Which service lines have the lowest commercial-to-Medicare ratio?
The one that started the company. Find the service 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.
Choose a revenue question
This is the product. Not a dashboard to interpret — a question you pick, and the dollar answer underneath it.
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.
Which payers have the largest hospital-vs-payer rate differences?
Where what a payer publishes and what the hospital publishes do not agree.
Which procedures have the largest hospital-vs-payer differences?
The same question, one level down: which specific procedures carry the gap.
Which facilities differ most from Medicare's realized outpatient payments?
Not the published benchmark — what Medicare actually paid out.
Where do hospital and payer files disagree on published rates?
Two public sources describing the same contract. When they diverge, someone is working from the wrong number.
What was actually allowed?
The allowed amount, by payer and procedure, from published data.
What did patients owe?
The patient responsibility that sits behind the negotiated rate.
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 identityThe federal registry and exclusion lists, so a rate is tied to the right facility.
The hard part isn’t the chart
It is getting two files that describe the same contract in different units onto one comparable scale — and refusing to publish a number when the evidence underneath it isn’t there.
01
Six public sources, normalized to one scale
Hospital machine-readable files, payer Transparency in Coverage files, Medicare’s published benchmark, what Medicare actually paid out, state Medicaid fee schedules, and the federal provider registry. Each arrives in its own format, its own units, and its own idea of what a “rate” is. Normalizing them is the product.
02
Identity is resolved, never invented
A third of the rural hospitals we scanned share a web domain with a sibling hospital. Before a single rate is indexed, the addresses and NPIs inside a file are matched against the hospital it claims to belong to. A match to a different hospital blocks the load outright. Insufficient evidence is held for human review rather than guessed at.
03
A source we can’t stand behind gets switched off
When a payer’s published index turned out to carry plans from four other states, we disabled that feed rather than let out-of-state rates be attributed to a local payer. When a payer’s own network stopped serving a file we already held a checksum-verified copy of, we kept using ours — and recorded that we had.
04
Built for the national payer set, not a sample
Rate files run to gigabytes and there are thousands of them. Ingestion runs as a staged pipeline across a fleet of workers with a column store behind it, so adding payers is a capacity decision rather than a rewrite.
None of this is visible in the answer you get. All of it is the reason the answer is worth taking to a negotiation.
Who this is for
Three different jobs. Start wherever you actually are.
State Offices of Rural Health
Every SHIP-eligible hospital in your state, ranked by what its published file is actually missing — so you can see where the award would do the most good before you spend it. Free, and yours whether or not we ever work together. SHIP is the federal Small Rural Hospital Improvement Program.
Get your state’s report →Critical access & small rural hospitals
Find out what you are paid against Medicare and against the facilities around you — including the imaging centre down the road, which is often the competition that actually matters. Free to start, and nothing of yours leaves the building.
See where you stand →Health systems & payers
Every negotiated rate in your market set against Medicare, Medicaid and the payer’s own published file, so the next contract conversation starts with the number instead of an argument about whose number is right.
Book 30 minutes →Where this came from
We started by checking whether rural hospitals were publishing the prices the rule requires. We scanned 1,692 rural hospitals across 45 states, most recently on 1 September 2026, and found roughly one in three publishing a file with a gap.
That work is why the rest of this exists. You cannot compare rates across hospitals and insurers until you know, file by file, what is actually in them and what is missing — and there was no way to learn that except to go and read all of them.
We still handle price transparency compliance for hospitals that want it — a flat annual fee for critical access and small rural hospitals, sized to sit inside a SHIP award. It is on the price list. It is not the reason to talk to us.