Add ue prost a/e ultlite mat cost in Pennsylvania

Add UE prost a/e ultlite mat · HCPCS L7401

Hospital City Cash price Negotiated range Payers
AHN WEXFORD HOSPITAL WEXFORD not published $195.84 – $739.87 13
GROVE CITY HOSPITAL GROVE CITY not published $208.42 – $739.87 13