicine Associates PA 3% Pediatrix Medical Group of

Texas of Texas 0%

HCA Houston Med Ctr Houston Texans Anestheisa Associates 0% North Houston Pathology Assoc 0% Innovative Radiology 0% Compass Point Emergency

Physicians, PLLC(Emcare) 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

HCA Houston Northwest Houston US Anesthesia Partners of Texas PA 0% North Houston Pathology Assoc 0% EmCare (Tx-1 Medical Services, PA) 0% Herald Emergency Physicians,

PLLC(Envision) 0% Pediatrix Medical Group of Texas of Texas 0%

HCA Houston West Houston US Anesthesia Partners of Texas PA 0% None of Network 0% EMCare (Tx-1 Medical Services, PA) 0% Compass Point Emergency Physicians, PLLC(Envision) 0% Pediatrix Medical Group of

Texas of Texas 0%

Houston Methodist Hospital Houston US Anesthesia Partners of Texas PA 0% Methodist Pathology Associates 0% Houston Radiology Associated 9% EmergiGroup Physician

Associates, PA 92% Texas Childrens Physician Group 0%

Houston Methodist West Hospital Houston US Anesthesia Partners of Texas PA 0% Methodist Pathology

Associates 0% Houston Radiology Associated 26% West Houston Emergency Physicians 100% Texas Childrens Physician

Group 0%

Houston Methodist Willowbrook Hospital Houston US Anesthesia Partners of Texas PA 0% Methodist Pathology

Associates 0% Houston Radiology Associated 11% Woodlands Emergency Physicians 100% Texas Childrens Physician

Group 0%

Md Anderson Cancer Center Houston Physicians Referral Service 0% Physicians Referral Service 0% Physicians Referral Service 0% Physicians Referral Service 0% Service not available 0%

Memorial Hermann Southwest Hospital Houston US Anesthesia Partners of Texas PA 0% Memorial Pathology

Consultants 0% Synergy Radiology Associates 0% Memorial Hermann Emergency Physicians 21% Pediatrix Medical Group of

Texas 0%

MHHS Greater Heights Hospital Houston Texans Anestheisa Associates 0% Memorial Pathology

Consultants 0% Synergy Radiology Associates 0% Memorial Hermann Emergency Physicians 21% UT Physicians 0%

MHHS Hermann Hospital Houston UT Physicians 0% Memorial Pathology Consultants 0% UT Physicians 0% UT Physicians 0% UT Physicians 0%

MHHS Memorial City Hospital Houston US Anesthesia Partners of Texas PA 0% Memorial Pathology Consultants 0% Singleton Associates 0% Memorial Hermann Emergency

Physicians 58% UT Physicians 0%

MHHS Southeast Hospital Houston Texans Anestheisa Associates 0% Memorial Pathology Consultants 0% Synergy Radiology 0% Memorial Hermann Emergency

Physicians 21% UT Physicians 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

St Joseph Medical Center Houston Northstar Anesthesia PA 100% Community Pathology Associates 0% Singleton Associates 0% St. Joseph Emergency

Physicians, PLLC 0% Pediatrix Medical Group of Texas of Texas 0%

St Lukes Hospital at The Vintage LLC Houston None in network 100% Community Pathology

Associates 0% Singleton Associates 0% Baylor College of Medicine 0% Texas Childrens Physician Group 0%

St Lukes Medical Center Houston None in network 51% Community Pathology Associates 0% Singleton Associates 0% None in network 58% Service not available 0%

Texas Childrens Hospital Houston Texas Childrens Physician Group, (dba TCPSO) 2% Pediatric Pathology

Consultants 0% Texas Childrens Physician Group 0% Texas Childrens Physician Group 0% Texas Childrens Physician Group 11%

Texas Childrens Hospital West Campus Houston Texas Childrens Physician Group 2% Pediatric Pathology

Consultants 0% Texas Childrens Physician Group 0% Texas Childrens Physician Group 0% Texas Childrens Physician Group 11%

Texas Orthopedic Hospital Houston US Anesthesia Partners of Texas PA 0% CBaylor Pathology 0% None in Network 100% Fondren Orthopedic Group 0% Service not available 0%

The Womans Hospital Of Texas Houston Austin Anesthesiology Group PLLC 19% Houston Pathology

Associates, P.A. 0% MedNax 0% Compass Point Emergency Physicians, PLLC(Emcare) 0% Pediatrix Medical Group of

Texas 0%

TOPS Surgical Specialty Hospital Houston Best Choice 0% North Houston Pathology

Associates 0% Rose Imaging Specialist 0% Service not Available 0% Service not available 0%

United Memorial Medical Center Houston None in Network 0% None in Network 100% Singleton Associates 100% United Memorial Medical Center

Physician Group 0% Service not available 0%

United Memorial Medical Center North Hospital Houston None in Network 0% None in Network 0% Singleton Associates 0% None in Network 0% Service not available 0%

Memorial Hermann Childrens Hospital Houston UT Physicians 0% UT Physicians 0% UT Physicians 0% UT Physicians 0% UT Physicians 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

MHHS Northeast Hospital Humble US Anesthesia Partners of Texas PA 0% North Houston Pathology Assoc 0% Synergy Radiology Associates 0% Memorial Hermann Emergency

Physicians 100% Pediatrix Medical Group of Texas 100%

Aspire Hospital LLC Huntsville Service not available 0% Service not available 0% Bryan Radiology Associates 0% Service not Available 0% Service not available 0%

Huntsville Memorial Hospital Huntsville Premier Anesthesia of Huntsville LLC 0% Community Pathology Associates 100% Bryan Radiology Associates 0% ACS Primary Care Physicians

Southwest, PA 0% Service not available 0%

Baylor Scott and White Medical Center Irving Irving US Anesthesia Partners of Texas PA 0% Irving Laboratories

PA/Scott and White Clinic 0%American Radiology Consultants LLC/Irving Radiological Associates LLP

63% Century Integrated Partners Inc 0% Pediatrix Medical Group of Texas of Texas 0%

Baylor Surgical Hospital at Las Colinas Irving US Anesthesia Partners of Texas PA 0% None in network 0% None in network 0% Campion Emergency Physicians

PLLC 0% None in network 0%

Medical City Las Colinas Irving US Anesthesia Partners of Texas PA 0% Propath Associates 0% None in network 57% Questcare Medical Services PLLC 0% Sheridan Healthcare of Texas PA 100%

Faith Community Hospital Jacksboro None in network 0% Affiliated Pathology Services PC 0% Concord Radiology PLLC 0% None in network 0% Service not available 0%

Mother Frances Hospital Jacksonville Jacksonville Mother Frances Hospital Jacksonville 0% Austin Pathology

Associates PA 0% Tyler Radiology Associates 0% Mother Frances Hospital Jacksonville 100% Service not available 0%

