Add ue prost a/e ultlite mat cost in Oklahoma

Add UE prost a/e ultlite mat ยท HCPCS L7401

Hospital City Cash price Negotiated range Payers
SSM Health St. Anthony Hospital - Shawnee Shawnee not published $424.75 โ€“ $828.26 8
SSM Health St. Anthony Hospital - Midwest Midwest City not published $424.75 โ€“ $908.96 8
SSM Health St. Anthony Hospital - Oklahoma City Oklahoma City not published $424.75 โ€“ $908.96 10