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Deep Dive · Differentiator

MRF vs TiC Divergence

Where the hospital-reported rate (MRF) and the payer-reported rate (TiC) for the same (hospital, CPT, payer) disagree by more than your threshold. Independent filings often diverge — treat this as a negotiation signal or audit prompt.

Scope
50
Lines analyzed
all hospitals
44
Above 10% threshold
signals to investigate
-$39,436
Net Δ (TiC − MRF)
signed sum across rows
2
Payers in slice
canonical
HospitalCPTPayerMRFTiCΔ$Δ%Biasn MRF / n TiCAction
Endeavor Health Evanston Hospitalthin
endeavor
71250
HB CT Thorax, Diagnostic W/O Dye
Aetna$112$2,154+$2,042+1822.7%TiC > MRF1 / 1
Endeavor Health Evanston Hospitalthin
endeavor
70551
HB MRI Brain Stem W/O Dye
Aetna$256$2,693+$2,437+953.2%TiC > MRF1 / 1
Endeavor Health Evanston Hospitalthin
endeavor
70553
HB MRI Brain Stem W/O & W/Dye
Aetna$374$2,693+$2,319+620.3%TiC > MRF1 / 1
Endeavor Health Evanston Hospitalthin
endeavor
74177
HB CT Abd & Pelv W/Contrast
Aetna$374$2,154+$1,780+476.2%TiC > MRF1 / 1
Endeavor Health Evanston Hospital
endeavor
43239
HB Egd Transoral Biopsy Single/Multiple
Aetna$2,505$6,865+$4,360+174.0%TiC > MRF2 / 2
Northwestern Memorial Hospital
northwestern
29881
HB Arthroscop Knee Med and Lat
Blue Cross Blue Shield$18,331$644-$17,687-96.5%MRF > TiC17 / 5
Northwestern Memorial Hospital
northwestern
99284
HB ED Visit Level 4
Blue Cross Blue Shield$2,603$145-$2,458-94.4%MRF > TiC42 / 5
Rush University Medical Centerthin
rush
99283
HB ED Visit Level 3
Blue Cross Blue Shield$1,468$89.28-$1,379-93.9%MRF > TiC6 / 1
Northwestern Memorial Hospital
northwestern
43239
HB Egd Transoral Biopsy Single/Multiple
Blue Cross Blue Shield$5,621$403-$5,218-92.8%MRF > TiC42 / 8
Northwestern Memorial Hospital
northwestern
99283
HB ED Visit Level 3
Blue Cross Blue Shield$1,126$84.81-$1,041-92.5%MRF > TiC42 / 5
Rush University Medical Centerthin
rush
99284
HB ED Visit Level 4
Blue Cross Blue Shield$2,184$172-$2,012-92.1%MRF > TiC6 / 1
Northwestern Memorial Hospital
northwestern
74177
HB CT Abd & Pelv W/Contrast
Blue Cross Blue Shield$4,321$384-$3,937-91.1%MRF > TiC21 / 8
Northwestern Memorial Hospital
northwestern
70551
HB MRI Brain Stem W/O Dye
Blue Cross Blue Shield$2,777$250-$2,526-91.0%MRF > TiC21 / 8
Northwestern Memorial Hospital
northwestern
71250
HB CT Thorax, Diagnostic W/O Dye
Blue Cross Blue Shield$1,865$169-$1,696-90.9%MRF > TiC21 / 8
Endeavor Health Evanston Hospital
endeavor
93005
Routine electrocardiogram (ECG) using at least 12 leads with tracing
Blue Cross Blue Shield$37.87$72.12+$34.25+90.4%TiC > MRF3 / 2
Advocate Christ Medical Center
advocate
99283
HB ED Visit Level 3
Blue Cross Blue Shield$889$87.05-$802-90.2%MRF > TiC5 / 4
Advocate Christ Medical Center
advocate
99284
HB ED Visit Level 4
Blue Cross Blue Shield$1,555$159-$1,397-89.8%MRF > TiC5 / 4
Northwestern Memorial Hospital
northwestern
70553
HB MRI Brain Stem W/O & W/Dye
Blue Cross Blue Shield$3,847$407-$3,439-89.4%MRF > TiC21 / 8
Rush University Medical Center
rush
43239
HB Egd Transoral Biopsy Single/Multiple
Blue Cross Blue Shield$2,897$338-$2,559-88.3%MRF > TiC7 / 2
Rush University Medical Center
rush
74177
HB CT Abd & Pelv W/Contrast
Blue Cross Blue Shield$3,178$382-$2,796-88.0%MRF > TiC7 / 2
Advocate Christ Medical Center
advocate
70551
HB MRI Brain Stem W/O Dye
Blue Cross Blue Shield$1,709$250-$1,458-85.3%MRF > TiC10 / 7
Advocate Christ Medical Center
advocate
93000
ELECTROCARDIOGRAM COMPLETE
