Under the No Surprises Act, disputes between payers and providers are settled through arbitration while the patient is held harmless for any surprise bill that occurs in an emergency or in-patient setting during which the patient could not have reasonably known the provider was out-of-network. Under the law, arbiters are required to weigh several non-monetary factors as well as one monetary benchmark: the median in-network contracted amount for the same or similar service in a local area.