houston hospital based physicians current as of : august 2013

21
City Hospital / Facility Name Specialty % Dollars Billed Out Of Network * Network Status Providers ANGLETON ** UTMB HEALTH ANGLETON DANBURY Anesthesiology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE UTMB HOSPITAL Emergency Room 23% IN NETWORK BARRIER REEF EMERGENCY PHYSICIANS SCURRY EMERGENCY MEDICINE ASSOCIA TEXAN STAR EMERGENCY PHYSICIANS Neonatology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE Pathology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE Radiology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE BAY CITY MATAGORDA REGIONAL MEDICAL CENTER Anesthesiology 1% IN NETWORK BAY CITY TEXAS ANESTHESIOLOGISTS Emergency Room 1% IN NETWORK BAY PRAIRIE EMERGENCY PHYSICIANS Neonatology SERVICE NOT AVAILABLE Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA BAYTOWN BAYTOWN MEDICAL CENTER LP Anesthesiology 0% IN NETWORK COMPASS ANESTHESIA PROVIDERS LLC US ANESTHESIA PARTNERS OF TX Emergency Room 51% IN NETWORK TK EMERGENCY PHYSICIANS GROUP OUT OF NETWORK ALTUS ER PHYSICIANS GROUP PLLC Neonatology INSUFFICIENT CLAIMS DATA Pathology 0% IN NETWORK GULF COAST PATHOLOGY ASSOCIATES MANGINI LAKHIA & ASSOCIATES PA METHODIST PATHOLOGY ASSOC PLLC Radiology 1% IN NETWORK SINGLETON ASSOCIATES PA HOUSTON METHODIST BAYTOWN HOSPITAL Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX Emergency Room SERVICE NOT AVAILABLE Neonatology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP Pathology 0% IN NETWORK METHODIST PATHOLOGY ASSOC PLLC Radiology 0% IN NETWORK HOUSTON RADIOLOGY ASSOCIATED MASTOS IMAGING ASSOCIATES BELLAIRE FIRST SURGICAL HOSPITAL Anesthesiology 13% IN NETWORK MEDICAL ANESTHESIOLOGY ASSOCIATES OUT OF NETWORK LINK ANESTHESIA STAFFING LLC ** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association * % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021 Current as of August 2021 Houston Texas Hospital Based Physicians Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton 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

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Page 1: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

ANGLETON

** UTMB HEALTH

ANGLETON DANBURY

Anesthesiology 0% IN NETWORKUTMB FACULTY GROUP PRACTICE

UTMB HOSPITAL

Emergency Room 23% IN NETWORKBARRIER REEF EMERGENCY PHYSICIANS

SCURRY EMERGENCY MEDICINE ASSOCIATEXAN STAR EMERGENCY PHYSICIANS

Neonatology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

Pathology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

Radiology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

BAY CITY

MATAGORDA REGIONAL MEDICAL CENTER

Anesthesiology 1% IN NETWORK BAY CITY TEXAS ANESTHESIOLOGISTS

Emergency Room 1% IN NETWORK BAY PRAIRIE EMERGENCY PHYSICIANS

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

BAYTOWN

BAYTOWN MEDICAL CENTER LP

Anesthesiology 0% IN NETWORKCOMPASS ANESTHESIA PROVIDERS LLC

US ANESTHESIA PARTNERS OF TX

Emergency Room 51%IN NETWORK TK EMERGENCY PHYSICIANS GROUP

OUT OF NETWORK ALTUS ER PHYSICIANS GROUP PLLC

Neonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORKGULF COAST PATHOLOGY ASSOCIATES

MANGINI LAKHIA & ASSOCIATES PAMETHODIST PATHOLOGY ASSOC PLLC

Radiology 1% IN NETWORK SINGLETON ASSOCIATES PA

HOUSTON METHODIST BAYTOWN HOSPITAL

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room SERVICE NOT AVAILABLE

Neonatology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

Pathology 0% IN NETWORK METHODIST PATHOLOGY ASSOC PLLC

Radiology 0% IN NETWORKHOUSTON RADIOLOGY ASSOCIATED

MASTOS IMAGING ASSOCIATES

BELLAIRE FIRST SURGICAL HOSPITAL Anesthesiology 13%

IN NETWORK MEDICAL ANESTHESIOLOGY ASSOCIATES

OUT OF NETWORK LINK ANESTHESIA STAFFING LLC

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 2: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

BELLAIRE FIRST SURGICAL HOSPITAL

Emergency Room 78% OUT OF NETWORKEMERGIGROUP PHYSICIAN ASSOC PA

OSIRIS EMERGENCY SERVICES PLLCNeonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKMANGINI LAKHIA & ASSOCIATES PA

UNITED PATHOLOGY ASSOCIATES PLLCRadiology 0% IN NETWORK HOUSTON NW RADIOLOGY ASSOCIATION

BELLVILLEBELLVILLE MEDICAL CENTER

Anesthesiology 0% IN NETWORKM AND M CLINICAL GROUP PLLC

PERFORMANCE ANESTHESIA SERVICESEmergency Room 98% OUT OF NETWORK CONCORD MEDICAL GROUP OF TX PLLC

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK

AUSTIN PATHOLOGY ASSOCIATESBROWN & ASSOC MED LABORATORIES

MEMORIAL PATHOLOGY CONSULTANTS PAMETHODIST PATHOLOGY ASSOC PLLC

Radiology 0% IN NETWORK BRYAN RADIOLOGY ASSOCIATES INC

BRENHAM

BAYLOR SCOTT & WHITE MEDICAL CENTER

BRENHAM

Anesthesiology 0% IN NETWORKSCOTT & WHITE CLINIC

SCOTT & WHITE MEMORIAL HOSPITALSCOTT AND WHITE CLINIC

Emergency Room 0% IN NETWORK CENTURY INTEGRATED PARTNERS INC

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK SCOTT AND WHITE CLINIC

Radiology 0% IN NETWORK SCOTT AND WHITE CLINIC

COLUMBUSCOLUMBUS

COMMUNITY HOSPITAL

Anesthesiology 0% IN NETWORK HUFFMAN ANESTHESIA PLLC

Emergency Room 98% OUT OF NETWORK CONCORD MEDICAL GROUP OF TX PLLC

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKCOASTAL PATHOLOGY PA

NORTHEAST PATHOLOGY GROUP PAPATHOLOGISTS BIO MEDICAL LAB

Radiology SERVICE NOT AVAILABLE

CONROE ASPIRE HOSPITAL LLC

Anesthesiology 0% IN NETWORK NORTH LAKES PAIN CONSULTANTS

Emergency Room 60% IN NETWORK ACS PRIMARY CARE PHYSICIANS SW PA

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 3: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

