Add ue prost be/wd, ultlite cost in Missouri

Add UE prost be/wd, ultlite · HCPCS L7400

Hospital City Cash price Negotiated range Payers
SSM Health Cardinal Glennon Children's Hospital Saint Louis not published $223.77 – $223.77 1
SSM Health Saint Louis University Hospital Saint Louis not published $263.03 – $450.64 6