SUP-202630 — Set Administration The Belmont 250 Um Universal Intravenous 3 Bag Spike Hydrophobic Filter Rapid Infusion Swivel Luer Connector Sterile Latex Free Disposable
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). SET ADMINISTRATION THE BELMONT 250 UM UNIVERSAL INTRAVENOUS 3 BAG SPIKE HYDROPHOBIC FILTER RAPID INFUSION SWIVEL LUER CONNECTOR STERILE LATEX FREE DISPOSABLE (CDM SUP-202630) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/SUP-202630?code_type=CDM
MLA (9th ed.)
“SET ADMINISTRATION THE BELMONT 250 UM UNIVERSAL INTRAVENOUS 3 BAG SPIKE HYDROPHOBIC FILTER RAPID INFUSION SWIVEL LUER CONNECTOR STERILE LATEX FREE DISPOSABLE (CDM SUP-202630) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/SUP-202630?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“SET ADMINISTRATION THE BELMONT 250 UM UNIVERSAL INTRAVENOUS 3 BAG SPIKE HYDROPHOBIC FILTER RAPID INFUSION SWIVEL LUER CONNECTOR STERILE LATEX FREE DISPOSABLE (CDM SUP-202630) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/SUP-202630?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,002–$56,040 (25th–75th percentile) across 4 hospitals · 21 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM SUP-202630 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| PORTNEUF MEDICAL CENTER BothFacility | ONCOLOGY PATIENT ASSISTANCE PROGRAMS [2295] | BCCS FAMILY CIRCLE OF CARE [229553] | $1,640.91 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | HEALTHCARE HIGHWAYS [2210] | HCH BROKEN ARROW [221012] | $1,640.91 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | LUCENT HEALTH [6000] | LUCENT HEALTH [600000] | $1,640.91 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | HEALTHCARE HIGHWAYS [2210] | HCH 90 DEGREE BENEFITS [221013] | $1,640.91 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | HEALTHCARE HIGHWAYS [2210] | HCH JOHN SOULES FOODS [221011] | $1,640.91 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445] | EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501] | $1,640.91 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | PENDING SSI [1616] | PENDING SSI RCA [161601] | $1,640.91 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | WEB TPA [2115] | WEB TPA HEALTHCARE HIGHWAYS [211504] | $1,640.91 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | BLACK LUNG [6055] | BLACK LUNG [605500] | $1,640.91 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | MODA HEALTH [6100] | MODA HEALTH [610000] | $1,640.91 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | PACIFIC SOURCE HEALTH PLANS [2850] | PACIFIC SOURCE HEALTH PLANS [285000] | $2,300.48 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445] | EBMS BINGHAM MEMORIAL HOSPITAL [244502] | $2,401.34 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | MEDISHARE CHRISTIAN CARE [1645] | MEDISHARE CHRISTIAN CARE [164500] | $2,401.34 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | MULTIPLAN [1680] | HMA [168003] | $2,681.49 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | WORKER'S COMP [2125] | FIRST HEALTH WORKER'S COMP [212555] | $2,911.62 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | WORKER'S COMP [2125] | JME CLAIMS WORK COMP [2125114] | $3,001.67 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | ENABLECOMP [1350] | W/C WORK COMP ENABLECOMP [135000] | $3,001.67 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | WORKER'S COMP [2125] | CNA INSURANCE WC [2125100] | $3,001.67 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | UNITED HEALTHCARE [2060] | UNITED HEALTHCARE STUDENT SVC [206012] | $3,602.01 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | UMR [2035] | UNITED MEDICAL RESOURCES [203503] | $3,602.01 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | GEHA [1415] | GEHA - ASA [141503] | $3,602.01 | $4,002.23 | $2,401.34 | 2026-03-31 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | CIGNA [100009] | HB CIGNA EPO ADULT LOCATIONS | $30,000.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST SOUTHLAKE MEDICAL CENTER Both | CIGNA [100009] | HB CIGNA EPO ADULT LOCATIONS | $30,000.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL Both | CIGNA [100009] | HB CIGNA EPO ADULT LOCATIONS | $30,000.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | CIGNA [100009] | HB CIGNA EPO ADULT LOCATIONS | $30,000.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC Heritage Select Contract | $46,176.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC Heritage Select Contract | $46,176.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL Both | UNITED HEALTHCARE [100060] | HB UHC Heritage Select Contract | $46,176.