Add ue prost b/e acrylic cost in Virginia

Add UE prost b/e acrylic · HCPCS L7403

Hospital City Cash price Negotiated range Payers
HENRICO DOCTORS HOSPITAL RICHMOND not published $376.19 – $473.56 19
TRICITIES HOSPITAL HOPEWELL not published $376.19 – $597.48 19
STONESPRINGS HOSPITAL CENTER Dulles not published $331.94 – $473.56 12
SPOTSYLVANIA REGIONAL MEDICAL CENTER Fredericksburg not published $429.30 – $473.56 14
RESTON HOSPITAL CENTER VIENNA not published $429.30 – $473.56 14
LEWISGALE MEDICAL CENTER ROANOKE not published $376.19 – $473.56 18
LEWISGALE HOSPITAL-MONTGOMERY CHRISTIANSBURG not published $376.19 – $473.56 16
CJW Medical Center-Chippenham Hospital Campus CHESTERFIELD not published $376.19 – $597.48 17