Secretary of Labor, through regulations. A final decision under subparagraph (B) may include the resolution of disputes for multiple items or services for a single patient, such as for instances in which multiple specialists are involved. (D) Factors In determining which final offer to select as the more reasonable amount under subparagraph (A), the independent dispute resolution entity shall consider relevant factors including— (i) the average in-network payment rate for comparable items or services in the same geographic region, including as calculated by an independent database or an all-payer claims database