CONROE

ASPIRE HOSPITAL LLC

Emergency Room 60%

IN NETWORK MEMORIAL HERMANN HB PHYSICIAN GRP

OUT OF NETWORKCOMPASS POINT EMERG PHYSICIANSINTEGRATIVE EMERGENCY SERVICES

WOODLANDS EMERGENCY PHYSICIANSNeonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK

COMMUNITY PATHOLOGY ASSOCIATESGULF COAST PATHOLOGY ASSOCIATES

MEMORIAL PATHOLOGY CONSULTANTS PAMETHODIST PATHOLOGY ASSOC PLLC

Radiology 7% IN NETWORK BRYAN RADIOLOGY ASSOCIATES INC

HCA HOUSTON HEALTHCARE

CONROE

Anesthesiology 2% IN NETWORK INDEPENDENT PHYSICIANS NETWORK

Emergency Room 99% OUT OF NETWORK COMPASS POINT EMERG PHYSICIANS

Neonatology 0% IN NETWORK PEDIATRIX MEDICAL GROUP OF TEXAS

Pathology 0% IN NETWORK GULF COAST PATHOLOGY ASSOCIATES

Radiology 0% IN NETWORKROSE IMAGING SPECIALIST PA

SINGLETON ASSOCIATES PA

CUEROCUERO

REGIONAL HOSPITAL

Anesthesiology 0% IN NETWORK AM ANESTHESIA SVCS SOUTH TX CUERO

Emergency Room 99% OUT OF NETWORK TEXAS EMERGENCY GROUP LLC

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKCOMMUNITY PATHOLOGY ASSOCIATES

NORTHEAST PATHOLOGY GROUP PAPATHOLOGISTS BIO MEDICAL LAB

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

CYPRESS

** HCA HOUSTON

HEALTHCARE N CYPRESS

CAMPUS OF HCA HOUSTON HC KINGWOOD

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORKCOMPASS POINT EMERG PHYSICIANS

OXBOW EMERGENCY PHYSICIANSNeonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKGULF COAST PATHOLOGY ASSOCIATESJ S WILKENFELD MD AND ASSOCIATES

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 4: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

CYPRESS

** MEMORIAL HERMANN CYPRESS HOSPITAL

Anesthesiology 0% IN NETWORKTEXANS ANESTHESIA ASSOCIATES PLLC

UT PHYSICIANS

Emergency Room 6% IN NETWORKMEMORIAL HERMANN HB PHYSICIAN GRP

UT PHYSICIANS

Neonatology 0% IN NETWORKPEDIATRIX MEDICAL GROUP OF TEXAS

UT PHYSICIANSPathology 0% IN NETWORK MEMORIAL PATHOLOGY CONSULTANTS PA

Radiology 0% IN NETWORKSYNERGY RADIOLOGY ASSOCIATES PA

UT PHYSICIANS

EAGLE LAKE RICE MEDICAL CENTER

Anesthesiology 0% IN NETWORK YOUNGS PROFESSIONAL SERVICES LLC

Emergency Room 3% IN NETWORK RICE MEDICAL CENTER

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKNORTHEAST PATHOLOGY GROUP PA

PATHOLOGISTS BIO MEDICAL LABRadiology 0% IN NETWORK SINGLETON ASSOCIATES PA

EDNAJACKSON

HEALTHCARE CENTER

Anesthesiology 0% IN NETWORKJACKSON CTY HOSP PHYSICIAN GROUP

VICTORIA ANESTHESIOLOGY ASSOCS

Emergency Room 21% IN NETWORKJACKSON CTY HOSP PHYSICIAN GROUP

OLEANDER EMERGENCY MEDICINE ASSOCNeonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORKCOMMUNITY PATHOLOGY ASSOCIATES

NORTHEAST PATHOLOGY GROUP PAPATHOLOGISTS BIO MEDICAL LAB

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

EL CAMPOEL CAMPO MEMORIAL HOSPITAL

Anesthesiology 2% IN NETWORK COWBOY ANESTHESIA SERVICES PLLC

Emergency Room SERVICE NOT AVAILABLE

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKCOMMUNITY PATHOLOGY ASSOCIATES

NORTHEAST PATHOLOGY GROUP PAPATHOLOGISTS BIO MEDICAL LAB

Radiology 0% IN NETWORK CONCORD RADIOLOGY PLLC

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 5: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

GALVESTON

SHRINERS HOSPITALS FOR

CHILDREN

Anesthesiology 0% IN NETWORK SHRINERS HOSPITALS FOR CHILDREN

Emergency Room INSUFFICIENT CLAIMS DATA

Neonatology INSUFFICIENT CLAIMS DATA

Pathology INSUFFICIENT CLAIMS DATA

Radiology INSUFFICIENT CLAIMS DATA

UTMB HEALTH GALVESTON

Anesthesiology 0% IN NETWORKUTMB FACULTY GROUP PRACTICE

UTMB HOSPITAL

Emergency Room 23% IN NETWORKBARRIER REEF EMERGENCY PHYSICIANS

SCURRY EMERGENCY MEDICINE ASSOCIATEXAN STAR EMERGENCY PHYSICIANS

Neonatology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

Pathology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

Radiology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

HALLETTSVILLELAVACA

MEDICAL CENTER

Anesthesiology 0% IN NETWORK LAVACA MEDICAL CENTER

Emergency Room 4% IN NETWORK LAVACA MEDICAL CENTER

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKCOMMUNITY PATHOLOGY ASSOCIATES

