| 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $23.55
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 63323078121 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $8.71 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $21.20 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $15.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $20.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Medicare | 
                                            
                                                $11.78
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $15.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $9.42
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $18.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $16.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $20.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $16.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $18.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $21.20
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $16.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $17.66
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $20.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $20.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $15.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $14.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $8.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $17.66
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $20.88
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 00143923401 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9.19 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $18.79 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $13.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $17.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $13.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $16.70
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $14.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $17.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $14.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $16.70
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $18.79
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $14.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $15.66
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $17.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $17.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $13.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $13.15
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $9.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $15.66
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $23.55
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 63323078110 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $10.36 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $21.20 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $15.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $20.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $15.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $18.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $16.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $20.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $16.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $18.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $21.20
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $16.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $17.66
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $20.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $20.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $15.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $14.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $10.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $17.66
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $16.69
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 55150023501 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $7.34 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $15.02 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $13.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $14.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $13.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $15.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $12.52
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $10.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $7.34
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $12.52
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $16.69
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 55150023510 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $6.18 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $15.02 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Medicare | 
                                            
                                                $8.34
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $6.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $13.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $14.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $13.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $15.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $12.52
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $10.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $6.18
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $12.52
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $22.63
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 47335093140 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $8.37 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $20.37 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $14.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $19.24
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Medicare | 
                                            
                                                $11.32
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $14.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $9.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $18.10
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $15.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $19.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $15.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $18.10
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $20.37
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $15.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $16.97
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $19.24
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $19.24
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $14.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $14.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $8.37
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $16.97
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $23.59
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 67457043800 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $10.38 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $21.23 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $15.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $20.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $15.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $18.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $16.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $20.29
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $16.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $18.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $21.23
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $16.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $17.69
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $20.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $20.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $15.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $14.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $10.38
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $17.69
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $35.94
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 41616093144 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $13.30 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $32.35 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $23.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $30.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Medicare | 
                                            
                                                $17.97
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $23.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $14.38
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $28.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $25.16
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $30.91
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $25.16
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $28.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $32.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $25.16
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $26.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $30.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $30.55
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $23.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $22.64
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $13.30
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $26.96
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $25.57
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 55390003710 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9.46 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $23.01 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $16.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $21.73
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Medicare | 
                                            
                                                $12.78
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $16.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $10.23
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $20.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $17.90
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $21.99
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $17.90
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $20.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $23.01
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $17.90
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $19.18
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $21.73
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $21.73
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $16.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $16.11
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $9.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $19.18
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $23.59
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 67457043800 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $8.73 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $21.23 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $15.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $20.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Medicare | 
                                            
                                                $11.80
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $15.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $9.44
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $18.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $16.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $20.29
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $16.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $18.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $21.23
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $16.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $17.69
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $20.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $20.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $15.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $14.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $8.73
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $17.69
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $23.59
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 67457043810 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $10.38 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $21.23 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $15.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $20.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $15.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $18.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $16.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $20.29
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $16.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $18.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $21.23
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $16.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $17.69
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $20.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $20.05
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $15.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $14.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $10.38
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $17.69
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $20.88
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 00143923401 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $7.73 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $18.79 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $13.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $17.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Medicare | 
                                            
                                                $10.44
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $13.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $8.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $16.70
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $14.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $17.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $14.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $16.70
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $18.79
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $14.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $15.66
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $17.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $17.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $13.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $13.15
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $7.73
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $15.66
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $29.26
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 00409163221 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $10.83 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $26.33 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $19.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $24.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Medicare | 
                                            
                                                $14.63
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $19.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $11.70
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $23.41
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $20.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $25.16
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $20.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $23.41
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $26.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $20.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $21.94
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $24.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $24.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $19.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $18.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $10.83
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $21.94
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $16.69
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 55150023501 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $6.18 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $15.02 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Medicare | 
                                            