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST SOUTHLAKE MEDICAL CENTER Both | UNITED HEALTHCARE [100060] | HB UHC Heritage Select Contract | $46,176.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | CIGNA [100009] | HB CIGNA HMO - LeBonheur | $47,688.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | CIGNA [100009] | HB CIGNA LocalPlus - LeBonheur | $47,688.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UHC MEDICAID [350006] | HB UHC MSCHIPS LEBONHEUR CONTRACT | $49,080.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | CIGNA [100009] | HB CIGNA OAP – LeBonheur | $49,284.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC Fed Ex Core | $52,080.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL Both | UNITED HEALTHCARE [100060] | HB UHC Fed Ex Core | $52,080.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC Fed Ex Core | $52,080.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST SOUTHLAKE MEDICAL CENTER Both | UNITED HEALTHCARE [100060] | HB UHC Fed Ex Core | $52,080.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC Fed Ex NEXUS ACO | $52,680.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST SOUTHLAKE MEDICAL CENTER Both | UNITED HEALTHCARE [100060] | HB UHC Fed Ex NEXUS ACO | $52,680.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL Both | UNITED HEALTHCARE [100060] | HB UHC Fed Ex NEXUS ACO | $52,680.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC Fed Ex NEXUS ACO | $52,680.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC Core | $53,676.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL Both | UNITED HEALTHCARE [100060] | HB UHC Core | $53,676.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST SOUTHLAKE MEDICAL CENTER Both | UNITED HEALTHCARE [100060] | HB UHC Core | $53,676.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC Core | $53,676.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST SOUTHLAKE MEDICAL CENTER Both | UNITED HEALTHCARE [100060] | HB UHC NEXUS ACO ADULT | $54,252.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL Both | UNITED HEALTHCARE [100060] | HB UHC NEXUS ACO ADULT | $54,252.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC NEXUS ACO ADULT | $54,252.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC NEXUS ACO ADULT | $54,252.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC FED EX ALL PAYER (CHOICE) | $56,040.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC FED EX ALL PAYER (CHOICE) | $56,040.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST SOUTHLAKE MEDICAL CENTER Both | UNITED HEALTHCARE [100060] | HB UHC FED EX ALL PAYER (CHOICE) | $56,040.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL Both | UNITED HEALTHCARE [100060] | HB UHC FED EX ALL PAYER (CHOICE) | $56,040.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL Both | UNITED HEALTHCARE [100060] | HB UHC All Payer Appendix - MUH-MNH-MSH-MGH-MCI | $57,720.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC All Payer Appendix - MUH-MNH-MSH-MGH-MCI | $57,720.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC All Payer Appendix - MUH-MNH-MSH-MGH-MCI | $57,720.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST SOUTHLAKE MEDICAL CENTER Both | UNITED HEALTHCARE [100060] | HB UHC All Payer Appendix - MUH-MNH-MSH-MGH-MCI | $57,720.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST SOUTHLAKE MEDICAL CENTER Both | LANGSTON PERFORMANCE HEALTH [100405] | HB XR LANGSTON COMPANIES ALL ADULTS | $78,000.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | LANGSTON PERFORMANCE HEALTH [100405] | HB XR LANGSTON COMPANIES ALL ADULTS | $78,000.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | LANGSTON PERFORMANCE HEALTH [100405] | HB XR LANGSTON COMPANIES ALL ADULTS | $78,000.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL Both | LANGSTON PERFORMANCE HEALTH [100405] | HB XR LANGSTON COMPANIES ALL ADULTS | $78,000.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL Both | BCBS Commercial [200011] | HB BCBS MS - Olive Branch | $90,000.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HEALTHCARE - OLIVE BRANCH HOSPITAL Both | BCBS MS [200002] | HB BCBS MS - Olive Branch | $90,000.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | UNITED HEALTHCARE [100060] | HB UHC Le Bonheur | $92,280.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | CIGNA [100009] | HB Cigna PPO - LeBonheur | $93,120.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | CIGNA [100009] | HB CIGNA IFP - LeBonheur | $101,280.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | AETNA [100001] | HB LeB Direct Aetna CONTRACT | $114,000.00 | $120,000.00 | $26,400.00 | 2026-03-19 | MRF ↗ |