RubricWard 52 PAYER & STATE PORTALS // 12 APIS
50-State Commercial Payer TiC MRF, Medicare MPFS RVU/GPCI & Federal NSA IDR Intelligence PRICING
52 PORTALS ACTIVE // FEDERAL CMS IDR & 50-STATE COMMERCIAL PAYER MRF DIRECTORY

Live Commercial Payer TiC MRF, ERISA Appeal & NSA IDR Directory

Every cohort below includes pre-modeled 25th/50th/75th-percentile TiC MRF CPT/DRG benchmarks, CMS Medicare MPFS RVU/GPCI baselines, and 1-Click 6-File OpenXML (.DOCX + .XLSX) Claim & IDR Package compilation.

State Cohort / Case ID Commercial Payer MRF Cohort & Regulatory Portal Cohort MRF Value Target Multiple Filing Window Dossier
TX TXDOI-MRF-CPT-29881-DFW [TXDOI-MRF-CPT-29881-DFW] UHC & BCBS-TX Commercial MRF Rate Disparity, ASC Facility Fee & NSA IDR Benchmark (CPT 29881 / 27447 Orthopedic Surgery)
Texas Department of Insurance (TDI) & CMS Novitas JH Payer MRF Index — Dallas-Fort Worth MSA
 $1,845,000 14.5% MPFS 2026-11-18 Open Dossier
CA CADMHC-MRF-CPT-63030-SFO [CADMHC-MRF-CPT-63030-SFO] Anthem Blue Cross & Aetna MRF Rate Spread, Knox-Keene Prompt-Pay & ERISA Appeal (CPT 63030 / 22551 Spine & Neurosurgery)
California Department of Managed Health Care (DMHC) & Noridian JE MRF Index — Bay Area MSA
 $2,480,000 18.0% MPFS 2026-11-20 Open Dossier
FL FLOIR-MRF-CPT-45378-MIA [FLOIR-MRF-CPT-45378-MIA] Florida Blue & UnitedHealthcare GI Endoscopy / ASC MRF Rate Spread & FL Stat. § 627.6131 Prompt-Pay Audit (CPT 45378 / 43239)
Florida Office of Insurance Regulation (OIR) & First Coast JN MRF Index — Miami-Dade MSA
 $1,560,000 12.65% MPFS 2026-11-24 Open Dossier
VA VABOI-MRF-CPT-99285-RIC [VABOI-MRF-CPT-99285-RIC] Anthem HealthKeepers & Cigna Emergency Medicine / Radiology Out-of-Network NSA IDR & Downcoding Audit (CPT 99285 / 74177)
Virginia Bureau of Insurance (SCC) & Palmetto GBA JM MRF Index — Northern VA / Richmond MSA
 $2,120,000 12.0% MPFS 2026-11-25 Open Dossier
PA PAPID-MRF-CPT-66984-PHL [PAPID-MRF-CPT-66984-PHL] Highmark BCBS & Independence Blue Cross Ophthalmology / Cataract ASC MRF Rate Spread & Act 68 Prompt-Pay (CPT 66984 / 67028)
Pennsylvania Insurance Department (PID) & Novitas JL MRF Index — Philadelphia MSA
 $1,420,000 11.0% MPFS 2026-11-26 Open Dossier
NY NYDFS-MRF-CPT-01402-NYC [NYDFS-MRF-CPT-01402-NYC] Empire BCBS, EmblemHealth & Oxford Anesthesiology / Plastic Reconstructive NSA IDR & NY ISC § 3224-a Prompt-Pay (CPT 01402 / 19318)
New York State Department of Financial Services (NYDFS) & NGS JK MRF Index — New York Metro MSA
 $3,150,000 16.5% MPFS 2026-11-27 Open Dossier
IL ILDOI-MRF-CPT-93458-CHI [ILDOI-MRF-CPT-93458-CHI] BCBS-IL & UnitedHealthcare Cardiology / Outpatient Cath Lab MRF Rate Benchmark & 215 ILCS 5/368a Prompt-Pay (CPT 93458 / 92928)
Illinois Department of Insurance (IDOI) & NGS J6 MRF Index — Chicago Metro MSA
 $1,940,000 13.0% MPFS 2026-11-28 Open Dossier
GA GAOCI-MRF-CPT-47562-ATL [GAOCI-MRF-CPT-47562-ATL] Anthem BCBS-GA & Ambetter General Surgery / Bariatric ASC MRF Rate Spread & O.C.G.A. § 33-24-59.14 Prompt-Pay (CPT 47562 / 49650)
Georgia Office of Commissioner of Insurance (OCI) & Palmetto GBA JJ MRF Index — Atlanta MSA
 $1,680,000 12.5% MPFS 2026-11-30 Open Dossier
NC NCDOI-MRF-CPT-70553-CLT [NCDOI-MRF-CPT-70553-CLT] Blue Cross NC & Cigna Diagnostic Imaging / IDTF MRI MRF Rate Benchmark & N.C.G.S. § 58-3-225 Prompt-Pay (CPT 70553 / 72148)
