How to use this directory
Every row links to a full benchmark page with state, payer, and code-level tables from the CMS Federal IDR public use files. Pages enter this directory once they reach 5,000 CMS disputes, which keeps thin pages out of the index.
Every payer benchmark, ranked by disputes
| Payer | Disputes | Share of national | Provider win rate | Median award |
|---|---|---|---|---|
| UnitedHealthcare | 901,260 | 26.6% | 84.9% | 3.7x |
| Aetna | 519,113 | 15.3% | 92.1% | 4.9x |
| BCBSTX | 481,736 | 14.2% | 84.7% | 8.9x |
| Cigna / MultiPlan | 364,143 | 10.7% | 81.6% | 5.4x |
| Anthem Blue Cross | 275,286 | 8.1% | 87.6% | 4.1x |
| UMR (clearhs.com) | 162,071 | 4.8% | 84.5% | 4.0x |
| Cigna | 117,079 | 3.5% | 82.2% | 3.3x |
| UMR (clearhealthcloud.com) | 94,281 | 2.8% | 88% | 2.7x |
| Florida Blue | 75,581 | 2.2% | 92% | 3.2x |
| BCBSAZ | 60,136 | 1.8% | 80.4% | 18.3x |
| BLUE CROSS AND BLUE SHIELD OF TEXAS | 53,720 | 1.6% | 81.2% | 5.5x |
| BlueCross BlueShield of Tennessee | 35,999 | 1.1% | 79.4% | 3.2x |
| AMBETTER | 26,139 | 0.8% | 93.8% | 4.8x |
| BLUECROSS BLUESHIELD OF NEW MEXICO | 16,078 | 0.5% | 97.6% | 6.0x |
| Cigna / Zelis | 15,881 | 0.5% | 79.8% | 3.0x |
| Blue Cross Blue Shield of Oklahoma | 12,154 | 0.4% | 96% | 13.1x |
| BCBSLA | 11,890 | 0.4% | 51.2% | 12.9x |
| Horizon | 11,278 | 0.3% | 83.1% | 30.4x |
| BLUE SHIELD OF CA | 9,953 | 0.3% | 76% | 14.0x |
| Blue Cross Blue Shield North Carolina | 9,726 | 0.3% | 86.1% | 2.8x |
| Emblem Health | 8,868 | 0.3% | 87.7% | 28.6x |
| Res-Care, Inc. DBA BrightSpring Health Services | 7,971 | 0.2% | 57.7% | 4.5x |
| BLUECROSS BLUESHIELD KANSAS | 5,247 | 0.2% | 91.8% | 3.1x |
| OSCAR | 5,072 | 0.1% | 92.3% | 6.2x |
Benchmark your own claims
IDR Explorer can compare a provider group against payer, state, specialty, and service-code outcomes in the public IDR files. The fastest next step is a free NSA audit.
FAQ
How many payers have federal IDR benchmark pages?
24 payers currently qualify, each with at least 5,000 CMS disputes.
What does a page need to be listed here?
A floor of 500 CMS disputes for code, state, and specialty pages, and 5,000 for payer pages. Lower-sample pages stay live for users but carry noindex and stay out of the sitemap.
How current is the data?
The pages are rebuilt from CMS Federal IDR public use files and currently cover disputes through 2025Q4.
Related benchmarks
Sources and method
Providers won 85.8% of 3.39 million federal IDR disputes through 2025Q4, with a median provider-won award of 4.7x the qualifying payment amount, per CMS public use files.
- CMS: Federal IDR reports and public use files
- CMS: Federal IDR operations final rule fact sheet
- CMS: Federal IDR timeline for claims
Data source: CMS Federal IDR public use files, coverage through 2025Q4; data build 2026-09-24. Counts are CMS dispute counts unless a table says line items. Win rates on this page exclude payer no-show defaults unless labeled otherwise. Award multiples are medians versus the qualifying payment amount (QPA). Dollar figures, where shown, come from CMS QPA-and-offer fields or are anchored estimates, not payment records. This page is informational, not legal or reimbursement advice.