Christus Jasper Memorial Hospital Jasper YPS Anesthesia Services 0% Beaumont Pathology 0% Radiology Associates 0% Sound Physicians Emergency

Medicine of Texas, PLLC 0% Service not available 0%

Methodist Hospital South Jourdanton None in network 0% Village Oaks Pathology Services 0% South Texas Radiology Group 0% None in network 0% Service not available 0%

Memorial Hermann Katy Hospital Katy US Anesthesia Partners of Texas PA 0% Brown & Associates

Medical Laboratories, LLP 0% Synergy Radiology Associates 0% Memorial Hermann Emergency Physicians 0% UT Physicians 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Texas Health Presbyterian Hospital Kaufman Kaufman Northstar Anesthesia PA 0% None in network 0% Radiology Associates of North

Texas PA 58% Texas Medicine Resources LLP 17% Service not available 0%

Baylor Scott and White Emergency Hospital Keller Keller Service not available 0% Service not available 0% Service not available 0% None in network 100% Service not available 0%

Otto Kaiser Memorial Hospital Kenedy YPS Anesthesia, Anesthesia

Associates of Seguin 0% None in network 100% None in network 0% Concord Medical Group 72% Service not available 0%

Winkler County Memorial Hospital Kermit Service not available 0% None in network 0% None in network 0% Concord Medical Group of Texas

PLLC 0% Service not available 0%

Peterson Regional Medical Center Kerrville Anesthesia Associates Group 0% Foundations Inc 0% Hill Country Imaging Associates 0% Travis County Emergency

Physicians 0% Service not available 0%

AdventHealth Central Texas Killeen Baylor Scott & White Clinic 0% Baylor Scott & White Clinic 0% Baylor Scott & White Clinic 0%

Emergency Associates of Central TX; Longhorn Emergency Medical Associates/TeamHealth

0% Baylor Scott & White Clinic 0%

Seton Medical Center Harker Heights Killeen EmCare, EmergencHealth 0% Brazos Valley Pathology 0% Austin Radiological Association PA 0% Emergency Service Partners 0% Pediatrix Medical Group of

Texas 0%

Christus Spohn Hospital Kleberg Kingsville EmergencHealth 0% None in network 0% Radiology and Imaging of South

Texas 0% Guadalupe Emergency Medicine Associates 0% Service not available 0%

HCA Houston Kingwood Kingwood US Anesthesia Partners of Texas PA 0% North Houston Pathology Associates 0% Inpatient Consultants of Texas,

PLLC (IPC) 0% Compass Point Emergency Physicians, PLLC(Emcare) 0% Pediatrix Medical Group of

Texas 0%

Memorial Hermann Specialty Hospital Kingwood Kingwood US Anesthesia Partners of Texas PA 0% North Houston Pathology

Associates 0% Singleton Associates 0% Memorial Hermann Emergency Physicians 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Knox County Hospital Knox City None in network 0% None in network 0% Radiology Associates of Abilene PA 0% None in network 0% None in network 0%

Ascension Seton Hays Kyle US Anesthesia Partners of Texas PA 0% Brazos Valley Pathology, PA 0% Austin Radiological Association PA 0%

Travis County Emergency Physicians; Third Coast Emergency Physicians - Southwest PA

0% Pediatrix Medical Group of Texas of Texas 0%

St Marks Medical Center La Grange YPS Anesthesia LLC 0% None in network 0% RadPartners 0% Victoria Emergency Partners LLC 0% Service not available 0%

Brazosport Regional Health System Lake Jackson Seven Flags Anesthesia Associates

PLLC 0% Community Pathology Associates 0% Singleton Associates 0% Envision Physician Services 0% Service not available 0%

Baylor Scott and White Medical Center - Lakeway Lakeway US Anesthesia Partners of Texas PA 0%

Scott and White Clinic; Austin Pathology Associates PA

0% Scott and White Clinic 0% Scott and White Clinic 0% Pediatrix Medical Group of Texas of Texas 0%

AdventHealth Rollins Brook Lampasas Baylor Scott & White 0% Baylor Scott & White 0% Baylor Scott & White 0% Emergency Associates of Central Texas/TeamHealth 0% Baylor Scott & White Clinic 0%

Crescent Medical Center Lancaster Lancaster Noble Anesthesia Partners PLLC 100% Ameripath 5 01 A

Corporation 0% Radiology Associates of North Texas PA 0% None in network 0% Service not available 0%

Doctors Hospital Of Laredo Laredo Standard Anesthesia 0% Pathology Reference Labs 0% Singleton Associates 10% Webb Emergency Medicine Associates 0% Jose L Berlioz, MD, Roberto

Villegas, MD 86%

Laredo Medical Center Laredo None in network 100% Corepath Laboratories 0% DeliverRad 53% Webb Emergency Medicine Associates 0% Satbir Chhina, MD 16%

UTMB League City League City UTMB Faculty Group Practice 0% UTMB Faculty Group Practice 0% UTMB Faculty Group Practice 0%

Barrier Reef Emergency Physicians PLLC(Emcare & Texas EM-1 Medical Services PA(Emcare)

0% UTMB Faculty Group Practice 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Covenant Hospital Levelland Levelland Covenant Hospital Levelland; Kinino PLLC 0% Ameripath Lubbock 0% Lubbock Diagnostic Radiology 0% None in network 0% Service not available 0%

Medical City Lewisville Lewisville Metropolitan Anesthesia Consultants LLP 0% ProPath Associates 0% Medical Imaging of Dallas 61% Questcare Medical Services PLLC 0% Sheridan Healthcare of Texas

PA 48%

Liberty Dayton Regional Medical Center Liberty Service not available 0% Gulf Coast Pathology

Associates 0% 1960 Physician Associates 0% Concord Medical Group of Texas 0% Service not available 0%

Lamb Healthcare Center Littlefield None in network 0% Ameripath Lubbock 0% Lubbock Diagnostic Radiology 0% Concord Medical Group 0% Service not available 0%

Northeast Methodist Hospital Live Oak US Anesthesia Partners of Texas PA 0% Village Oaks Pathology Services 0% South Texas Radiology Group 0% TX-I Medical Services, Judson

Road Emergency Physicians 0% Service not available 0%

CHI St Lukes Health Memorial Livingston Livingston AC Provider Services of Texas LLC 0% None in network 0% ADRA Medical Imaging 0% Camino Real Emergency

Physicians PLLC 0% Service not available 0%

W J Mangold Memorial Hospital Lockney Roderick Stelle, CRNA 0% None in network 0% Abilene Radiology Associates 0% None in Network 0% Service not available 0%

Good Shepherd Medical Center Longview Trinity Clinic 0% Community Pathology

Associates 0% Medical Imaging Consultants LLP 0% Longview Emergency Medicine Associates 0% Ancore Health Center PA 0%