North Carolina Department of Insurance (NCDOI) & Palmetto GBA JM MRF Index — Charlotte / Raleigh MSA
 $1,390,000 11.5% MPFS 2026-12-01 Open Dossier
OH OHODI-MRF-CPT-52356-CMH [OHODI-MRF-CPT-52356-CMH] Anthem BCBS-OH & Medical Mutual Urology / Lithotripsy ASC MRF Rate Spread & O.R.C. § 3901.389 Prompt-Pay (CPT 52356 / 50590)
Ohio Department of Insurance (ODI) & CGS J15 MRF Index — Columbus / Cleveland MSA
 $1,490,000 11.0% MPFS 2026-12-02 Open Dossier
US CMS-NSA-IDR-2026-Q4-FED [CMS-NSA-IDR-2026-Q4-FED] Federal No Surprises Act (45 CFR 149.510) Certified IDR Entity Arbitration & ERISA 29 CFR 2560.503-1 Multi-Specialty Benchmark
Centers for Medicare & Medicaid Services (CMS) CCIIO & EBSA Federal IDR Portal — National Docket
 $3,850,000 15.0% MPFS 2026-12-03 Open Dossier
MU MUNICIPAL-ASC-RCM-2026-09 [MUNICIPAL-ASC-RCM-2026-09] Multi-State Ambulatory Surgery Center (ASC) Payer Contract Renegotiation, 835 Underpayment & GFE Compliance Audit
Multi-State Self-Funded Municipal / Public Employee Health Plan & Commercial ASC Network Index
 $2,250,000 14.0% MPFS 2026-12-04 Open Dossier
WA WADOI-MRF-CPT-29881-310 [WADOI-MRF-CPT-29881-310] Washington UHC, Anthem & BCBS-WA Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 29881 / 27447 Orthopedic & ASC Knee Arthroscopy)
Washington Office of the Insurance Commissioner (WA OIC) & CMS TiC Payer MRF Index
 $1,420,000 195.0% MPFS 2026-11-18 Open Dossier
MI MIDOI-MRF-CPT-63030-311 [MIDOI-MRF-CPT-63030-311] Michigan UHC, Anthem & BCBS-MI Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 63030 / 22551 Spine & Neurosurgery Laminotomy)
Michigan Department of Insurance and Financial Services (DIFS) & CMS TiC Payer MRF Index
 $1,605,000 203.5% MPFS 2026-11-19 Open Dossier
NJ NJDOI-MRF-CPT-45378-312 [NJDOI-MRF-CPT-45378-312] New Jersey UHC, Anthem & BCBS-NJ Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 45378 / 45380 GI Endoscopy & Colonoscopy ASC)
New Jersey Department of Banking and Insurance (NJDOBI) & CMS TiC Payer MRF Index
 $1,790,000 212.0% MPFS 2026-11-20 Open Dossier
MA MADOI-MRF-CPT-99285-313 [MADOI-MRF-CPT-99285-313] Massachusetts UHC, Anthem & BCBS-MA Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 99285 / 00100 Emergency & Anesthesia NSA IDR)
Massachusetts Division of Insurance (MA DOI) & CMS TiC Payer MRF Index
 $1,975,000 220.5% MPFS 2026-11-21 Open Dossier
CO CODOI-MRF-CPT-93458-314 [CODOI-MRF-CPT-93458-314] Colorado UHC, Anthem & BCBS-CO Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 93458 / 93306 Cardiology Left Heart Catheterization)
Colorado Division of Insurance (DORA DOI) & CMS TiC Payer MRF Index
 $2,160,000 229.0% MPFS 2026-11-22 Open Dossier
AZ AZDOI-MRF-CPT-29881-315 [AZDOI-MRF-CPT-29881-315] Arizona UHC, Anthem & BCBS-AZ Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 29881 / 27447 Orthopedic & ASC Knee Arthroscopy)
Arizona Department of Insurance and Financial Institutions (DIFI) & CMS TiC Payer MRF Index
 $2,345,000 237.5% MPFS 2026-11-23 Open Dossier
MN MNDOI-MRF-CPT-63030-316 [MNDOI-MRF-CPT-63030-316] Minnesota UHC, Anthem & BCBS-MN Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 63030 / 22551 Spine & Neurosurgery Laminotomy)
Minnesota Department of Commerce — Insurance Division & CMS TiC Payer MRF Index
 $2,530,000 246.0% MPFS 2026-11-24 Open Dossier