Blue Cross Blue Shield$144$23.45-$120-83.7%MRF > TiC3 / 4
Advocate Christ Medical Center
advocate
71250
HB CT Thorax, Diagnostic W/O Dye
Blue Cross Blue Shield$1,038$169-$869-83.7%MRF > TiC5 / 7
Advocate Christ Medical Center
advocate
70553
HB MRI Brain Stem W/O & W/Dye
Blue Cross Blue Shield$2,423$407-$2,016-83.2%MRF > TiC5 / 7
Advocate Christ Medical Center
advocate
74177
HB CT Abd & Pelv W/Contrast
Blue Cross Blue Shield$1,454$384-$1,069-73.6%MRF > TiC5 / 7
Northwestern Memorial Hospital
northwestern
71250
HB CT Thorax, Diagnostic W/O Dye
Aetna$1,063$1,752+$689+64.8%TiC > MRF18 / 2
Endeavor Health Evanston Hospital
endeavor
70551
HB MRI Brain Stem W/O Dye
Blue Cross Blue Shield$1,448$2,382+$934+64.5%TiC > MRF3 / 2
Endeavor Health Evanston Hospital
endeavor
70553
HB MRI Brain Stem W/O & W/Dye
Blue Cross Blue Shield$2,345$3,856+$1,512+64.5%TiC > MRF3 / 2
Endeavor Health Evanston Hospital
endeavor
29881
HB Arthroscop Knee Med and Lat
Aetna$4,843$7,936+$3,092+63.8%TiC > MRF2 / 6
Endeavor Health Evanston Hospital
endeavor
71250
HB CT Thorax, Diagnostic W/O Dye
Blue Cross Blue Shield$582$924+$341+58.6%TiC > MRF3 / 2
Rush University Medical Center
rush
70553
HB MRI Brain Stem W/O & W/Dye
Blue Cross Blue Shield$2,779$1,203-$1,576-56.7%MRF > TiC14 / 4
Rush University Medical Center
rush
71250
HB CT Thorax, Diagnostic W/O Dye
Blue Cross Blue Shield$661$316-$345-52.2%MRF > TiC7 / 4
Rush University Medical Center
rush
70551
HB MRI Brain Stem W/O Dye
Blue Cross Blue Shield$1,251$612-$639-51.1%MRF > TiC14 / 4
Endeavor Health Evanston Hospital
endeavor
93000
ELECTROCARDIOGRAM COMPLETE
Blue Cross Blue Shield$107$160+$53.08+49.7%TiC > MRF3 / 2
Rush University Medical Center
rush
93005
Routine electrocardiogram (ECG) using at least 12 leads with tracing
Blue Cross Blue Shield$59.26$33.09-$26-44.2%MRF > TiC21 / 3
Endeavor Health Evanston Hospital
endeavor
99283
HB ED Visit Level 3
Blue Cross Blue Shield$303$417+$114+37.6%TiC > MRF3 / 2
Endeavor Health Evanston Hospital
endeavor
99284
HB ED Visit Level 4
Blue Cross Blue Shield$578$795+$217+37.6%TiC > MRF3 / 2
Northwestern Memorial Hospital
northwestern
74177
HB CT Abd & Pelv W/Contrast
Aetna$2,463$1,752-$711-28.9%MRF > TiC18 / 2
Endeavor Health Evanston Hospital
endeavor
74177
HB CT Abd & Pelv W/Contrast
Blue Cross Blue Shield$1,553$1,945+$392+25.2%TiC > MRF3 / 2
Endeavor Health Evanston Hospital
endeavor
27130
HB Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft
Aetna$11,957$9,691-$2,266-19.0%MRF > TiC2 / 3
Rush University Medical Center
rush
70551
HB MRI Brain Stem W/O Dye
Aetna$1,569$1,854+$286+18.2%TiC > MRF12 / 2
Northwestern Memorial Hospital
northwestern
70553
HB MRI Brain Stem W/O & W/Dye
Aetna$2,193$1,832-$361-16.4%MRF > TiC18 / 2
Northwestern Memorial Hospital
northwestern
70551
HB MRI Brain Stem W/O Dye
Aetna$1,583$1,832+$249+15.8%TiC > MRF18 / 2
Rush University Medical Center
rush
71250
HB CT Thorax, Diagnostic W/O Dye
Aetna$1,018$1,133+$116+11.4%TiC > MRF6 / 2
How this is computed

For each (hospital, CPT, canonical payer) combination, we take the median MRF rate (with the percentage→dollar derivation) and the median TiC rate (filtered to negotiated_type = 'negotiated'). The delta is tic_median − mrf_median; the percentage is normalized to MRF as the denominator.

Rows where MRF or TiC has only n=1 sample carry a thin chip. Independent filings are known to disagree by 20%+ even when both parties are correct — interpret as a signal, not a contradiction.