Deep Dive
Payer Cross-Reference
Side-by-side: what your hospital filed in its Machine-Readable File versus what the payer filed for you in its Transparency in Coverage file. They are independent disclosures and are known to disagree.
Delta
TiC reports 96% lower than MRF for this combo.
MRF median $18,331 · TiC median $644
Δ -$17,687 (-96.5%)
MRF · Hospital-reported
What your hospital filed
17 plans
| Plan | Rate | Methodology |
|---|---|---|
NMHC CHWN IPA BLUE CROSS BLUE SHIELD [1401] | $16,498(45% × gross) | percent of total billed charges |
NMHC CHWN IPA BLUE CROSS BLUE SHIELD [1401] | $16,498(45% × gross) | percent of total billed charges |
NMHC CHWN IPA BLUE CROSS BLUE SHIELD [1401] | $16,498(45% × gross) | percent of total billed charges |
NMHC CHWN IPA BLUE CROSS BLUE SHIELD [1401] | $16,498(45% × gross) | percent of total billed charges |
NMHC NON-CONTRACTED PAYORS BLUE CROSS BLUE SHIELD [1401] | $36,663(100% × gross) | percent of total billed charges |
NMHC NON-CONTRACTED PAYORS BLUE CROSS BLUE SHIELD [1401] | $36,663(100% × gross) | percent of total billed charges |
NMHC NON-CONTRACTED PAYORS BLUE CROSS BLUE SHIELD [1401] | $36,663(100% × gross) | percent of total billed charges |
NMHC NON-CONTRACTED PAYORS BLUE CROSS BLUE SHIELD [1401] | $36,663(100% × gross) | percent of total billed charges |
NMHC NON-CONTRACTED PAYORS BLUE CROSS BLUE SHIELD [1401] | $36,663(100% × gross) | percent of total billed charges |
NMHC SCPP IPA BLUE CROSS BLUE SHIELD [1401] | $16,498(45% × gross) | percent of total billed charges |
NMHC SCPP IPA BLUE CROSS BLUE SHIELD [1401] | $16,498(45% × gross) | percent of total billed charges |
NMHC SCPP IPA BLUE CROSS BLUE SHIELD [1401] | $16,498(45% × gross) | percent of total billed charges |
NMHC SCPP IPA BLUE CROSS BLUE SHIELD [1401] | $16,498(45% × gross) | percent of total billed charges |
NMHC UIC IPA BLUE CROSS BLUE SHIELD [1401] | $18,331(50% × gross) | percent of total billed charges |
NMHC UIC IPA BLUE CROSS BLUE SHIELD [1401] | $18,331(50% × gross) | percent of total billed charges |
NMHC UIC IPA BLUE CROSS BLUE SHIELD [1401] | $18,331(50% × gross) | percent of total billed charges |
NMHC UIC IPA BLUE CROSS BLUE SHIELD [1401] | $18,331(50% × gross) | percent of total billed charges |
TiC · Payer-reported
What the payer filed for you
5 rows
| Plan network | Rate | Type |
|---|---|---|
Blue Choice PPO NPI 1497859649 | $644 | negotiated |
Blue Choice Preferred PPO NPI 1497859649 | $644 | negotiated |
Blue Choice Preferred PPO NPI 1497859649 | $6,534 | negotiated |
Blue Options or Blue Choice Options NPI 1497859649 | $6,693 | negotiated |
Blue Options or Blue Choice Options NPI 1497859649 | $644 | negotiated |
MRF and TiC are independent filings of the same contract. They are known to diverge — that is the negotiation signal.
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