TN TNDOI-MRF-CPT-45378-317 [TNDOI-MRF-CPT-45378-317] Tennessee UHC, Anthem & BCBS-TN Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 45378 / 45380 GI Endoscopy & Colonoscopy ASC)
Tennessee Department of Commerce and Insurance (TDCI) & CMS TiC Payer MRF Index
 $2,715,000 254.5% MPFS 2026-11-25 Open Dossier
IN INDOI-MRF-CPT-99285-318 [INDOI-MRF-CPT-99285-318] Indiana UHC, Anthem & BCBS-IN Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 99285 / 00100 Emergency & Anesthesia NSA IDR)
Indiana Department of Insurance (IDOI) & CMS TiC Payer MRF Index
 $1,420,000 263.0% MPFS 2026-11-26 Open Dossier
MO MODOI-MRF-CPT-93458-319 [MODOI-MRF-CPT-93458-319] Missouri UHC, Anthem & BCBS-MO Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 93458 / 93306 Cardiology Left Heart Catheterization)
Missouri Department of Commerce and Insurance (DCI) & CMS TiC Payer MRF Index
 $1,605,000 195.0% MPFS 2026-11-27 Open Dossier
WI WIDOI-MRF-CPT-29881-320 [WIDOI-MRF-CPT-29881-320] Wisconsin UHC, Anthem & BCBS-WI Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 29881 / 27447 Orthopedic & ASC Knee Arthroscopy)
Wisconsin Office of the Commissioner of Insurance (OCI) & CMS TiC Payer MRF Index
 $1,790,000 203.5% MPFS 2026-11-18 Open Dossier
SC SCDOI-MRF-CPT-63030-321 [SCDOI-MRF-CPT-63030-321] South Carolina UHC, Anthem & BCBS-SC Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 63030 / 22551 Spine & Neurosurgery Laminotomy)
South Carolina Department of Insurance (SCDOI) & CMS TiC Payer MRF Index
 $1,975,000 212.0% MPFS 2026-11-19 Open Dossier
OR ORDOI-MRF-CPT-45378-322 [ORDOI-MRF-CPT-45378-322] Oregon UHC, Anthem & BCBS-OR Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 45378 / 45380 GI Endoscopy & Colonoscopy ASC)
Oregon Division of Financial Regulation (DFR) & CMS TiC Payer MRF Index
 $2,160,000 220.5% MPFS 2026-11-20 Open Dossier
CT CTDOI-MRF-CPT-99285-323 [CTDOI-MRF-CPT-99285-323] Connecticut UHC, Anthem & BCBS-CT Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 99285 / 00100 Emergency & Anesthesia NSA IDR)
Connecticut Insurance Department (CID) & CMS TiC Payer MRF Index
 $2,345,000 229.0% MPFS 2026-11-21 Open Dossier
UT UTDOI-MRF-CPT-93458-324 [UTDOI-MRF-CPT-93458-324] Utah UHC, Anthem & BCBS-UT Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 93458 / 93306 Cardiology Left Heart Catheterization)
Utah Insurance Department (UID) & CMS TiC Payer MRF Index
 $2,530,000 237.5% MPFS 2026-11-22 Open Dossier
NV NVDOI-MRF-CPT-29881-325 [NVDOI-MRF-CPT-29881-325] Nevada UHC, Anthem & BCBS-NV Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 29881 / 27447 Orthopedic & ASC Knee Arthroscopy)
Nevada Division of Insurance (NDOI) & CMS TiC Payer MRF Index
 $2,715,000 246.0% MPFS 2026-11-23 Open Dossier
AL ALDOI-MRF-CPT-63030-326 [ALDOI-MRF-CPT-63030-326] Alabama UHC, Anthem & BCBS-AL Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 63030 / 22551 Spine & Neurosurgery Laminotomy)
Alabama Department of Insurance (ALDOI) & CMS TiC Payer MRF Index
 $1,420,000 254.5% MPFS 2026-11-24 Open Dossier
LA LADOI-MRF-CPT-45378-327 [LADOI-MRF-CPT-45378-327] Louisiana UHC, Anthem & BCBS-LA Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 45378 / 45380 GI Endoscopy & Colonoscopy ASC)
Louisiana Department of Insurance (LDI) & CMS TiC Payer MRF Index
 $1,605,000 263.0% MPFS 2026-11-25 Open Dossier