NORTHEAST PATHOLOGY GROUP PAPHYSICIANS REFERRAL SERVICE

Radiology 0% IN NETWORK BRYAN RADIOLOGY ASSOCIATES INC

HOUSTON

AD HOSPITAL EAST LLC

Anesthesiology 0% IN NETWORK BEST CHOICE ANES & PAIN PLLC

Emergency Room 3% IN NETWORK BAY AREA EMERGENCY PARTNERS

Neonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORKMANGINI LAKHIA & ASSOCIATES PA

NORTH HOUSTON PATHOLOGY ASSOCSUNITED PATHOLOGY ASSOCIATES PLLC

Radiology 0% IN NETWORK ADVANCED DIAGNOSTICS

BEN TAUB GENERAL HOSPITAL

Anesthesiology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

Emergency Room 3% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 6: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

HOUSTON

BEN TAUB GENERAL HOSPITAL

Neonatology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

Pathology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

HARRIS COUNTY PSYCHIATRIC CENTER

Radiology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

CHI ST LUKES AT THE VINTAGE

HOSPITAL

Anesthesiology 0% IN NETWORK BCM PHYSICIANS

Emergency Room 100% OUT OF NETWORK INTEGRATIVE EMERGENCY SERVICES

Neonatology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 7% IN NETWORK SINGLETON ASSOCIATES PA

CHI ST LUKES HLTH BAYLOR

COLLEGE MEDICINE

MEDICAL CTR

Anesthesiology 0% IN NETWORKBCM PHYSICIANS

US ANESTHESIA PARTNERS OF TXEmergency Room 98% OUT OF NETWORK INTEGRATIVE EMERGENCY SERVICES

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 1% IN NETWORKBCM PHYSICIANS

SINGLETON ASSOCIATES PA

** CHILDRENS MEMORIAL HERMANN HOSPITAL

Anesthesiology 0% IN NETWORKTEXANS ANESTHESIA ASSOCIATES PLLC

UT PHYSICIANS

Emergency Room 6% IN NETWORKMEMORIAL HERMANN HB PHYSICIAN GRP

UT PHYSICIANS

Neonatology 0% IN NETWORKPEDIATRIX MEDICAL GROUP OF TEXAS

UT PHYSICIANSPathology 0% IN NETWORK MEMORIAL PATHOLOGY CONSULTANTS PA

Radiology 0% IN NETWORKSYNERGY RADIOLOGY ASSOCIATES PA

UT PHYSICIANS

DOCTORS HOSPITAL PARKWAY TIDWELL

Anesthesiology SERVICE NOT AVAILABLE

Emergency Room 72%IN NETWORK MEMORIAL HERMANN HB PHYSICIAN GRP

OUT OF NETWORK PHYSICIANS MEDICAL GROUP OF HOUST

Neonatology SERVICE NOT AVAILABLE

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 7: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

HOUSTON

DOCTORS HOSPITAL PARKWAY TIDWELL

Pathology 0% IN NETWORKCOASTAL PATHOLOGY PA

NORTHSIDE PATHOLOGY GROUP PLLC

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

HCA HOUSTON HEALTHCARE

MEDICAL CENTER

Anesthesiology 0% IN NETWORK TEXANS ANESTHESIA ASSOCIATES PLLC

Emergency Room 99% OUT OF NETWORK COMPASS POINT EMERG PHYSICIANS

Neonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORKGULF COAST PATHOLOGY ASSOCIATES

NORTH HOUSTON PATHOLOGY ASSOCSRadiology 0% IN NETWORK SINGLETON ASSOCIATES PA

HCA HOUSTON HEALTHCARE NORTHWEST

Anesthesiology 0% IN NETWORKBEST CHOICE ANES & PAIN PLLC

US ANESTHESIA PARTNERS OF TXEmergency Room 99% OUT OF NETWORK HERALD EMERGENCY PHYSICIANS PLLC

Neonatology 0% IN NETWORK PEDIATRIX MEDICAL GROUP OF TEXAS

Pathology 0% IN NETWORK NORTH HOUSTON PATHOLOGY ASSOCS

Radiology 0% IN NETWORK HOUSTON NW RADIOLOGY ASSOCIATION

HCA HOUSTON HEALTHCARE

WEST

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORK COMPASS POINT EMERG PHYSICIANS

Neonatology 0% IN NETWORK PEDIATRIX MEDICAL GROUP OF TEXAS

Pathology 0% IN NETWORK MANGINI LAKHIA & ASSOCIATES PA

Radiology 0% IN NETWORKROSE IMAGING SPECIALIST PA

SINGLETON ASSOCIATES PA

HOUSTON METHODIST

HOSPITAL

Anesthesiology 0% IN NETWORKANESTHESIA COMPANY OF HOUSTON

US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORKEMERGIGROUP PHYSICIAN ASSOC PAKIRBY EMERGENCY PHYSICIANS PLLC

Neonatology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

Pathology 0% IN NETWORK METHODIST PATHOLOGY ASSOC PLLC

Radiology 0% IN NETWORK HOUSTON RADIOLOGY ASSOCIATED

HOUSTON METHODIST

WEST HOSPITAL

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORK KIRBY EMERGENCY PHYSICIANS PLLC

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 8: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

HOUSTON

HOUSTON METHODIST

WEST HOSPITAL

Emergency Room 99% OUT OF NETWORK WEST HOUSTON EMERGENCY PHYSICIANS

Neonatology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

Pathology 0% IN NETWORK METHODIST PATHOLOGY ASSOC PLLC

Radiology 0% IN NETWORKHOUSTON RADIOLOGY ASSOCIATED

MASTOS IMAGING ASSOCIATES

HOUSTON METHODIST

WILLOWBROOK

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORK WOODLANDS EMERGENCY PHYSICIANS

