Anesthesia reimbursement
by service line
Compare commercial anesthesia conversion factors and service-line payment structures across payers, provider entities, and states.
Compare national anesthesia conversion factors by payer
Start with professional anesthesia unit rates, then compare payer ranges and named billing entities in the state relevant to your question.
Aetna state variation in anesthesia unit rates
National anesthesia unit-rate distribution
Each marker shows the average eligible conversion-factor record published by that payer.
National conversion-factor rates by payer
| Payer | Rate period | Provider entities | P25 | Median | P75 | P90 | Average |
|---|---|---|---|---|---|---|---|
| Aetna | Jul 2026 | 85,756 | $83.19 | ||||
| Cigna | May 2026 | 72,681 | $91.95 | ||||
| United | May 2026 | 64,475 | $81.29 | ||||
| Anthem | May 2026 | 80,673 | $93.79 |
- Source
- Negotiated rates published directly by payers in their machine-readable files.
- Rate shown
- Published commercial conversion factor in dollars per anesthesia unit.
- Method
- Eligible professional rates are standardized for billing code, unit logic, and payer reporting so the comparison stays on the same basis.
Case rates, daily management amounts, and code-level fees remain separate in the service-line table.
How do specific anesthesia providers compare?
Compare named provider unit rates with the selected payer's median and percentile distribution.
Anesthesia provider unit rates by payer
| Provider entity | State | Size | $ per anesthesia unit | Gap to median | Position in Aetna range |
|---|
Named provider examples are available in a scoped anesthesia market comparison.
Choose one state to replace the mixed-state examples with payer-specific provider rates across all three preview codes.
No trial or data preparation required.How reimbursement changes across anesthesia services
Keep anesthesia case rates, obstetric services, regional blocks, daily pain management, qualifying circumstances, and adjacent professional services in their appropriate payment units.
| Service line / billing code | Nat'l avg | Aetna | Cigna | United | Anthem |
|---|---|---|---|---|---|
Case rate · 4 codes | |||||
00731Anesthesia for upper gastrointestinal endoscopy | $392.59 | ||||
00811Anesthesia for lower intestinal endoscopy | $329.58 | ||||
00812Anesthesia for screening colonoscopy | $329.87 | ||||
00813Anesthesia for combined upper and lower GI endoscopy | $377.54 | ||||
Delivery-specific case rate · 2 codes | |||||
01961Anesthesia for cesarean delivery only | $604.59 | ||||
01967Neuraxial labor analgesia for vaginal delivery | $504.48 | ||||
Per service · 1 code | |||||
64447Continuous femoral nerve block injection | $202.46 | ||||
Per day · 1 code | |||||
01996Daily management of continuous epidural or subarachnoid drug administration | $291.74 | ||||
Per service or reported amount · 5 codes | |||||
01999Unlisted anesthesia procedure | $84.70 | ||||
64999Unlisted nervous-system procedure | $1,150.79 | — | |||
99100Anesthesia qualifying circumstance for extreme age | $143.48 | ||||
99199Unlisted special service, procedure, or report | $4,069.94 | ||||
99214Established patient office visit, moderate complexity | $137.64 | ||||
Tell us the services, payers, states, and networks you need. We'll confirm available coverage and scope the comparison on a 20-minute call.
Book a 20-min scoping call No trial or data preparation required.How these anesthesia rates are calculated
Use this methodology to understand what each published conversion factor or service rate represents and which billing details must match before comparing anesthesia reimbursement.
- Rate sourceEach value is a negotiated professional anesthesia rate published in a payer machine-readable file, not a paid claim, billed charge, or facility payment.
- Rate calculationConversion-factor records are grouped by payer and geography. National and state summaries are not weighted by case volume, base units, time units, or patient acuity.
- Provider entityNamed examples use payer-file NPI and TIN records and may represent an individual clinician, anesthesia group, health system, or another billing entity.
- Comparable ratesMatch the payment structure, billing class, place of service, payer product, network, and modifiers such as AA, QK, QX, QY, and QZ. Conversion factors, case rates, daily amounts, and code-level fees are not interchangeable.
Get the anesthesia reimbursement data you're looking for
Choose the services, payers, states, networks, and provider entities relevant to your question. We'll confirm the available coverage and prepare the comparison.
- Tell us your marketShare the specialty, geography, payers, networks, and providers.
- We find comparable ratesPayerPrice aligns billing codes, services, settings, and units.
- Get your market viewSee relevant payer and provider rates organized around your question.
We'll tell you what the data can support, where the gaps are, and the clearest way to structure the comparison.
Trusted by teams that need defensible reimbursement data
How to interpret anesthesia rates
How to interpret the selected market and payer-published rates.
What is an anesthesia conversion factor?
An anesthesia conversion factor is the contracted dollar value applied to anesthesia units. The allowed amount is typically based on base units plus time units, then adjusted by the payer's rules and any applicable modifiers.
How can commercial anesthesia rates be compared across payers?
First separate conversion-factor arrangements from case rates, daily management amounts, fee schedules, and percentage-of-Medicare terms. Then align the billing codes, modifiers, place of service, provider entities, plans, networks, and contract periods.
Why can the same anesthesia billing code have different rates?
A published rate can vary by payer, plan, network, provider entity, place of service, modifier, payment structure, and contract period. The billing code alone does not establish an apples-to-apples comparison.
What does percentage of Medicare mean in an anesthesia contract?
Some anesthesia contracts price services as a percentage of the Medicare anesthesia methodology rather than a flat commercial conversion factor. The result depends on the applicable base units, time units, geographic adjustment, conversion factor, and contract terms.
Where do the rates on this page come from?
The rates come from negotiated prices published directly by payers in their machine-readable files. PayerPrice identifies eligible professional anesthesia records and organizes them into comparable unit, case, daily, or per-service views. They are not claims, utilization, or guaranteed reimbursement.
Can these published rates be used to benchmark an anesthesia contract?
Published rates can provide market evidence, but they are not a standalone valuation of a contract. A negotiation-ready benchmark should match the state, payer, plan or network, provider peer set, service lines, billing context, and payment methodology relevant to the contract.