Longview Regional Medical Center Longview Horizon Anesthesia Associates

PA/Premier Pediatrics PLLC 79% Baylor Pathology 0%East Texas Radiologists Consultants PC/Radiology Associates of North Texas PA

0% ACS Primary Care Physicians Southwest PA 0% Onsite Neonatal Texas PLLC 0%

Covenant Children's Hospital Lubbock Northstar Anesthesia PA 0% Ameripath Lubbock 0% Lubbock Diagnostic Radiology 0% Covenant Medical Group 0% Pediatrix Medical Group of Texas of Texas 0%

Covenant Medical Center Lubbock Northstar Anesthesia PA; Great Plains Anesthesia 0% Ameripath Lubbock 0% Lubbock Diagnostic Radiology 0% Covenant Medical Group 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Covenant Specialty Hospital Lubbock Northstar Anesthesia PA 0% Ameripath Lubbock 0% Lubbock Diagnostic Radiology 0% Service not available 0% Service not available 0%

Grace Surgical Hospital Lubbock Lubbock Texas Highland Medical Center; Grace Clinic 0% Avero Diagnostics 0% Grace Clinic of Lubbock 0%

Yellow House Canyon Emergency Physicians PLLC; Lubbock Texas Highland Medical Center

0% Service not available 0%

University Medical Center Lubbock Texas Tech University Health Sciences Center 9% Texas Tech University

Health Sciences Center 0% UMC Radiology 0% UMC EC Physicians 0% Pediatrix Medical Group of Texas of Texas 0%

CHI St Lukes Health Memorial Lufkin AC Provider Services of Texas LLC 0% None in network 0% ADRA Medical Imaging 0% Camino Real Emergency Physicians PLLC 0% Service not available 0%

Woodland Heights Hospital Lufkin EmergencHealth, LLC 0% None in network 0% None in Network 100%Angelina Emergency Medicine Associates, P.A./Lufkin Physician Services PA

0% Pediatrix Medical Group of Texas 0%

Ascension Seton Edgar B Davis Luling YPS Anesthesia 0% Clinical Pathology

Associates 0% Austin Radiological Association PA 0% Travis County Emergency Physicians 0% Service not available 0%

CHI St Joseph Health Madison Hospital Madisonville Service not available 0% Austin Pathology

Associates PA 0% Bryan Radiology Associates 0% Brazos Valley Emergency Physicians 0% Service not available 0%

Methodist Mansfield Medical Center Mansfield US Anesthesia Partners of Texas PA 0% Laboratory Physicians

Association 0% Radiology Associates of North Texas PA 0% Texas Physician Resources LLP 0% Pediatrix Medical Group of

Texas 0%

Baylor Scott and White Medical Center Marble Falls Marble Falls Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Century Integrated Partners Inc;

Scott and White Clinic 0% Service not available 0%

Falls Community Hospital And Clinic Llc Marlin Service not available 0% Clinical Pathology

Associates 0%

Central Texas Radiological Association PA; Radiology Consultants of Texas; Bing Obaldo MD

0% Falls Community Hospital and Clinic Inc 0% Service not available 0%

Christus Good Shepherd Medical Center Marshall Good Shepherd Medical Center 8% Community Pathology

Associates 0% Medical Imaging Consultants LLP 0%Longview Emergency Medicine Associates/Marshall Regional Medical Cte Emerg

100% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

McCamey County Hospital Mc Camey Service not available 0% Quest 0% John Garvish MD 0% McCamey County Hospital 0% Service not available 0%

McAllen Heart Hospital McAllen Premier Anesthesia of Huntsville LLC 0% RGV Pathology Consultants 0% RFC Radiology Associates 3% Edinburg Emergency Medicine Associates PA 0% Service not available 0%

Rio Grande Regional Hospital McAllen Rio Grande Anesthesia and Pain Medicine Consultants 0% Valencia & Sanchez MD 12% Singleton Associates 0% Texas EM-I Medical Services 0% Pediatrix Medical Group of

Texas 0%

STHS McAllen Medical Center McAllen Premier Anesthesia of Huntsville LLC 0% RGV Pathology Consultants 0% RFC Radiology Associates 0% Edinburg Emergency Medicine Associates PA 0% Pediatrix Medical Group of

Texas 0%

Baylor Scott And White Medical Center McKinney McKinney Allen Anesthesia Associates PA 100% Pathologist Bio Medical

Laboratories PLLC 0% None in network 100% Century Integrated Partners Inc 0% Pediatrix Medical Group of Texas of Texas 0%

Medical City McKinney McKinney US Anesthesia Partners of Texas PA 0% Propath Associates 0% Medical Imaging of Dallas 56% Questcare Medical Services PLLC 0% Sheridan Healthcare of Texas PA 0%

Methodist Mckinney Hospital McKinney US Anesthesia Partners of Texas PA 53% Laboratory Physicians Association 0% None in Network 0% Western Texas Emergency

Physicians PLLC 0% Service not available 0%

Parkview Regional Hospital MexiaLimestone County Anesthesia Associates PA; Pinnacle Anesthesia Consultants PA

0% East Texas Pathology Laboratories, PA 0% Radiology Consultants of Texas 0%

Fort Parker Emergency Physicians, Texas EM-1 Medical Services

0% Service not available 0%

Midland Memorial Hospital Midland Anesthesia Medical Group of the Permian Basin LLP 0% Midland Pathology

Associates 0% None in Network 100% Sheridan Healthcare of North Texas PA; Premier Physicians 100%

Pediatrix Medical Group of Texas of Texas; Sheridan Healthcare of North Texas PA

0%

Palo Pinto General Hospital Mineral Wells US Anesthesia Partners of Texas PA 0% Affiliated Pathology Services PC 0% Palo Pinto General Hospital 0% Palo Pinto Emergency Physicians 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Ward Memorial Hospital Monahans Ward Memorial Hospital 0% Midland Pathology Associates 0% None in network 0% Ward Memorial Hospital 18% Service not available 0%

Cochran Memorial Hospital Morton Service not available 0% Service not available 0% Service not available 0% Charles Von Oden Hughes III, MD, Clifton Dane Smith PA 0% Service not available 0%

Titus Regional Medical Center Mount Pleasant Titus Regional Medical Center MSO 0% Motaz Albahra MD PA 0% Titus Regional Medical Center MSO 15%Emergency Physicians of West Bluff PLLC/Texas EM-1 Medical Services PA

0% Pediatrix Medical Group of Texas of Texas 0%

Muenster Memorial Hospital Muenster Tommy Duncan CRNA 0% Ameripath 5 01 A Corporation 0% Concord Radiology PLLC 0% None in network 0% Service not available 0%