Neonatology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

Pathology 0% IN NETWORK METHODIST PATHOLOGY ASSOC PLLC

Radiology 0% IN NETWORKHOUSTON RADIOLOGY ASSOCIATED

MASTOS IMAGING ASSOCIATES

** LYNDON B JOHNSON GENERAL HOSPITAL

Anesthesiology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

Emergency Room 3% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

Neonatology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

Pathology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

HARRIS COUNTY PSYCHIATRIC CENTER

Radiology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

MD ANDERSON CANCER CENTER

Anesthesiology 0% IN NETWORK PHYSICIANS REFERRAL SERVICE

Emergency Room 9% IN NETWORK PHYSICIANS REFERRAL SERVICE

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK PHYSICIANS REFERRAL SERVICE

Radiology 0% IN NETWORK PHYSICIANS REFERRAL SERVICE

** MEMORIAL HERMANN GREATER HEIGHTS

Anesthesiology 0% IN NETWORKTEXANS ANESTHESIA ASSOCIATES PLLC

US ANESTHESIA PARTNERS OF TX

Emergency Room 2% IN NETWORKACS PRIMARY CARE PHYSICIANS SW PA

MEMORIAL HERMANN HB PHYSICIAN GRPNeonatology 0% IN NETWORK PEDIATRIX MEDICAL GROUP OF TEXAS

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 9: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

HOUSTON

** MEMORIAL HERMANN GREATER HEIGHTS

Neonatology 0% IN NETWORK UT PHYSICIANS

Pathology 0% IN NETWORK MEMORIAL PATHOLOGY CONSULTANTS PA

Radiology 0% IN NETWORK SYNERGY RADIOLOGY ASSOCIATES PA

** MEMORIAL HERMANN HEART &

VASCULAR INSTITUTE

Anesthesiology 0% IN NETWORKTEXANS ANESTHESIA ASSOCIATES PLLC

US ANESTHESIA PARTNERS OF TXEmergency Room SERVICE NOT AVAILABLE

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK MEMORIAL PATHOLOGY CONSULTANTS PA

Radiology 0% IN NETWORK SYNERGY RADIOLOGY ASSOCIATES PA

MEMORIAL HERMANN HOSPITAL

Anesthesiology 0% IN NETWORKTEXANS ANESTHESIA ASSOCIATES PLLC

UT PHYSICIANS

Emergency Room 6% IN NETWORKMEMORIAL HERMANN HB PHYSICIAN GRP

UT PHYSICIANS

Neonatology 0% IN NETWORKPEDIATRIX MEDICAL GROUP OF TEXAS

UT PHYSICIANSPathology 0% IN NETWORK MEMORIAL PATHOLOGY CONSULTANTS PA

Radiology 0% IN NETWORKSYNERGY RADIOLOGY ASSOCIATES PA

UT PHYSICIANS

MEMORIAL HERMANN

MEMORIAL CITY HOSPITAL

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 4% IN NETWORKACS PRIMARY CARE PHYSICIANS SW PA

MEMORIAL HERMANN HB PHYSICIAN GRP

Neonatology 0% IN NETWORKPEDIATRIX MEDICAL GROUP OF TEXAS

UT PHYSICIANSPathology 0% IN NETWORK MEMORIAL PATHOLOGY CONSULTANTS PA

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

** MEMORIAL HERMANN

SOUTHEAST HOSPITAL

Anesthesiology 0% IN NETWORKTEXANS ANESTHESIA ASSOCIATES PLLC

US ANESTHESIA PARTNERS OF TX

Emergency Room 2% IN NETWORKACS PRIMARY CARE PHYSICIANS SW PA

MEMORIAL HERMANN HB PHYSICIAN GRP

Neonatology 0% IN NETWORKPEDIATRIX MEDICAL GROUP OF TEXAS

UT PHYSICIANS

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 10: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

HOUSTON

** MEMORIAL HERMANN

SOUTHEAST HOSPITAL

Pathology 0% IN NETWORK MEMORIAL PATHOLOGY CONSULTANTS PA

Radiology 0% IN NETWORK SYNERGY RADIOLOGY ASSOCIATES PA

MEMORIAL HERMANN

SOUTHWEST HOSPITAL

Anesthesiology 0% IN NETWORKTEXANS ANESTHESIA ASSOCIATES PLLC

US ANESTHESIA PARTNERS OF TX

Emergency Room 2% IN NETWORKACS PRIMARY CARE PHYSICIANS SW PA

MEMORIAL HERMANN HB PHYSICIAN GRP

Neonatology 0% IN NETWORKPEDIATRIX MEDICAL GROUP OF TEXAS

UT PHYSICIANSPathology 0% IN NETWORK MEMORIAL PATHOLOGY CONSULTANTS PA

Radiology 0% IN NETWORK SYNERGY RADIOLOGY ASSOCIATES PA

** QUENTIN MEASE

COMMUNITY HOSPITAL

Anesthesiology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

Emergency Room 3% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

Neonatology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

Pathology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

HARRIS COUNTY PSYCHIATRIC CENTER

Radiology 0% IN NETWORKBAYLOR COLLEGE OF MEDICINE

UT PHYSICIANS

RIVER OAKS HOSPITAL & CLINICS LLC

Anesthesiology 0% IN NETWORK BEST CHOICE ANES & PAIN PLLC

Emergency Room SERVICE NOT AVAILABLE

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKMANGINI LAKHIA & ASSOCIATES PA

NORTH HOUSTON PATHOLOGY ASSOCSRadiology SERVICE NOT AVAILABLE

ST JOSEPH MEDICAL CENTER

Anesthesiology 44% IN NETWORKANESTHESIA OF SOUTHEAST TEXAS

SOUND PHYSICIANS ANESTHESIOLOGYEmergency Room 60% IN NETWORK ST JOSEPH EMERGENCY PHYSICIANS

Neonatology 0% IN NETWORK PEDIATRIX MEDICAL GROUP OF TEXAS

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 11: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

