← Back to 52-Portal Commercial Payer MRF & NSA IDR Directory
RUBRICWARD AI DOSSIER // TIER 2 AUTOPILOT (#01–#06, #11)
UT
UTDOI-MRF-CPT-93458-324
•
Utah Insurance Department (UID) & CMS TiC Payer MRF Index
•
Salt Lake County, UT
•
Filing / IDR Window: 2026-11-22
[UTDOI-MRF-CPT-93458-324] Utah UHC, Anthem & BCBS-UT Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 93458 / 93306 Cardiology Left Heart Catheterization)
Commercial payer Transparency in Coverage (TiC) Machine-Readable File (MRF) negotiated rate audit and Federal No Surprises Act (NSA) IDR arbitration dossier for CPT 93458 / 93306 Cardiology Left Heart Catheterization in Utah (Utah Code § 31A-26-301.6).
Cohort MRF 75th-Pct Value
$2,530,000
Target % of Medicare
237.5% MPFS
Statutory Authority
UT-GPCI-2026 (Utah Code § 31A-26-301.6)
ERISA / Timely-Filing Window
560 Days
1. Commercial Payer TiC MRF Allowed-Amount Benchmarks (API #02)
| CPT / DRG Code | Clinical Procedure Description | Unit | Cohort Claims | MRF 25th Pct | MRF Median (QPA) | MRF 75th Pct |
|---|---|---|---|---|---|---|
| CPT-93458 | Left Heart Catheterization with Coronary Angiography | CLAIM | 460 | $1,073.80 | $2,493.40 | $3,112.20 |
| CPT-93306 | Transthoracic Echocardiography Complete with Doppler | CLAIM | 240 | $1,557.01 | $3,615.43 | $4,512.69 |
| CPT-99214-25 | Level 4 Established Patient Outpatient E/M with Separately Identifiable Modifier 25 | CLAIM | 1,200 | $115.00 | $172.00 | $204.00 |
2. Regional Peer Specialty Groups & EIN/NPI MRF Comparables (API #11)
Utah Specialty Surgical AssociatesUtah Ambulatory Surgery Center LLCRegional Medical Group of UtahUtah Physician Billing & RCM Partners