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
12
Lines analyzed
your hospital
12
Above 10% threshold
signals to investigate
-$38,135
Net Δ (TiC − MRF)
signed sum across rows
2
Payers in slice
canonical
| Hospital | CPT | Payer | MRF | TiC | Δ$ | Δ% | Bias | n MRF / n TiC | Action |
|---|---|---|---|---|---|---|---|---|---|
Northwestern Memorial Hospital northwestern | 29881 HB Arthroscop Knee Med and Lat | Blue Cross Blue Shield | $18,331 | $644 | -$17,687 | -96.5% | MRF > TiC | 17 / 5 | |
Northwestern Memorial Hospital northwestern | 99284 HB ED Visit Level 4 | Blue Cross Blue Shield | $2,603 | $145 | -$2,458 | -94.4% | MRF > TiC | 42 / 5 | |
Northwestern Memorial Hospital northwestern | 43239 HB Egd Transoral Biopsy Single/Multiple | Blue Cross Blue Shield | $5,621 | $403 | -$5,218 | -92.8% | MRF > TiC | 42 / 8 | |
Northwestern Memorial Hospital northwestern | 99283 HB ED Visit Level 3 | Blue Cross Blue Shield | $1,126 | $84.81 | -$1,041 | -92.5% | MRF > TiC | 42 / 5 | |
Northwestern Memorial Hospital northwestern | 74177 HB CT Abd & Pelv W/Contrast | Blue Cross Blue Shield | $4,321 | $384 | -$3,937 | -91.1% | MRF > TiC | 21 / 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 > TiC | 21 / 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 > TiC | 21 / 8 | |
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 > TiC | 21 / 8 | |
Northwestern Memorial Hospital northwestern | 71250 HB CT Thorax, Diagnostic W/O Dye | Aetna | $1,063 | $1,752 | +$689 | +64.8% | TiC > MRF | 18 / 2 | |
Northwestern Memorial Hospital northwestern | 74177 HB CT Abd & Pelv W/Contrast | Aetna | $2,463 | $1,752 | -$711 | -28.9% | MRF > TiC | 18 / 2 | |
Northwestern Memorial Hospital northwestern | 70553 HB MRI Brain Stem W/O & W/Dye | Aetna | $2,193 | $1,832 | -$361 | -16.4% | MRF > TiC | 18 / 2 | |
Northwestern Memorial Hospital northwestern | 70551 HB MRI Brain Stem W/O Dye | Aetna | $1,583 | $1,832 | +$249 | +15.8% | TiC > MRF | 18 / 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.