KY KYDOI-MRF-CPT-99285-328 [KYDOI-MRF-CPT-99285-328] Kentucky UHC, Anthem & BCBS-KY Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 99285 / 00100 Emergency & Anesthesia NSA IDR)
Kentucky Department of Insurance (KDOI) & CMS TiC Payer MRF Index
 $1,790,000 195.0% MPFS 2026-11-26 Open Dossier
OK OKDOI-MRF-CPT-93458-329 [OKDOI-MRF-CPT-93458-329] Oklahoma UHC, Anthem & BCBS-OK Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 93458 / 93306 Cardiology Left Heart Catheterization)
Oklahoma Insurance Department (OID) & CMS TiC Payer MRF Index
 $1,975,000 203.5% MPFS 2026-11-27 Open Dossier
IA IADOI-MRF-CPT-29881-330 [IADOI-MRF-CPT-29881-330] Iowa UHC, Anthem & BCBS-IA Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 29881 / 27447 Orthopedic & ASC Knee Arthroscopy)
Iowa Insurance Division (IID) & CMS TiC Payer MRF Index
 $2,160,000 212.0% MPFS 2026-11-18 Open Dossier
KS KSDOI-MRF-CPT-63030-331 [KSDOI-MRF-CPT-63030-331] Kansas UHC, Anthem & BCBS-KS Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 63030 / 22551 Spine & Neurosurgery Laminotomy)
Kansas Insurance Department (KID) & CMS TiC Payer MRF Index
 $2,345,000 220.5% MPFS 2026-11-19 Open Dossier
AR ARDOI-MRF-CPT-45378-332 [ARDOI-MRF-CPT-45378-332] Arkansas UHC, Anthem & BCBS-AR Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 45378 / 45380 GI Endoscopy & Colonoscopy ASC)
Arkansas Insurance Department (AID) & CMS TiC Payer MRF Index
 $2,530,000 229.0% MPFS 2026-11-20 Open Dossier
MS MSDOI-MRF-CPT-99285-333 [MSDOI-MRF-CPT-99285-333] Mississippi UHC, Anthem & BCBS-MS Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 99285 / 00100 Emergency & Anesthesia NSA IDR)
Mississippi Insurance Department (MID) & CMS TiC Payer MRF Index
 $2,715,000 237.5% MPFS 2026-11-21 Open Dossier
NM NMDOI-MRF-CPT-93458-334 [NMDOI-MRF-CPT-93458-334] New Mexico UHC, Anthem & BCBS-NM Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 93458 / 93306 Cardiology Left Heart Catheterization)
New Mexico Office of Superintendent of Insurance (OSI) & CMS TiC Payer MRF Index
 $1,420,000 246.0% MPFS 2026-11-22 Open Dossier
NE NEDOI-MRF-CPT-29881-335 [NEDOI-MRF-CPT-29881-335] Nebraska UHC, Anthem & BCBS-NE Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 29881 / 27447 Orthopedic & ASC Knee Arthroscopy)
Nebraska Department of Insurance (NDOI) & CMS TiC Payer MRF Index
 $1,605,000 254.5% MPFS 2026-11-23 Open Dossier
ID IDDOI-MRF-CPT-63030-336 [IDDOI-MRF-CPT-63030-336] Idaho UHC, Anthem & BCBS-ID Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 63030 / 22551 Spine & Neurosurgery Laminotomy)
Idaho Department of Insurance (IDOI) & CMS TiC Payer MRF Index
 $1,790,000 263.0% MPFS 2026-11-24 Open Dossier
HI HIDOI-MRF-CPT-45378-337 [HIDOI-MRF-CPT-45378-337] Hawaii UHC, Anthem & BCBS-HI Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 45378 / 45380 GI Endoscopy & Colonoscopy ASC)
Hawaii Insurance Division (DCCA) & CMS TiC Payer MRF Index
 $1,975,000 195.0% MPFS 2026-11-25 Open Dossier
NH NHDOI-MRF-CPT-99285-338 [NHDOI-MRF-CPT-99285-338] New Hampshire UHC, Anthem & BCBS-NH Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 99285 / 00100 Emergency & Anesthesia NSA IDR)
New Hampshire Insurance Department (NHID) & CMS TiC Payer MRF Index
 $2,160,000 203.5% MPFS 2026-11-26 Open Dossier
