Add ue prost b/e acrylic cost in Oklahoma

Add UE prost b/e acrylic ยท HCPCS L7403

Hospital City Cash price Negotiated range Payers
SSM Health St. Anthony Hospital - Shawnee Shawnee not published $455.88 โ€“ $888.97 8
SSM Health St. Anthony Hospital - Midwest Midwest City not published $455.88 โ€“ $975.58 8
SSM Health St. Anthony Hospital - Oklahoma City Oklahoma City not published $455.88 โ€“ $975.58 10