Add ue prost a/e acrylic cost in Oklahoma

Add UE prost a/e acrylic ยท HCPCS L7404

Hospital City Cash price Negotiated range Payers
SSM Health St. Anthony Hospital - Shawnee Shawnee not published $688.03 โ€“ $1,341.66 8
SSM Health St. Anthony Hospital - Midwest Midwest City not published $688.03 โ€“ $1,472.38 8
SSM Health St. Anthony Hospital - Oklahoma City Oklahoma City not published $688.03 โ€“ $1,472.38 10