Baylor Emergency Medical Center at Murphy Murphy Northstar Anesthesia 0% Service not available 0% Service not available 0% Questcare Medical Services

PLLC/Legacy Er And Urgent Care 100% Service not available 0%

Nacogdoches Medical Center Nacogdoches AC Provider Services of Texas LLCMain Street Anesthesia of Texas PA 0% None in Network 0% None in Network 100%

Living Forest Country Emergency Physicians PLLC/Texas EM-1 Medical Services PA

0% Pediatrix Medical Group of Texas of Texas 0%

Houston Methodist Clear Lake Hospital Nassau Bay None in network 96% Methodist Pathology

Associates 0% Houston Radiology Associated 71% Kirby Emergency Physicians, PLLC 63% Texas Childrens Physician

Group 0%

CHI St Joseph Health Grimes Hospital Navasota Service not available 0% Austin Pathology

Associates PA 0% Bryan Radiology Associates 0% Brazos Valley Emergency Physicians 0% Service not available 0%

Christus Santa Rosa Creekside Emergency New Braunfels Service not available 100% Pathology Associates of

San Antonio 0% River City Imaging Associates 0% Victoria Emergency Partners 0% Service not available 0%

Christus Santa Rosa Hospital New Braunfels New Braunfels US Anesthesia Partners of Texas PA 0% Pathology Associates of

San Antonio 0% River City Imaging Associates 0% Victoria Emergency Partners 0% Pediatrix Medical Group of Texas 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Resolute Hospital Company LLC New Braunfels US Anesthesia Partners of Texas PA 0% Clinical Pathology

Associates 0% M & S Radiology Associates 0% None in network 100% Pediatrix Medical Group of Texas 0%

Nocona General Hospital Nocona None in network 0% None in network 0% United Clinics of North Texas PLLC/UT Health Physicians 0% None in network 0% Service not available 0%

Medical City North Hills North Richland Hills

US Anesthesia Partners of Texas PA, Pinnacle Anesthesia 0% Ameripath 5 01 A

Corporation 0% Radiology Associates of North Texas PA 0% Questcare Medical Services PLLC 0% Pediatrix Medical Group of

Texas 0%

Odessa Regional Hospital Odessa Permian Anesthesia Associates 30% Baylor Pathology; Affiliated Pathologists PA 0% None in network 100%

Comprehensive Hospitalist Services of Texas PLLC; Odessa Physician Associates; Schumacher Medical Group

0% Pediatrix Medical Group of Texas of Texas 0%

Odessa Regional Hospital South Campus Odessa Permian Anesthesia Associates 30% Baylor Pathology; Affiliated

Pathologists PA 0% None in network 100%

Comprehensive Hospitalist Services of Texas PLLC; Odessa Physician Associates; Schumacher Medical Group

0% Pediatrix Medical Group of Texas of Texas 0%

Palacios Community Medical Center Palacios Service not available 0% Community Pathology

Associates 0% Concord Radiology 0% Concord Medical Group of Texas 0% Service not available 0%

Palestine Regional Medical Center Palestine

Anderson County Anesthesia Associates, PA/Anesthesia Providers of East Texas PA

0% None in network 0% Eagle Partners, PLLC 0% Texas Medicine Resources LLP 0% Service not available 0%

Pampa Regional Medical Center Pampa YPS Anesthesia 0% Amarillo Pathology

Associates   0% High Plains Radiological Association   0%

Concord Medical Group of Texas PLLC; Concord Medical Group PLLC; Sound Physicians

0% Service not available 0%

Paris Regional Medical Center North Paris PRMC Healthcare Group Inc 0% Red River Valley Pathology

PA 0% None in network 0% None in network 0% Service not available 0%

HCA Houston Southeast Pasadena None in network 0% Alliance Pathology Consultants 0% EMCare (Tx-1 Meical Services, PA) 0% Compass Point Emergency

Physicians, PLLC(Emcare) 0% Pediatrix Medical Group of Texas of Texas 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

St Lukes Patients Medical Center Pasadena None in Network 100% Baylor Pathology 0% Singleton Associates 0% None in network 0% Service not available 0%

HCA Houston Pearland Pearland None in network 0% Mangini, Lakhia & Associates 0% Singleton Associates 0% Compass Point Emergency

Physicians, PLLC(Emcare) 0% Service not available 0%

Memorial Hermann Pearland Hospital Pearland Texans Anesthesia Associates 0% Memorial Pathology

Consultants 0% Synergy Radiology Associates 0% Memorial Hermann Emergency Physicians 21% UT Physicians 0%

Frio Regional Hospital Pearsall Frio Regional Hospital Physicians 0% Village Oaks Pathology Services 0% Concord Radiology 0% Concord Medical Group 0% Service not available 0%

Ochiltree General Hospital Perryton Ochiltree General Hospital 0% Quest Laboratories 0% None in Network 0% Rex Mann, MD, Manon Childers MD, Jennifer McGaughy, DO 0% Service not available 0%

Baylor Scott and White Medical Centers-Pflugerville Pflugerville Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Service not available 0%

Covenant Hospital Plainview Plainview Northstar Anesthesia PA 0% Ameripath 0% Lubbock Diagnostic Radiology 0%Crow Emerg Physicians PLLC; Texas EM-1 Medical Services PA; Emcare

0% Service not available 0%

Baylor Regional Medical Center at Plano Plano Dallas Anesthesiology Associates 0% Pathologist Bio Medical

Laboratories PLLC 0% Century Integrated Partners Inc 70% Century Integrated Partners Inc 0% Century Integrated Partners Inc 0%

Baylor Scott and White The Heart Hospital Plano Plano Northstar Anesthesia 0% Pathologist Bio Medical

Laboratories PLLC 0% American Radiology Consultants LLC 100% Century Integrated Partners Inc 0% Pediatrix Medical Group of

Texas of Texas 0%

Childrens Medical Center Dallas Plano

Anesthesiologists for Children/University of Texas Southwestern Medical Center

0% UT Southwestern Medical Center 0% UT Southwestern Medical Center 43%

Pediatric Emergency Medicine Group LLP/UT Southwestern Medical Center

25% UT Southwestern Medical Center 0%

Medical City Plano Plano US Anesthesia Partners of Texas PA 45% Ameripath 5 01 A Corporation 0% Radiology Consultants of North

Dallas PA 90% Questcare Medical Services PLLC 27% Sheridan Healthcare of Texas PA 68%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Texas Health Center for Diagnostics and Surgery Plano

PlanoDallas Anesthesiology Associates PA/US Anesthesia Partners of Texas PA

0% MD Pathology 0% None in network 100% None in network 0% None in network 0%

Texas Health Presbyterian Hospital Plano Plano US Anesthesia Partners of Texas PA,

