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Viral Illness with Major Complications

Texas rates for MS-DRG 865

Viral Illness with MCC

Rates data updated July 2026.

How much does Viral Illness with Major Complications cost?

$19,498

Typical facility fee. In Texas, July 2026.

Insurers have agreed to pay about $19,498 for this service. Most negotiated rates run $13,490 to $26,303.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $19,498 · 10th to 90th $9,333 to $35,481
$2.0K$5.0K$10.0K$20.0K$50.0K$100.0Kfacility $19,498

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$14,454.40
Median
$21,379.62
Typical High
$41,686.94
BCBS
Setting
Facility
Modifier
Global
Typical Low
$7,585.78
Median
$15,488.17
Typical High
$28,183.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$13,489.63
Median
$22,387.21
Typical High
$40,738.03
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$53,703.18
Median
$53,703.18
Typical High
$53,703.18
Providence
Setting
Facility
Modifier
Global
Typical Low
$13,489.63
Median
$19,054.61
Typical High
$44,668.36
United
Setting
Facility
Modifier
Global
Typical Low
$8,317.64
Median
$15,488.17
Typical High
$37,153.52

Where Texas sits

The same service costs 6.0 times more in Montana than in New Mexico. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Texas $19,498 · 34th of 51
MT $72,444NM $12,023

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.