SUP-202630 (CDM) by state — Price Transparency

CDM · across United States

SUP-202630 — Set Administration The Belmont 250 Um Universal Intravenous 3 Bag Spike Hydrophobic Filter Rapid Infusion Swivel Luer Connector Sterile Latex Free Disposable

State-by-state median negotiated rates. Lower bars are cheaper states; the range bar shows the IQR (25th to 75th percentile within each state).

$52,080 National median

$3,002 – $56,040 IQR (p25 – p75)

4 hospitals filing

4 states

View hospital-by-hospital → Raw rate rows →

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This estimate runs on the hospital’s facility charge only. The surgeon’s and anesthesiologist’s fees are billed separately and aren’t in this number — your EOB shows your complete total.

Uninsured estimates use the cash / self-pay median for this code: $230.

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Out-of-pocket max (assumed — typical plan) Coinsurance % (after deductible)

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Median negotiated rate, by state

Ranked by typical (median) negotiated price. Hover for state-level IQR.

Median negotiated rate by state for SUP-202630 (CDM), with interquartile range
State	Median	p25	p75
MS	$54,252	$52,380	$67,860
TN	$53,676	$49,131	$57,720
TX	$53,676	$52,080	$56,040
ID	$2,300	$1,641	$3,002

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
State	Median	p25	p75	Min	Max	Hospitals	Payers	Rates

MS	$54,252	$52,380	$67,860	$30,000	$90,000	1 ⚠ thin data	5	11
TN	$53,676	$49,131	$57,720	$30,000	$114,000	1 ⚠ thin data	4	26
TX	$53,676	$52,080	$56,040	$30,000	$78,000	1 ⚠ thin data	3	9
ID	$2,300	$1,641	$3,002	$1,641	$3,602	1 ⚠ thin data	16	21