Anesthesiologists for Children 0% MD Pathology 0% None in Network 100% Texas Medicine Resources LLP 0% Pediatrix Medical Group of Texas 0%

Medical Center Of Southeast Texas Port Arthur Northstar Anesthesia PA 100% Baylor Pathology 0% Southeast Texas Imaging LLP 0% Port Arthur Emergency

Physicians, PLLC 0% None in network 0%

Memorial Medical Center Port Lavaca Victoria Anesthesiology Associates 0% None in network 0% None in Network 0% None in network 100% Service not available 0%

Northshore Emergency Center Portland Service not available 0% Service not available 15% Radiology Associates 0% TX-1 Medical Services, Oxbow

Emergency Physicians 0% Service not available 0%

Hardeman County Memorial Hospital Quanah None in network 0% Pathology Associates of

North Texas PA 0% None in network 0% None in network 0% None in network 0%

Rankin County Hospital Rankin Service not available 0% Service not available 0% None in network 0% Rankin County ER 0% Service not available 0%

Refugio County Memorial Hospital District Refugio Service not available 0% None in network 0% None in network 0% None in network 67% Service not available 0%

Methodist Richardson Medical Center Richardson US Anesthesia Partners of Texas PA 0% Laboratory Physicians

Association 0% Radiology Associates of North Texas PA 94% EmCare-RSN Emergency

Physicians PLLC 0% Pediatrix Medical Group of Texas of Texas 0%

Oakbend Medical Center Richmond US Anesthesia Partners of Texas PA 0% Brown & Associates Medical Laboratories, LLP 0% West Houston Radiology 0% Memorial Hermann Emergency

Physicians 0% Pediatrix Medical Group of Texas 0%

Starr County Memorial Hospital Rio Grande City Northstar Anesthesia PA 0% None in network 0% None in network 100% Renaissance Medical Foundation 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Baylor Emergency Medical Center at Rockwall Rockwall Service not available 0% Service not available 0% Service not available 0% Questcare Medical Services PLLC 100% Service not available 0%

Texas Health Presbyterian Hospital Rockwall Rockwall Metropolitan Anesthesia Consultants

LLP 0% North Texas Pathology Services PA 100% Irving Radiological Associates LLP 96% Texas Medicine Resources LLP 0% Pediatrix Medical Group of

Texas of Texas 0%

Fisher County Hospital District Rotan Service not available 0% Clinical Pathology

Associates 0% Radiology Associates of Abilene 0% Fisher County Hospital District 0% Service not available 0%

Ascension Seton Williamson Round Rock US Anesthesia Partners of Texas PA 0% Brazos Valley Pathology PA 0% Austin Radiological Association PA 0%

Emergency Services of Texas PA; Travis County Emergency Physicians; USACS Critical Care Medicine Services of Texas PLLC

0% Pediatrix Medical Group of Texas of Texas 0%

Baylor Scott and White Medical Center Round Rock Round Rock Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 23% Scott and White Clinic 75%

Scott and White Clinic; Pediatrix Medical Group of Texas of Texas

0%

Round Rock Medical Center Round Rock Austin Anesthesiology Group PLLC 0% Clinical Pathology Associates 0% Austin Radiological Association PA 0% Longhorn Emergency Medical

Associates PA 0% Pediatrix Medical Group of Texas of Texas 0%

Baylor Scott and White Medical Center Lake Pointe Rowlett Metropolitan Anesthesia Consultants

LLP 0%North Texas Pathology Services PA/Northeast Pathology Associates

100% Lake Pointe Radiology Associates PA 0% Century Integrated Partners Inc 0% Pediatrix Medical Group of

Texas of Texas 0%

San Angelo Community Medical Center San Angelo

West Texas Medical Associates, Joe Robinson, MD, Community Anesthesia Services

0%West Texas Medical Associates LLC, Jerry Gideon MD

0% San Angelo Radiologists 0% San Angelo Emergency Medicine Associates, PA 0% Pediatrix Medical Group of

Texas of Texas 0%

Shannon Medical Center San Angelo Shannon Clinic 0% Shannon Clinic 0% Shannon Clinic 0% Shannon Clinic 0% Service not available 0%

Baptist Emergency Hospital Hausman San Antonio Service not available 0% Service not available 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Service not available 0%

Baptist Emergency Hospital Kelly San Antonio Service not available 0% Service not available 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Baptist Emergency Hospital Overlook San Antonio Service not available 0% Service not available 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Service not available 0%

Baptist Emergency Hospital Shavano Park San Antonio Service not available 0% Service not available 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Service not available 0%

Baptist Emergency Hospital Thousand Oaks San Antonio Service not available 0% Service not available 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Service not available 0%

Baptist Emergency Hospital Westover Hills San Antonio Service not available 0% Service not available 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Service not available 0%

Baptist Emergency Hospital Zarzamora San Antonio Service not available 0% Service not available 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Service not available 0%

Baptist Medical Center San AntonioSouth Texas Anesthesia Group, US Anesthesia Partners of Texas PA, Tejas Anesthesia

0% Clinical Pathology Associates 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Pediatrix Medical Group of Texas 0%

Baptist Orthopedic Hospital San AntonioSouth Texas Anesthesia Group, US Anesthesia Partners of Texas PA, Tejas Anesthesia

0% Clinical Pathology Associates 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Pediatrix Medical Group of Texas 0%

Childrens Hospital of San Antonio San Antonio US Anesthesia Partners of Texas PA,

BCM Physicians of San Antonio 0% Pathology Associates of San Antonio 0% River City Imaging Associates 3% BCM Physicians of San Antonio,

Victoria Emergency Partners 0% Pediatrix Medical Group of Texas 0%

Christus Santa Rosa Emergency center-Alon Towne Centre

San Antonio Service not available 0% Pathology Associates of San Antonio 0% River City Imaging Associates 0% Victoria Emergency Partners 0% Service not available 0%

Christus Santa Rosa Hospital Alamo Heights San Antonio US Anesthesia Partners of Texas PA 0% Pathology Associates of

San Antonio 0% River City Imaging Associates 0% Victoria Emergency Partners 0% Service not available 0%

Christus Santa Rosa Hospital Westover Hills San Antonio US Anesthesia Partners of Texas PA 0% Pathology Associates of

San Antonio 0% River City Imaging Associates 0% Victoria Emergency Partners 0% Pediatrix Medical Group of Texas 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Christus Santa Rosa Medical Center San Antonio US Anesthesia Partners of Texas PA 0% Pathology Associates of

San Antonio 0% River City Imaging Associates 0% Victoria Emergency Partners 0% Service not available 0%

Foundation Surgical Hospital of San Antonio San Antonio None in network 0% None in network 0% None in network 0% None in network 0% None in network 0%

Legent Orthopedic Plus Spine San Antonio None in network 0% Service not available 0% None in network 0% None in network 0% Service not available 0%