HOUSTON

ST JOSEPH MEDICAL CENTER

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

** ST JOSEPH MEDICAL

CENTER IN THE HEIGHTS

Anesthesiology 44% IN NETWORKANESTHESIA OF SOUTHEAST TEXAS

SOUND PHYSICIANS ANESTHESIOLOGYEmergency Room 60% IN NETWORK ST JOSEPH EMERGENCY PHYSICIANS

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

TEXAS CHILDRENS HOSPITAL

Anesthesiology 0% IN NETWORKTEXAS CHILDRENS PHYSICIAN GROUP

US ANESTHESIA PARTNERS OF TXEmergency Room 11% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

Neonatology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

Pathology 0% IN NETWORK PEDIATRIC PATHOLOGY CONSULTANTS

Radiology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

TEXAS ORTHOPEDIC

HOSPITAL

Anesthesiology 0% IN NETWORKCAPITOL MEDICAL MANAGEMENT GROUP

US ANESTHESIA PARTNERS OF TX

Emergency Room 56%IN NETWORK ACS PRIMARY CARE PHYSICIANS SW PA

OUT OF NETWORKCOMPASS POINT EMERG PHYSICIANSEMERGIGROUP PHYSICIAN ASSOC PA

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 0% IN NETWORK MUSCULOSKELETAL RADIOLOGY ASSOC

THE WOMANS HOSPITAL OF

TEXAS

Anesthesiology 0% IN NETWORK AUSTIN ANESTHESIOLOGY GROUP PLLC

Emergency Room 98% OUT OF NETWORK COMPASS POINT EMERG PHYSICIANS

Neonatology 0% IN NETWORK PEDIATRIX MEDICAL GROUP OF TEXAS

Pathology 0% IN NETWORK HOUSTON PATHOLOGY ASSOCIATES PLLC

Radiology 0% IN NETWORKROSE IMAGING SPECIALIST PA

SYNERGY RADIOLOGY ASSOCIATES PA

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 12: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

HOUSTON

TOPS SURGICAL SPECIALTY HOSPITAL

Anesthesiology 0% IN NETWORK BEST CHOICE ANES & PAIN PLLC

Emergency Room SERVICE NOT AVAILABLE

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK

AVERO DIAGNOSTICSMEDICAL & PATHOLOGY LAB

NORTH HOUSTON PATHOLOGY ASSOCSUNITED PATHOLOGY ASSOCIATES PLLC

Radiology 0% IN NETWORK ROSE IMAGING SPECIALIST PA

** TOWNSEN MEMORIAL SURGERY

CENTER MED CENTER

Anesthesiology 1% IN NETWORK COMPASS ANESTHESIA PROVIDERS LLC

Emergency Room INSUFFICIENT CLAIMS DATA

Neonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORKGULF COAST PATHOLOGY ASSOCIATES

MANGINI LAKHIA & ASSOCIATES PAPRECISE PATHOLOGY ASSOCIATES PLLC

Radiology 0% IN NETWORKINNOVATIVE RADIOLOGY PASINGLETON ASSOCIATES PA

** UNITED MEMORIAL

MEDICAL CENTER NORTH

HOSPITAL

Anesthesiology 1% IN NETWORK COMPASS ANESTHESIA PROVIDERS LLC

Emergency Room 72%IN NETWORK MEMORIAL HERMANN HB PHYSICIAN GRP

OUT OF NETWORK PHYSICIANS MEDICAL GROUP OF HOUST

Neonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORKCOASTAL PATHOLOGY PA

NORTHSIDE PATHOLOGY GROUP PLLCRadiology 0% IN NETWORK SINGLETON ASSOCIATES PA

HUMBLE

MEMORIAL HERMANN

NORTHEAST HOSPITAL

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 2% IN NETWORKACS PRIMARY CARE PHYSICIANS SW PA

MEMORIAL HERMANN HB PHYSICIAN GRPNeonatology 0% IN NETWORK PEDIATRIX MEDICAL GROUP OF TEXAS

Pathology 0% IN NETWORK NORTH HOUSTON PATHOLOGY ASSOCS

Radiology 0% IN NETWORK SYNERGY RADIOLOGY ASSOCIATES PA

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 13: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

HUMBLETOWNSEN MEMORIAL HOSPITAL

Anesthesiology 1% IN NETWORK COMPASS ANESTHESIA PROVIDERS LLC

Emergency Room INSUFFICIENT CLAIMS DATA

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKGULF COAST PATHOLOGY ASSOCIATES

MANGINI LAKHIA & ASSOCIATES PAPRECISE PATHOLOGY ASSOCIATES PLLC

Radiology 0% IN NETWORKINNOVATIVE RADIOLOGY PASINGLETON ASSOCIATES PA

HUNTSVILLEHUNTSVILLE MEMORIAL HOSPITAL

Anesthesiology 0% IN NETWORK PREMIER ANESTHESIA OF HUNTSVILLE

Emergency Room 4% IN NETWORK ACS PRIMARY CARE PHYSICIANS SW PA

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK SAGIS PLLC

Radiology 0% IN NETWORK BRYAN RADIOLOGY ASSOCIATES INC

KATYMEMORIAL HERMANN

KATY HOSPITAL

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 1% IN NETWORKACS PRIMARY CARE PHYSICIANS SW PA

MEMORIAL HERMANN HB PHYSICIAN GRP

Neonatology 0% IN NETWORKPEDIATRIX MEDICAL GROUP OF TEXAS

UT PHYSICIANSPathology 0% IN NETWORK BROWN & ASSOC MED LABORATORIES

Radiology 0% IN NETWORK SYNERGY RADIOLOGY ASSOCIATES PA

KINGWOODHCA HOUSTON HEALTHCARE KINGWOOD

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORKCOMPASS POINT EMERG PHYSICIANS

