Sydra is an AI-powered platform for the No Surprises Act (NSA) Independent Dispute Resolution (IDR) process. It automates eligibility screening, evidence packaging, offer preparation, submission, and deadline tracking so providers, contingency firms, and RCM companies recover fair out-of-network payments.

Healthcare providers and provider groups, contingency firms pursuing out-of-network disputes, and revenue cycle management (RCM) companies that add NSA IDR to their services.

Do you file disputes for us, or is it self-service?

Both. Sydra offers full-service filing (we file for you), self-service (your team files with the software), or staff training. You can switch models at any time.

How much does Sydra cost?

Sydra is a flat, predictable fee — less than half of what most contingency firms charge (which typically take 20% or more of every recovery, indefinitely) — or you can license the software and run it yourself.

Is Sydra HIPAA compliant?

Yes. Protected health information is handled under a Business Associate Agreement (BAA).

Which payer is hardest to win an IDR dispute against?

Among the four national carriers in the 2025 CMS Federal IDR data, Cigna has the lowest provider win rate at about 81%, followed by UnitedHealthcare (including UMR and Optum) at about 84%. Blue Cross Blue Shield is around 87% and Aetna is the highest at about 90.5%. Kaiser, at about 74.5%, is the lowest among the major payers shown.

What is the provider win rate against UnitedHealthcare in federal IDR?

Providers win roughly 84% of federal IDR determinations against UnitedHealthcare (including its UMR and Optum lines) in the 2025 CMS Federal IDR Public Use Files, across about 1.56 million decided line items — below the ~85.8% all-payer average.

What is the average provider win rate across all payers?

Across roughly 5.46 million decided line items in the 2025 CMS Federal IDR Public Use Files, providers prevailed in about 85.8% of determinations across all payers.

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Data & benchmarks

Federal IDR win rates by payer

How often providers win out-of-network disputes under the No Surprises Act, broken down by insurance payer. Computed from the CMS Federal IDR Public Use Files for 2025 — payer-level outcomes consolidated into canonical payer families, weighted by decided line items.

~85.8%

provider win rate, all payers (2025)

Aetna

highest of the big four (~90.5%)

Cigna

lowest of the big four (~81.0%)

Provider win rate by payer

Payer	Win rate	Decided line items	Notes
Aetna	90.5%	~845,000	Highest of the four national carriers.
Centene / Ambetter	90.1%	~122,000	Marketplace-heavy; providers prevail often.
Oscar	90.3%	~13,000	Smaller volume, high provider win rate.
Blue Cross Blue Shield	87.0%	~1,840,000	Largest dispute volume in the data.
Anthem / Elevance	86.9%	~206,000	Blues licensee, tracked separately.
UnitedHealthcare (incl. UMR / Optum)	83.8%	~1,560,000	Second-largest volume; below the average.
Cigna	81.0%	~640,000	Lowest of the big four — the toughest.
Kaiser	74.5%	~45,000	Lowest among the major payers shown.

CMS Federal IDR Public Use Files, calendar year 2025; win rate = provider-prevailing line items ÷ decided line items, consolidated across payer name variants. Figures rounded. Individual practices vary widely — many self-filing groups win well below these averages.

What the payer data shows

Providers win the majority against every major payer. Even the toughest — Cigna at ~81% and Kaiser at ~74.5% — still lose most of their contested determinations.
The big four split into two tiers. Aetna (~90.5%) and Blue Cross Blue Shield (~87%) sit above the average; UnitedHealthcare (~84%) and Cigna (~81%) sit below it.
Volume is concentrated. Blue Cross Blue Shield and UnitedHealthcare together account for over 3.4 million of the ~5.46 million decided line items — so how you handle those two payers moves your recovery the most.

Know your own win rate by payer

These are national averages. Sydra shows you your win and default rates by payer and CPT from the same CMS data — and closes the gap for a flat fee.

Win rates by specialty →

Medically & clinically reviewed by Dr. John M. Abrahams, MD

Board-certified neurosurgeon and founder of Sydra · Last reviewed September 2026 · About the author

Sources

Figures reflect the published federal record across all disputes, not a prediction about any individual claim. This is general information, not legal or financial advice.