Methodist Childrens Hospital of South Texas San Antonio Tejas Anesthesia 5% South Texas Pathology

Associates 0% South Texas Radiology Group 0%Texas EM-I Medical Services, Floyd Ridge Emergency Physicians

0% Pediatrix Medical Group of Texas 3%

Methodist Hospital San Antonio Tejas Anesthesia,US Anesthesia Partners of Texas PA 5% South Texas Pathology

Associates 0% South Texas Radiology Group 0%Texas EM-I Medical Services, Floyd Ridge Emergency Physicians

0% Service not available 3%

Methodist Specialty And Transplant Hospital San Antonio Tejas Anesthesia 0% South Texas Pathology

Associates 0% South Texas Radiology Group 0%Texas EM-I Medical Services, Floyd Ridge Emergency Physicians

0% Service not available 0%

Methodist Stone Oak Hospital San Antonio US Anesthesia Partners of Texas PA 0% South Texas Pathology Associates 0% South Texas Radiology Group 0%

Texas EM-I Medical Services, Floyd Ridge Emergency Physicians

0% Pediatrix Medical Group of Texas 0%

Methodist Texsan Hospital San Antonio Tejas Anesthesia 0% Pathology Associates of San Antonio 0% South Texas Radiology Group 0% Hawk Emergency Physicians 0% Service not available 0%

Metropolitan Methodist Hospital San Antonio US Anesthesia Partners of Texas PA 0% Pathology Associates of

San Antonio 0% South Texas Radiology Group 0%TX-I Medical Services, Countdown City Emergency Physicians

0% Pediatrix Medical Group of Texas 0%

Mission Trail Baptist Hospital San AntonioSouth Texas Anesthesia Group, US Anesthesia Partners of Texas PA, Tejas Anesthesia

0% Clinical Pathology Associates 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Pediatrix Medical Group of Texas 0%

North Central Baptist Hospital San AntonioSouth Texas Anesthesia Group, US Anesthesia Partners of Texas, Tejas Anesthesia

0% Clinical Pathology Associates 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Pediatrix Medical Group of Texas 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Northeast Baptist Hospital San AntonioSouth Texas Anesthesia Group, US Anesthesia Partners of Texas PA, Tejas Anesthesia

0% Clinical Pathology Associates 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Pediatrix Medical Group of Texas 0%

South Texas Spine And Surgical Hospital LP San Antonio

US Anesthesia Partners of Texas PA, UT Health Physicians, Tejas Anesthesia, South Texas Anesthesia Group

0% Village Oaks Pathology Services 0% River City Imaging Associates 0% None in network 100% Service not available 0%

Southwest General Hospital San Antonio EmergencHealth 0% Village Oaks Pathology Services 0% South Texas Radiology Group 0% Southwest General Emergency

Physicians 21% Pediatrix Medical Group of Texas 0%

St Lukes Baptist Hospital San AntonioSouth Texas Anesthesia Group, US Anesthesia Partners of Texas PA, Tejas Anesthesia

0% Clinical Pathology Associates 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 0% Pediatrix Medical Group of Texas 0%

The Childrens Hospital of San Antonio Emergency Center Stone

San Antonio Service not available 0% Service not available 0% Service not available 3% Victoria Emergency Partners 0% Service not available 0%

University Hospital San Antonio UT Health Physicians, Tejas Anesthesia 0% UT Health Physicians 0% UT Health Physicians 2% UT Health Physicians 0%

UT Health Physicians, University Medicine Associates

0%

CHI St Lukes Health Memorial San Augustine San Augustine AC Provider Services of Texas LLC 0% None in network 0% ADRA Medical Imaging 0% Camino Real Emergency

Physicians PLLC 0% Service not available 0%

Christus Santa Rosa Hospital - San Marcos San Marcos US Anesthesia Partners of Texas PA 0%

Clinical Pathology Associates; Central Texas Pathology Associates

0% San Marcos Medical Imaging 83% Hill Country Emergency Medical Associates PA 0% Pediatrix Medical Group of

Texas of Texas 0%

Baptist Emergency Hospital Schertz Schertz Service not available 0% Service not available 0% M & S Radiology Associates 0% Travis County Emergency

Physicians 34% Service not available 0%

Guadalupe Regional Medical Center Seguin Anesthesia Associates of Seguin 0% Clinical Pathology

Associates 0% San Marcos Medical Imaging 16% Travis County Emergency Physicians 0% GRMC Hospitalist Group 0%

Memorial Hospital Seminole Memorial Hospital 0% Memorial Hospital 0% High Plains Radiological Associates 0% Memorial Hospital 0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Seymour Hospital Seymour Baylor County Hospital District 0% Affiliated Pathology Services 0% Radiology Associates 0% Baylor County Hospital District 0% Service not available 0%

Shamrock General Hospital Shamrock Service not available 0% None in network 0% High Plains Radiology 0% Shamrock General Hospital ER 0% Service not available 0%

Baylor Scott and White Sherman Surgical Hospital at Sherman

Sherman US Anesthesia Partners of Texas PA 0% Tarrant Pathology Associates 0% None in network 0% Old Settlers Emergency

Physicians PLLC 0% None in network 0%

Wilson N Jones Regional Medical Center Sherman None in Network 0% Ameripath 5 01 A

Corporation 0% None in Network 0% None in network 0% Service not available 0%

Ascension Seton Smithville Smithville YPS Anesthesia 0% Clinical Pathology Associates 0% Austin Radiological Association PA 0% Emergency Service Partners 0% Service not available 0%

Cogdell Memorial Hospital SnyderFlatland Anesthesia and Pain Services PLLC; Northstar Anesthesia PA

0% Ameripath 0% Lubbock Diagnostic Radiology 0%Western Texas Emergency Physicians PLLC; Cogdell Family Clinic

0% Service not available 0%

Lillian M Hudspeth Memorial Hospital Sonora Service not available 0% Jason Gregorio MD 0% Radiology Partners 0% Lillian M Hudspeth Memorial

Hospital 0% Pediatrix Medical Group of Texas 0%

Methodist Southlake Hospital Southlake US Anesthesia Partners of Texas PA 0% Pathologist Bio Medical Laboratories PLLC 0% Radiology Associates of North

Texas PA 0% Live Oak Emergency Physicians PLLC 0% Service not available 0%

Texas Health Harris Methodist Hospital Southlake Southlake Noble Anesthesia Partners PLLC/US

Anesthesia Partners of Texas PA 0% ProPath Associates 0% None in network 0% None in network 0% None in network 0%

Hansford County Hospital Spearman Service not available 0% Amarillo Pathology Associates   0% High Plains Radiology 0%