OXBOW EMERGENCY PHYSICIANS

Neonatology 0% IN NETWORKHEALTHCARE SPECIALISTS PLLC

PEDIATRIX MEDICAL GROUP OF TEXAS

Pathology 0% IN NETWORKGULF COAST PATHOLOGY ASSOCIATESJ S WILKENFELD MD AND ASSOCIATES

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 14: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

KINGWOOD

MEMORIAL HERMANN SURGICAL HOSPITAL

KINGWOOD

Anesthesiology 0% IN NETWORKNORTHWEST ANESTHESIA AND PAIN MA

US ANESTHESIA PARTNERS OF TXEmergency Room INSUFFICIENT CLAIMS DATA

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKMANGINI LAKHIA & ASSOCIATES PA

NORTH HOUSTON PATHOLOGY ASSOCSRadiology 0% IN NETWORK SINGLETON ASSOCIATES PA

LAKE JACKSONCHI ST LUKES

HEALTH BRAZOSPORT

Anesthesiology 81% OUT OF NETWORK SEVEN FLAGS ANESTHESIA ASSOCIATES

Emergency Room 99% OUT OF NETWORK OXBOW EMERGENCY PHYSICIANS

Neonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

LEAGUE CITY** UTMB

HEALTH AT LEAGUE CITY

Anesthesiology 0% IN NETWORKUTMB FACULTY GROUP PRACTICE

UTMB HOSPITAL

Emergency Room 23% IN NETWORKBARRIER REEF EMERGENCY PHYSICIANS

SCURRY EMERGENCY MEDICINE ASSOCIATEXAN STAR EMERGENCY PHYSICIANS

Neonatology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

Pathology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

Radiology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

NASSAU BAY

HOUSTON METHODIST CLEAR LAKE

HOSPITAL

Anesthesiology 0% IN NETWORK SPACE CITY ANESTHESIA

Emergency Room SERVICE NOT AVAILABLE

Neonatology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

Pathology 0% IN NETWORK METHODIST PATHOLOGY ASSOC PLLC

Radiology 0% IN NETWORKHOUSTON RADIOLOGY ASSOCIATED

MASTOS IMAGING ASSOCIATES

NAVASOTA

** CHI ST JOSEPH HEALTH

GRIMES HOSPITAL

Anesthesiology 0% IN NETWORKAUSTIN ANESTHESIOLOGY GROUP PLLC

AUSTIN ANESTHESIOLOGY GRP PLLCEmergency Room 2% IN NETWORK BRYAN EMERGENCY PHYSICIANS PA

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK AUSTIN PATHOLOGY ASSOCIATES

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 15: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

NAVASOTA

** CHI ST JOSEPH HEALTH

GRIMES HOSPITAL

Radiology 0% IN NETWORK BRYAN RADIOLOGY ASSOCIATES INC

PALACIOS

PALACIOS COMMUNITY

MEDICAL CENTER

Anesthesiology INSUFFICIENT CLAIMS DATA

Emergency Room INSUFFICIENT CLAIMS DATA

Neonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORK

COMMUNITY PATHOLOGY ASSOCIATESMEMORIAL PATHOLOGY CONSULTANTS PA

PATHOLOGISTS BIO MEDICAL LABPEDIATRIC PATHOLOGY CONSULTANTS

Radiology 0% IN NETWORK CONCORD RADIOLOGY PLLC

PASADENA

HCA HOUSTON HEALTHCARE SOUTHEAST

Anesthesiology 0% IN NETWORKBELTWAY ANESTHIA GROUP PA

COMPASS ANESTHESIA PROVIDERS LLCEmergency Room 99% OUT OF NETWORK COMPASS POINT EMERG PHYSICIANS

Neonatology 0% IN NETWORK PEDIATRIX MEDICAL GROUP OF TEXAS

Pathology 0% IN NETWORK ALLIANCE PATHOLOGY CONSULTANTS PA

Radiology 0% IN NETWORKROSE IMAGING SPECIALIST PA

SINGLETON ASSOCIATES PA

ST LUKES PATIENTS MEDICAL CENTER

Anesthesiology 0% IN NETWORK SPACE CITY ANESTHESIA

Emergency Room 99% OUT OF NETWORK INTEGRATIVE EMERGENCY SERVICES

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

SURGERY SPECIALTY

HOSPITALS OF AMERICA SE

HOUSTON

Anesthesiology 5% IN NETWORK ANES ASSOC OF HOUSTON METROPLEX

Emergency Room INSUFFICIENT CLAIMS DATA

Neonatology SERVICE NOT AVAILABLE

Pathology INSUFFICIENT CLAIMS DATA

Radiology 0% IN NETWORK EL PASO VINTON DIAGNOSTIC PA

PEARLANDHCA HOUSTON HEALTHCARE

PEARLAND

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORK COMPASS POINT EMERG PHYSICIANS

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 16: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

PEARLAND

HCA HOUSTON HEALTHCARE

PEARLAND

Neonatology SERVICE NOT AVAILABLE

Pathology 3% IN NETWORK MANGINI LAKHIA & ASSOCIATES PA

Radiology 0% IN NETWORKROSE IMAGING SPECIALIST PA

SINGLETON ASSOCIATES PA

** MEMORIAL HERMANN PEARLAND HOSPITAL

Anesthesiology 0% IN NETWORKTEXANS ANESTHESIA ASSOCIATES PLLC

US ANESTHESIA PARTNERS OF TX

Emergency Room 2% IN NETWORKACS PRIMARY CARE PHYSICIANS SW PA

MEMORIAL HERMANN HB PHYSICIAN GRP

Neonatology 0% IN NETWORKPEDIATRIX MEDICAL GROUP OF TEXAS

UT PHYSICIANSPathology 0% IN NETWORK MEMORIAL PATHOLOGY CONSULTANTS PA

Radiology 0% IN NETWORK SYNERGY RADIOLOGY ASSOCIATES PA

PORT LAVACAMEMORIAL

MEDICAL CENTER

Anesthesiology 0% IN NETWORK VICTORIA ANESTHESIOLOGY ASSOCS

Emergency Room 58% IN NETWORK ESS OF PORT LAVACA LLC

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

RICHMONDOAKBEND MEDICAL CENTER

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORK ROSE RICH EM PHYSICIANS PLLC

Neonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORK BROWN & ASSOC MED LABORATORIES

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

SHENANDOAH

HOUSTON METHODIST

THE WOODLANDS

HOSPITAL

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORK WOODLANDS EMERGENCY PHYSICIANS

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK METHODIST PATHOLOGY ASSOC PLLC

Radiology 0% IN NETWORKHOUSTON RADIOLOGY ASSOCIATED

MASTOS IMAGING ASSOCIATES

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 17: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

SPRING

** TOWNSEN MEMORIAL SURGERY

CENTER SPRING

Anesthesiology 1% IN NETWORK COMPASS ANESTHESIA PROVIDERS LLC

Emergency Room INSUFFICIENT CLAIMS DATA

Neonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORKGULF COAST PATHOLOGY ASSOCIATES

MANGINI LAKHIA & ASSOCIATES PAPRECISE PATHOLOGY ASSOCIATES PLLC

Radiology 0% IN NETWORKINNOVATIVE RADIOLOGY PASINGLETON ASSOCIATES PA

** UNITED MEMORIAL

MEDICAL CENTER SPRING

HOSPITAL

Anesthesiology 1% IN NETWORK COMPASS ANESTHESIA PROVIDERS LLC

Emergency Room 72%IN NETWORK MEMORIAL HERMANN HB PHYSICIAN GRP

OUT OF NETWORK PHYSICIANS MEDICAL GROUP OF HOUST

Neonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORKCOASTAL PATHOLOGY PA

NORTHSIDE PATHOLOGY GROUP PLLCRadiology 0% IN NETWORK SINGLETON ASSOCIATES PA

SUGAR LAND

CHI ST LUKES SUGAR LAND

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 98% OUT OF NETWORK INTEGRATIVE EMERGENCY SERVICES

Neonatology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

HOUSTON METHODIST SUGAR LAND

HOSPITAL

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORKEMERGIGROUP PHYSICIAN ASSOC PAKIRBY EMERGENCY PHYSICIANS PLLC

Neonatology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

Pathology 0% IN NETWORK METHODIST PATHOLOGY ASSOC PLLC

Radiology 0% IN NETWORKHOUSTON RADIOLOGY ASSOCIATED

MASTOS IMAGING ASSOCIATESMEMORIAL HERMANN SURGICAL

HOSPITAL FIRST COLONY

Anesthesiology 0% IN NETWORKENDO SEDATION LLC

US ANESTHESIA PARTNERS OF TXEmergency Room INSUFFICIENT CLAIMS DATA

Neonatology SERVICE NOT AVAILABLE

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 18: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

SUGAR LAND

MEMORIAL HERMANN SURGICAL

HOSPITAL FIRST COLONY

Pathology 0% IN NETWORKMANGINI LAKHIA & ASSOCIATES PA

TX DIGESTIVE DISEASE CONSULTANTS

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

MHHS SUGAR LAND HOSPITAL

Anesthesiology 1% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 1% IN NETWORKACS PRIMARY CARE PHYSICIANS SW PA

MEMORIAL HERMANN HB PHYSICIAN GRPNeonatology 0% IN NETWORK PEDIATRIX MEDICAL GROUP OF TEXAS

Pathology 0% IN NETWORK BROWN & ASSOC MED LABORATORIES

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

** UNITED MEMORIAL

MEDICAL CENTER SUGAR LAND HOSPITAL

Anesthesiology 1% IN NETWORK COMPASS ANESTHESIA PROVIDERS LLC

Emergency Room 72%IN NETWORK MEMORIAL HERMANN HB PHYSICIAN GRP

OUT OF NETWORK PHYSICIANS MEDICAL GROUP OF HOUST

Neonatology INSUFFICIENT CLAIMS DATA

Pathology 0% IN NETWORKCOASTAL PATHOLOGY PA

NORTHSIDE PATHOLOGY GROUP PLLCRadiology 0% IN NETWORK SINGLETON ASSOCIATES PA

SWEENYSWEENY

COMMUNITY HOSPITAL

Anesthesiology 0% IN NETWORKDELEON, GEORGE W, MD

SWEENY COMMUNITY HOSPITALEmergency Room 1% IN NETWORK BAY AREA EMERGENCY PARTNERS

Neonatology SERVICE NOT AVAILABLE

Pathology 5% IN NETWORKCOMMUNITY PATHOLOGY ASSOCIATESMETHODIST PATHOLOGY ASSOC PLLC

UTMB FACULTY GROUP PRACTICERadiology 0% IN NETWORK SINGLETON ASSOCIATES PA

TEXAS CITY

** HCA HOUSTON HC MAINLAND A CAMPUS OF

HCA HOUSTON HC CLEAR LAKE

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORK COMPASS POINT EMERG PHYSICIANS

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKCLEARLAKE PATHOLOGY PARTNERS LTD

S J ASSOCIATE PATHOLOGISTS LCRadiology 0% IN NETWORK ROSE IMAGING SPECIALIST PA

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 19: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

TEXAS CITY

** HCA HOUSTON HC MAINLAND A CAMPUS OF

HCA HOUSTON HC CLEAR LAKE

Radiology 0% IN NETWORK SYNERGY RADIOLOGY ASSOCIATES PA

THE WOODLANDS

CHI ST LUKES LAKESIDE HOSPITAL

Anesthesiology 0% IN NETWORKHEDE, VIDYADHAR S, MD

US ANESTHESIA PARTNERS OF TXEmergency Room 99% OUT OF NETWORK INTEGRATIVE EMERGENCY SERVICES

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 1% IN NETWORK SINGLETON ASSOCIATES PA

