Add ue prost b/e acrylic cost in North Dakota

Add UE prost b/e acrylic · HCPCS L7403

Hospital City Cash price Negotiated range Payers
Sanford Fargo Medical Center Fargo not published $412.46 – $471.91 10
Sanford Medical Center Bismarck Bismarck not published $426.97 – $471.91 9