Hansford County Health District, Mark Garnett DO, Abdullah Dar MD

0% Service not available 0%

Texas Health Harris Methodist Hospital Stephenville

Stephenville Northstar Anesthesia PA; Wharton Anesthesia PA 0% Clinical Partners 0% None in network 100% Texas Medicine Resources LLP 41% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Houston Methodist Sugar Land Hospital Sugar Land US Anesthesia Partners of Texas PA 0% Methodist Pathology

Associates 0% Houston Radiology Associated 17% EmergiGroup Physician Associates, PA 100% Texas Childrens Physician

Group 0%

Memorial Hermann Surgical Hospital First Colony Sugar Land US Anesthesia Partners of Texas PA 0% Brown & Associates

Medical Laboratories, LLP 0% Singleton Associates 0% Service not available 0% Pediatrix Medical Group of Texas of Texas 0%

MHHS Sugar Land Hospital Sugar Land US Anesthesia Partners of Texas PA 0% Brown & Associates Medical Laboratories, LLP, 0% Singleton Associates 0% Memorial Hermann Emergency

Physicians 100% Pediatrix Medical Group of Texas of Texas 0%

St Lukes Sugar Land Hospital Sugar Land US Anesthesia Partners of Texas PA 0% Community Pathology Associates 0% Singleton Associates 0% None in network 0% Texas Childrens Physician

Group 0%

United Memorial Medical Center Sugar Land Hospital Sugar Land US Anesthesia Partners of Texas PA 0% None in network 0% Singleton Associates 0% United Memorial Medical Center

Physicians 0% Service not available 0%

Christus Mother Frances Hospital Sulphur Springs Sulphur Springs None in network 100% Pathology Associates PA 0% Tyler Radiology Associates 0% Trinity Mother Frances Hospital 0% Service not available 0%

Baylor Scott and White Medical Center Sunnyvale Sunnyvale US Anesthesia Partners of Texas PA 0% Laboratory Physicians

Association 0% Service not available 16% Ray Hubbard Emergency Physicians PLLC 55% Newborn Intensive Care

Specialists PA 0%

Sweeny Community Hospital Sweeny George DeLeon MD 0% Memorial Pathology Consultants 0% Singleton Associates 0% None in network 0% Service not available 0%

Rolling Plains Memorial Hospital Sweetwater None in network 0% Clinical Pathology

Associates 0% None in network 0%

Texas EM-1 Medical Services, P.A.; Hubbard Creek Emergency Physicians PLLC

0% Service not available 0%

Lynn County Hospital Dist Tahoka Service not available 0% Quest 0% High Plains Radiological 0%

Melanie Richburg, FNP; Shannon Hammonds FNP, Ashley Skrabanek FNP, Sara Hite, FNP, Christopher Leach, MD, Kimberley Billingsley, FNP

0% Service not available 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Scott and White Hospital-Taylor Taylor Scott and White Clinic; Scott and

White Taylor Hospital 0% Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic; Scott and White Taylor Hospital 0% Service not available 0%

Baylor Scott and White McLane Childrens Medical Center

Temple Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0%

Baylor Scott and White Medical Center - Temple Temple Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0%

Christus St Michael Health System Texarkana NorthStar Anesthesia/Independent

Anesthesia of Texarkana LLP 0% Ameripath 5 01 A Corporation 0% Radiology Consultants LLP 12% Travis Co. Emergency Physicians 0% Pediatrix Medical Group of

Texas of Texas 0%

Wadley Regional Medical Center Texarkana Northstar Anesthesia PA 0% George English, MD 0% Radiology Associates of North

Texas (RANT) 88% Texarkana Emergency Physicians PLLC 0% Pediatrix Medical Group of

Texas of Texas 0%

HCA Houston Healthcare Mainland Texas City Patients Anesthesia Group 0% S J Associated Pathologists 0% Mainland Radiology 0% Compass Point Emergency

Physicians, PLLC(Emcare) 0% Service not available 0%

Houston Methodist The Woodlands Hospital The Woodlands US Anesthesia Partners of Texas PA 0% Methodist Pathology

Associates 0% Houston Radiology Associated 16% Woodlands Emergency Physicians 100% Texas Childrens Physician

Group 0%

MHHS The Woodlands Hospital The Woodlands US Anesthesia Partners of Texas PA 0% Memorial Pathology

Consultants 0% Synergy Radiology Associates 0% Memorial Hermann Emergency Physicians 21% Pediatrix Medical Group of

Texas 0%

St Lukes Lakeside Hospital The Woodlands US Anesthesia Partners of Texas PA 0% Community Pathology Associates 0% Singleton Associates 0% None in network 0% None in network 0%

St Lukes The Woodlands Hospital The Woodlands US Anesthesia Partners of Texas PA 0% Community Pathology

Associates 0% Baylor College of Medicine 0% None in network 92% Texas Childrens Physician Group 0%

HCA Houston Tomball Tomball Bayou Anesthesia and Pain 0% North Houston Pathology Associates 0% None in network 0% Herald Emergency Physicians,

PLLC(Emcare) 0% Pediatrix Medical Group of Texas of Texas 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Baylor Scott and White Medical Center - Trophy Club Trophy Club Noble Anesthesia Partners PLLC/US

Anesthesia Partners of Texas PA 0% Pathologist Bio Medical Laboratories PLLC 0% Radiology Associates of North

Texas PA 0% Bay Prairie Emergency Physicians PLLC 0% Service not available 0%

Swisher Memorial Hospital Tulia Service not available 0% Quest 0% Lubbock Radiology 0% Swisher Memorial Hospital 0% Service not available 0%

Texas Spine and Joint Hospital Ltd Tyler US Anesthesia Partners of Texas PA 0% None in network 0% Tyler Radiology Associates 0% None in network 0% None in network 0%

Christus Mother Francis Hospital South Tyler Tyler Trinity Clinic 8%

Austin Pathology Associates PA/Pathology Associates of Tyler PA

0%Neuro IR of East Texas/Trinity Mother Frances Hospital/Tyler Radiology Associates

0% Trinity Mother Frances Hospital 0% Service not available 0%

Louis and Peaches Owen Heart Hospital Tyler Trinity Clinic/UT Southwestern

Medical Center 8%Austin Pathology Associates PA/Pathology Associates of Tyler PA

0% Neuro IR of East Texas/Tyler Radiology Associates 0% Trinity Mother Frances Hospital 0% Service not available 0%

Mother Frances Hospital Tyler Trinity Clinic 8% Austin Pathology Associates PA 0% Neuro IR of East Texas 0% Trinity Clinic 0% Trinity Clinic 0%

The University of Texas Health Science Center at Tyler

Tyler University of Texas Health Science Center at Tyler 0% University of Texas Health

Science Center at Tyler 0% University of Texas Health Center at Tyler 0% University of Texas Health

