Add ue prost be/wd, ultlite cost in Oklahoma

Add UE prost be/wd, ultlite ยท HCPCS L7400

Hospital City Cash price Negotiated range Payers
SSM Health St. Anthony Hospital - Shawnee Shawnee not published $379.41 โ€“ $739.85 8
SSM Health St. Anthony Hospital - Midwest Midwest City not published $379.41 โ€“ $811.94 8
SSM Health St. Anthony Hospital - Oklahoma City Oklahoma City not published $379.41 โ€“ $811.94 10