CHI ST LUKES THE

WOODLANDS HOSPITAL

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 100% OUT OF NETWORK INTEGRATIVE EMERGENCY SERVICES

Neonatology 0% IN NETWORK TEXAS CHILDRENS PHYSICIAN GROUP

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 4% IN NETWORK SINGLETON ASSOCIATES PA

** MEMORIAL HERMANN THE WOODLANDS

MEDICAL CENTER

Anesthesiology 0% IN NETWORKTEXANS ANESTHESIA ASSOCIATES PLLC

US ANESTHESIA PARTNERS OF TX

Emergency Room 2% IN NETWORKACS PRIMARY CARE PHYSICIANS SW PA

MEMORIAL HERMANN HB PHYSICIAN GRP

Neonatology 0% IN NETWORKPEDIATRIX MEDICAL GROUP OF TEXAS

UT PHYSICIANSPathology 0% IN NETWORK MEMORIAL PATHOLOGY CONSULTANTS PA

Radiology 0% IN NETWORK SYNERGY RADIOLOGY ASSOCIATES PA

TOMBALLHCA HOUSTON HEALTHCARE

TOMBALL

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 100% OUT OF NETWORKCOMPASS POINT EMERG PHYSICIANS

HERALD EMERGENCY PHYSICIANS PLLCNeonatology 0% IN NETWORK PEDIATRIX MEDICAL GROUP OF TEXAS

Pathology 1% IN NETWORK TOMBALL CLINICAL LAB PLLC

Radiology 0% IN NETWORKHOUSTON NW RADIOLOGY ASSOCIATION

ROSE IMAGING SPECIALIST PA

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 20: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

VICTORIA

CITIZENS MEDICAL CENTER

Anesthesiology 1% IN NETWORK VICTORIA ANESTHESIOLOGY ASSOCS

Emergency Room 62% IN NETWORK OLEANDER EMERGENCY MEDICINE ASSOC

Neonatology 0% IN NETWORKCHILDRENS PHYSICIAN SVCS SOUTH TX

MAGELLA MEDICAL ASSOCIATES

Pathology 0% IN NETWORKNORTHEAST PATHOLOGY GROUP PA

PATHOLOGISTS BIO MEDICAL LAB

Radiology 0% IN NETWORKDIAGNOSTIC IMAGING ASSOCIATES PA

SINGLETON ASSOCIATES PA

DETAR HOSPITAL NAVARRO

Anesthesiology 6% IN NETWORK VICTORIA ANESTHESIOLOGY ASSOCS

Emergency Room 99% OUT OF NETWORK LONE STAR EMERGENCY ASSOCIATES

Neonatology 0% IN NETWORK ONSITE NEONATAL TEXAS PLLC

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 0% IN NETWORK DIAGNOSTIC IMAGING ASSOCIATES PA

** DETAR HOSPITAL

NORTH

Anesthesiology 6% IN NETWORK VICTORIA ANESTHESIOLOGY ASSOCS

Emergency Room 99% OUT OF NETWORK LONE STAR EMERGENCY ASSOCIATES

Neonatology 0% IN NETWORK ONSITE NEONATAL TEXAS PLLC

Pathology 0% IN NETWORK COMMUNITY PATHOLOGY ASSOCIATES

Radiology 0% IN NETWORK DIAGNOSTIC IMAGING ASSOCIATES PA

WEBSTER

HCA HOUSTON HEALTHCARE CLEAR LAKE

Anesthesiology 0% IN NETWORK US ANESTHESIA PARTNERS OF TX

Emergency Room 99% OUT OF NETWORK COMPASS POINT EMERG PHYSICIANS

Neonatology 0% IN NETWORK PEDIATRIX MEDICAL GROUP OF TEXAS

Pathology 0% IN NETWORKCLEARLAKE PATHOLOGY PARTNERS LTD

S J ASSOCIATE PATHOLOGISTS LC

Radiology 0% IN NETWORKROSE IMAGING SPECIALIST PA

SYNERGY RADIOLOGY ASSOCIATES PA

** UTMB HEALTH

GALVESTON

Anesthesiology 0% IN NETWORKUTMB FACULTY GROUP PRACTICE

UTMB HOSPITAL

Emergency Room 23% IN NETWORKBARRIER REEF EMERGENCY PHYSICIANS

SCURRY EMERGENCY MEDICINE ASSOCIATEXAN STAR EMERGENCY PHYSICIANS

Neonatology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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

Page 21: Houston Hospital Based Physicians Current as of : August 2013

City Hospital / Facility Name Specialty

% Dollars Billed Out Of

Network *Network Status Providers

WEBSTER** UTMB HEALTH

GALVESTON

Pathology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

Radiology 0% IN NETWORK UTMB FACULTY GROUP PRACTICE

YOAKUMYOAKUM

COMMUNITY HOSPTAL

Anesthesiology 6% IN NETWORK YOAKUM FAMILY PRACTICE

Emergency Room 100% OUT OF NETWORK LONE STAR EMERGENCY ASSOCIATES

Neonatology SERVICE NOT AVAILABLE

Pathology 0% IN NETWORKCOMMUNITY PATHOLOGY ASSOCIATES

NORTHEAST PATHOLOGY GROUP PAPATHOLOGISTS BIO MEDICAL LAB

Radiology 0% IN NETWORK SINGLETON ASSOCIATES PA

** Indicates Hospitals that are part of a large Hospital System with multiple locations. The specialty provider groups shown may not be practicing at the specific physical location. Please contact the hospital to confirm.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

* % of Total Dollar Amount Billed 5/1/2020 - 4/30/2021

BlueChoice PPO℠ Current as of August 2021

Houston Texas Hospital Based Physicians

Counties: Austin, Brazoria, Calhoun, Colorado, DeWitt, Fort Bend, Galveston, Goliad, Grimes, Harris, Jackson, Lavaca, Matagorda, Montgomery, Victoria, Walker, Waller, Washington, Wharton

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