Add ue prost b/e acrylic cost in Minnesota

Add UE prost b/e acrylic · HCPCS L7403

Hospital City Cash price Negotiated range Payers
Sanford Worthington Medical Center Worthington not published $412.46 – $556.01 8
Sanford Bemidji Medical Center Bemidji not published $419.88 – $556.01 8