                                                $8.34
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $6.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $13.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $14.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $13.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $15.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $12.52
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $10.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $6.18
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $12.52
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $26.08
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 00703291401 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $11.48 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $23.47 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $20.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $22.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $20.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $23.47
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $19.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $16.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $11.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $19.56
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $29.26
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 00409163221 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $12.87 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $26.33 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $19.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $24.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $19.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $23.41
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $20.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $25.16
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $20.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $23.41
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $26.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $20.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $21.94
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $24.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $24.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $19.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $18.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $12.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $21.94
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $22.63
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 47335093140 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9.96 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $20.37 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $14.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $19.24
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $14.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $18.10
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $15.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $19.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $15.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $18.10
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $20.37
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $15.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $16.97
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $19.24
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $19.24
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $14.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $14.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $9.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $16.97
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $16.69
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 55150023510 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $7.34 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $15.02 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $13.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $14.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $13.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $15.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $11.68
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $12.52
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $14.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $10.85
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $10.51
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $7.34
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $12.52
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $22.63
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 47335093144 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9.96 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $20.37 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $14.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $19.24
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $14.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $18.10
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $15.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $19.46
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $15.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $18.10
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $20.37
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $15.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $16.97
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $19.24
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $19.24
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $14.71
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $14.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $9.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $16.97
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $20.88
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 00143923410 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9.19 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $18.79 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $13.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $17.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $13.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $16.70
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $14.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $17.96
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $14.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $16.70
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $18.79
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $14.62
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $15.66
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $17.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $17.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $13.57
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $13.15
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $9.19
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $15.66
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $26.08
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 00703291403 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9.65 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $23.47 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Medicare | 
                                            
                                                $13.04
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $10.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $20.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $22.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $20.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $23.47
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $19.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $16.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $9.65
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $19.56
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $23.55
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 63323078121 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $10.36 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $21.20 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $15.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $20.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $15.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $18.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $16.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $20.25
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $16.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $18.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $21.20
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $16.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $17.66
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $20.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $20.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $15.31
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $14.84
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $10.36
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $17.66
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $26.08
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 00703291401 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $9.65 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $23.47 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Medicare | 
                                            
                                                $13.04
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: BCBS Complete | 
                                            
                                                $10.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $20.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $22.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $20.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $23.47
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $19.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $16.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $9.65
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $19.56
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $29.26
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 00409163201 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $12.87 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $26.33 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $19.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $24.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $19.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $23.41
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $20.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $25.16
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $20.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $23.41
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $26.33
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $20.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $21.94
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $24.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $24.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $19.02
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $18.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $12.87
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $21.94
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION
                     | 
                    
                        Facility
                     | 
                    
                        IP
                     | 
                    
                        $26.08
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                NDC 00703291403 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            11634
                                         | 
                                     
                                    
                                    
                                    
                                        | 
                                            Hospital Revenue Code
                                         | 
                                        
                                            250
                                         | 
                                     
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $11.48 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $23.47 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna American Axle | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna New Business (MI Preferred) | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cash Price  | 
                                            
                                                $20.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Commercial | 
                                            
                                                $22.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Cofinity Medicare Advantage | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Encore Health Key Benefits Commercial | 
                                            
                                                $20.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Healthscope Commercial | 
                                            
                                                $23.47
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Kalamazoo County Sherrif's Dept Commercial | 
                                            
                                                $18.26
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lakeland Regional Health Systems Commercial | 
                                            
                                                $19.56
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Multiplan/Beech St/PHCS Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: PHP Commercial | 
                                            
                                                $22.17
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health Cigna Priority Health | 
                                            
                                                $16.95
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Priority Health SBD | 
                                            
                                                $16.43
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: UMR Bronson Commercial | 
                                            
                                                $11.48
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Van Buren County Sheriff Dept. Commercial | 
                                            
                                                $19.56
                                             | 
                                         
                                    
                                
                             
                         
                     |