Add ue prost s/d ultlite mat cost in Oklahoma

Add UE prost s/d ultlite mat ยท HCPCS L7402

Hospital City Cash price Negotiated range Payers
SSM Health St. Anthony Hospital - Shawnee Shawnee not published $458.68 โ€“ $894.43 8
SSM Health St. Anthony Hospital - Midwest Midwest City not published $458.68 โ€“ $981.58 8
SSM Health St. Anthony Hospital - Oklahoma City Oklahoma City not published $458.68 โ€“ $981.58 10