ME MEDOI-MRF-CPT-93458-339 [MEDOI-MRF-CPT-93458-339] Maine UHC, Anthem & BCBS-ME Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 93458 / 93306 Cardiology Left Heart Catheterization)
Maine Bureau of Insurance (BOI) & CMS TiC Payer MRF Index
 $2,345,000 212.0% MPFS 2026-11-27 Open Dossier
RI RIDOI-MRF-CPT-29881-340 [RIDOI-MRF-CPT-29881-340] Rhode Island UHC, Anthem & BCBS-RI Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 29881 / 27447 Orthopedic & ASC Knee Arthroscopy)
Rhode Island Department of Business Regulation — Insurance & CMS TiC Payer MRF Index
 $2,530,000 220.5% MPFS 2026-11-18 Open Dossier
MT MTDOI-MRF-CPT-63030-341 [MTDOI-MRF-CPT-63030-341] Montana UHC, Anthem & BCBS-MT Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 63030 / 22551 Spine & Neurosurgery Laminotomy)
Montana Commissioner of Securities and Insurance (CSI) & CMS TiC Payer MRF Index
 $2,715,000 229.0% MPFS 2026-11-19 Open Dossier
DE DEDOI-MRF-CPT-45378-342 [DEDOI-MRF-CPT-45378-342] Delaware UHC, Anthem & BCBS-DE Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 45378 / 45380 GI Endoscopy & Colonoscopy ASC)
Delaware Department of Insurance (DDOI) & CMS TiC Payer MRF Index
 $1,420,000 237.5% MPFS 2026-11-20 Open Dossier
SD SDDOI-MRF-CPT-99285-343 [SDDOI-MRF-CPT-99285-343] South Dakota UHC, Anthem & BCBS-SD Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 99285 / 00100 Emergency & Anesthesia NSA IDR)
South Dakota Division of Insurance (SD DOI) & CMS TiC Payer MRF Index
 $1,605,000 246.0% MPFS 2026-11-21 Open Dossier
ND NDDOI-MRF-CPT-93458-344 [NDDOI-MRF-CPT-93458-344] North Dakota UHC, Anthem & BCBS-ND Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 93458 / 93306 Cardiology Left Heart Catheterization)
North Dakota Insurance Department (NDID) & CMS TiC Payer MRF Index
 $1,790,000 254.5% MPFS 2026-11-22 Open Dossier
AK AKDOI-MRF-CPT-29881-345 [AKDOI-MRF-CPT-29881-345] Alaska UHC, Anthem & BCBS-AK Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 29881 / 27447 Orthopedic & ASC Knee Arthroscopy)
Alaska Division of Insurance & CMS TiC Payer MRF Index
 $1,975,000 263.0% MPFS 2026-11-23 Open Dossier
VT VTDOI-MRF-CPT-63030-346 [VTDOI-MRF-CPT-63030-346] Vermont UHC, Anthem & BCBS-VT Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 63030 / 22551 Spine & Neurosurgery Laminotomy)
Vermont Department of Financial Regulation (DFR) & CMS TiC Payer MRF Index
 $2,160,000 195.0% MPFS 2026-11-24 Open Dossier
WV WVDOI-MRF-CPT-45378-347 [WVDOI-MRF-CPT-45378-347] West Virginia UHC, Anthem & BCBS-WV Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 45378 / 45380 GI Endoscopy & Colonoscopy ASC)
West Virginia Offices of the Insurance Commissioner (WVOIC) & CMS TiC Payer MRF Index
 $2,345,000 203.5% MPFS 2026-11-25 Open Dossier
WY WYDOI-MRF-CPT-99285-348 [WYDOI-MRF-CPT-99285-348] Wyoming UHC, Anthem & BCBS-WY Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 99285 / 00100 Emergency & Anesthesia NSA IDR)
Wyoming Department of Insurance (WDOI) & CMS TiC Payer MRF Index
 $2,530,000 212.0% MPFS 2026-11-26 Open Dossier
MD MDDOI-MRF-CPT-93458-349 [MDDOI-MRF-CPT-93458-349] Maryland UHC, Anthem & BCBS-MD Commercial MRF Rate Disparity & NSA IDR Benchmark (CPT 93458 / 93306 Cardiology Left Heart Catheterization)
Maryland Insurance Administration (MIA) & CMS TiC Payer MRF Index
 $2,715,000 220.5% MPFS 2026-11-27 Open Dossier