Center at Tyler 0% Service not available 0%

Uvalde Memorial Hospital Uvalde Uvalde County Hospital Authority Group 0% Village Oaks Pathology

Services 0% Radiology Associates of Uvalde 3% Victoria Emergency Associates 0% Service not available 0%

Wilbarger General Hospital Vernon Wilbarger General Hospital 0% Pathology Associates of North Texas PA 0% None in Network 0% Concord Medical Group of Texas

PLLC 0% None in network 0%

Citizens Medical Center Victoria Victoria Anesthesiology Associates 0% None in network 89% None in Network 0% Oleander Emergency Medicine Associates 0% Childrens Physician Services

of South Texas 0%

DeTar Healthcare System Victoria Victoria Anesthesiology Associates 21% Baylor Pathology 0% Santiago Marroquin MD, John Mikus MD 0% Lone Star Emergency

Associates 1% Onsite Neonatal Texas PLLC 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

DeTar Healthcare System Victoria Victoria Anesthesiology Associates 21% Baylor Pathology 0% Santiago Marroquin MD, John Mikus MD 0% Lone Star Emergency

Associates 1% Onsite Neonatal Texas PLLC 0%

Ascension Providence Waco Mid Texas Anesthesia Associates PA; Providence Health Center ER 0% Waco Pathology

Associates PA, 0% Central Texas Radiological Association PA 24% McLennan County Hospitalist

Services 0% Pediatrix Medical Group of Texas 0%

Baylor Scott and White Medical Center Hillcrest Waco Scott and White Clinic 0% Scott and White Clinic 0% Scott and White Clinic 0% Century Integrated Partners Inc;

Scott and White Clinic 0%Scott and White Clinic, Pediatrix Medical Group of Texas of Texas

0%

Baylor Medical Center at Waxahachie Waxahachie None in network 0% Pathology Associates of

North Texas PA 0% None in Network 42% Century Integrated Partners Inc 0% Pediatrix Medical Group of Texas 0%

Medical City Weatherford Weatherford Weatherford Anesthesia Associates PA 0% ProPath Associates 0% Peachtree Radiology PC 0% Questcare Medical Services PLLC 0% Service not available 0%

HCA Houston Clear Lake Webster None in network 0% None in network 100% EMCare ( Tx-1 Medical Services, PA) 0% Compass Point Emergency Physicians, PLLC(Envision) 0% Pediatrix Medical Group of

Texas of Texas 0%

UTMB Clear Lake Webster UTMB Faculty Group Practice 0% UTMB Faculty Group Practice 0% UTMB Faculty Group Practice 0% Scurry Emergency Medicine

Associates PA 0% UTMB Faculty Group Practice 0%

Collingsworth General Hospital Wellington Service not available 0% Service not available 0% High Plains Radiology 0% Bethany Pickard, MD, Hayden

Behling PA 0% Service not available 0%

Knapp Medical Center Weslaco Clinical Associates 0% Mid Valley Pathology 0% West Valley Radiology 0% Rio Grande Valley Emergency Physicians 0% Pediatrix Medical Group of

Texas 0%

Valley Baptist Micro Hospital Weslaco Weslaco None in network 0% None in network 0% None in network 0% None in network 0% Service not available 0%

The Hospital At Westlake Medical Center West Lake Hills Westlake Anesthesia Group PA 39%

Cinical Pathology Associates; Westlake Eye Specialists

0% Austin Radiological Association PA 0% Oleander Emergency Medicine Associates PA 0% Eric D Schultz DO PA 0%

*Total Dollar Amounts Billed 01/1/2019 - 12/31/2019

Hospital City Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

Provider

% Dollars Billed Out

of Network*

This grid indicates the contracting status and out of network dollars billed as a percent of total dollars billed for the Anesthesiologists, Pathologists, Radiologists, Emergency Room and Neonatologists Physicians/Groups

Current as of October 2021

Counties: Andrews, Angelina, Atascosa, Austin, Bailey, Bastrop, Baylor, Bee, Bell, Bexar, Bosque, Bowie, Brazoria, Brazos, Brewster, Brown, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Castro, Chambers, Cherokee, Childress, Clay, Cochran, Collin, Collingsworth, Colorado, Comal, Comanche, Cooke, Crane, Crosby, Dallam, Dallas, Deaf Smith, Denton, DeWitt, Eastland, Ector, El Paso, Ellis, Erath, Falls, Fayette, Floyd, Fort Bend, Frio, Galveston, Gillespie, Gonzalez, Gray, Grayson, Gregg, Guadalupe, Hale, Hamilton, Hansford, Harris,

Harrison, Hays, Hemphill, Hidalgo, Hill, Hockly, Hood, Howard, Hunt, Hutchinson, Jack, Jackson, Jasper, Jefferson, Jim Wells, Jones, Karnes, Kaufman, Kendall, Kerr, Kleberg, Lamb, Lampasas, Lavaca, Liberty, Limestone, Llano, Lubbock, Lynn, Matagorda, Maverick, McLennan, Medina, Midland, Milam, Mitchell, Montague, Montgomery, Moore, Nacogdoches, Nueces, Ochiltree, Orange, Paker, Parmer, Pecos, Polk, Potter, Refugio, Rockwall, Sabine, San Augustine, San Patricio, Scurry, Smith, Somervell, Starr, Swisher, Tarrant, Taylor, Terry,

Titus, Tom Green, Travis, Upton, Uvalde, Van Zandt, Victoria, Walker, Webb, Wharton, Wheeler, Wichita, Williamson, Wilson, Winkler, Wise, Wood

Anesthesiology Pathology Radiology Emergency Physicians Neonatology

Texas PPO

Parkview Hospital Wheeler Service not available 0% Labcorp 0% High Plains Radiological 0% Schumacher Medical Group 0% Service not available 0%

Kell West Regional Hospital Wichita Falls YPS Anesthesia LLC 0% Pathology Associates of North Texas PA 0% Radiology Associates 0% Lucy Park Emergency Physicians

PLLC 0% None in network 0%

Riceland Medical Center Winnie None in network 0% Diagnostic Pathology Associates 0% Houston Northwest Radiology

Assoc 0% Riceland Medical Clinic 0% Service not available 0%

Mother Frances Hospital Winnsboro Winnsboro None in network 0% Austin Pathology

Associates PA 0% Tyler Radiology Associates 0% Trinity Mother Frances Hospital 0% Service not available 0%

Tyler County Hospital District WoodVille Service not available 0% Diagnostic Pathology Associates 0% Radiology Associates, Beaumont

Radiology 0% Emergency Physicians of West Bluff PLLC(Emcare) 0% Service not available 0%

Yoakum Community Hospital Yoakum None in Network 0% None in network 100% None in Network 0% Victoria Emergency Partners LLC 0% Service not available 0%