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Viral Illness with Major Complications

Texas rates for MS-DRG 865

Viral Illness with MCC

Rates data updated October 2026.

How much does Viral Illness with Major Complications cost?

$18,621

Typical facility fee. In Texas, October 2026.

Insurers have agreed to pay about $18,621 for this service. Most negotiated rates run $14,125 to $27,542.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $18,621 · 10th to 90th $9,550 to $36,308
$10K$20K$50K$100Kfacility $18,621

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$14,125.38
Median
$26,302.68
Typical High
$34,673.69
Ambetter
Setting
Facility
Modifier
None
Typical Low
$15,488.17
Median
$15,488.17
Typical High
$23,442.29
BCBS Texas
Setting
Facility
Modifier
None
Typical Low
$8,709.64
Median
$17,378.01
Typical High
$30,199.52
Cigna
Setting
Facility
Modifier
None
Typical Low
$13,489.63
Median
$23,442.29
Typical High
$46,773.51
Moda Health
Setting
Facility
Modifier
None
Typical Low
$13,489.63
Median
$34,673.69
Typical High
$35,481.34
Providence
Setting
Facility
Modifier
None
Typical Low
$13,803.84
Median
$25,703.96
Typical High
$64,565.42
United
Setting
Facility
Modifier
None
Typical Low
$6,165.95
Median
$18,197.01
Typical High
$40,738.03

Where Texas sits

The same service costs 147.9 times more in Alaska than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Texas· 37th of 51

$18,621

AK $40,738HI $275

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.