Which service lines have the lowest commercial-to-Medicare ratio?
The one that started the company. Find the line you are paid worst on, before someone else tells you.
Built on data every hospital and insurer is already required to publish
See what every hospital in your market is actually paid.
By payer. By procedure. Against Medicare and Medicaid. Your negotiated rates and your competitors’, side by side — so you can stop guessing where you stand, and start the renegotiation with the number in front of you.
What the data actually looks like
Four things we can show you right now
Every figure below is measured from published files. Nothing here is modelled, and nothing here is a demo dataset.
One hospital. One code. One year. Two insurers.
One hospital, MRI of the lumbar spine, billed to two different insurers in the same year.
3.95× apart, for the same procedure
The same data, read two different ways
A real dataset, measured against Medicare. One switch is the difference between a state that looks underpaid and a state that is not.
20.9%
below Medicare — as the files are published
Read the file as it arrives and Texas looks like a state where hospitals are paid less than
Medicare across the board. Every conclusion you draw from here is wrong.
How much is at stake depends on where you are
The same procedure and the same insurer, compared across every facility in the market. Two very different pictures.
A small marketfewer facilities, narrower spread
1.26×
Houston metro77–97 facilities per procedure
4–6×
Sources: hospital and payer machine-readable files, scanned 1 September 2026 · Institutional rates on 35 benchmark procedure codes · Houston comparison across 77–97 facilities per procedure.
Both sides of the same contract
The hospital publishes what it says it is paid. The insurer publishes what it says it pays. They are describing the same contract, and nobody has been putting them side by side.
The hospital’s file
What this hospital says it is paid for the procedure
Filed by the hospital, under the price transparency rule.
vs
The insurer’s file
What the insurer says it pays that same hospital
Filed separately by the payer, in a different format entirely.
Questions nobody could answer until now
Not because the data was secret — it has been public for years. Because it was unusable. These are answerable today.
What you are paid
Which negotiated rates are below Medicare’s published benchmark?
A commercial payer paying you less than Medicare. It happens, and it is hard to defend once it is on paper.
How do we compare to what Medicare actually paid out?
Not the published benchmark — the realized payments. Different number, and almost nobody uses it.
Where do the hospital file and the payer file disagree?
Two public sources describing the same contract. When they diverge, someone is working from the wrong number.
Is our negotiated rate higher than our own cash price?
It happens more than anyone expects, and it is indefensible the moment somebody notices.
Does what we publish match what our insurer publishes about us?
Two files, two formats, one contract. Where they disagree, somebody is going to ask why.
Where you stand in your market
Which of our prices are above market, and which are below?
Facility by facility, payer by payer, against everyone else publishing in your market.
Where are our widest price spreads?
The same procedure, the same hospital, two payers — and the gap between them.
Which of our prices are least defensible?
The ones that will not survive a payer asking you to justify them.
Which facilities are market outliers?
Yours and everyone else’s — because an outlier next door changes your negotiation too.
What to actually do about it
Where should we defend our price, and where should we reposition?
Not just the number. The recommendation, ranked by what it is worth.
Should this service line standardize or specialize?
Across your facilities, where consistency pays and where differentiation does.
What should we take into the next renegotiation, in order?
Pricing action priorities, weighted by the dollars behind each one.
Which data gaps are costing us the most?
Facilities with no published rates, payer attribution gaps, identity conflicts — ordered by the leverage in fixing them.
The whole episode, not just the hospital
What does the surgeon get paid, not just the facility?
Individual physician rates alongside facility rates — the part of a procedure nobody else lines up.
Which providers in our market are federally excluded?
Excluded from federal healthcare programs, geocoded and mapped.
What does the same procedure cost across every facility near us?
Same code, same insurer, every facility in the market, side by side.
Ask it anything else, in plain language
And it cites the source and the date behind every number it gives you.
Every answer shows its work
You can see exactly which source produced each number, because a rate you cannot defend is a rate you cannot negotiate with.
Facility-reportedWhat the hospital publishes in its own machine-readable file.
Payer-reportedWhat the insurer publishes under Transparency in Coverage.
Medicare referenceThe published federal benchmark for the same code.
Medicare realizedWhat Medicare actually paid out, not just what it lists.
Medicaid referenceThe state layer almost nobody has normalized.
Provider registryWho each provider is — organizations and individual physicians.
Federal exclusionsProviders excluded from federal healthcare programs.
What it refuses to tell you
The comparisons it will not make are the reason to trust the ones it does.
Professional is not facilityEvery rate is classified before it is compared — and where an imaging file omits the modifier, the component is inferred rather than guessed.
Floor values are strippedPublished files repeat the same $50 or $114 thousands of times. Those are not facility rates. Average them in and the answer is confidently wrong.
Invalid comparisons are refusedEffective dates, temporal alignment, completeness, plausibility of attribution. Where a comparison should not be made, it says so.
We do not price the patientWe hold the allowed amount, not deductibles or out-of-pocket balances. Anyone showing you patient responsibility from this data is modeling it, not reading it.
And what else is in it
The rate comparison is the reason people come. It is not all that is here.
Ask it in plain languageFind facilities, identify the codes two of them share, compare their rates, load your analytics — with the source and date behind every answer.
Federal exclusion screeningWhich providers in your market are excluded from federal healthcare programs, geocoded and mapped.
Direct query accessFor analysts who would rather ask their own questions of the underlying data.
An APIFor consultancies and vendors who want the rate layer inside their own product rather than ours.
Nationwide
Every state in the country
We read insurers’ own published rate files — what they actually pay, by facility and by procedure code — across all fifty states.
The national carriers, the Blues, the regional plans and the Medicaid managed-care plans — file by file, code by code, facility by facility.
Every rate file is fetched and confirmed before it counts. What you see in your market is what your insurers published about your market.
Price transparency compliance
We still do this, and we do it well — it is how the company started. We run your file through CMS’s official validator and tell you what it sees, free. See pricing.