Anesthesia reimbursement rates by service line
Compare national anesthesia reimbursement benchmarks calculated from price transparency data. Reference benchmarks cover commercial anesthesia conversion factor across Aetna, Anthem, Cigna and United. Reporting periods: Jun–Jul 2026.
Rate ExplorerCommercial professional conversion factors
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 median 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 | 80,856 | $79.87 | $80.08 | |||
| Cigna | Jun–Jul 2026 | 72,435 | $85.82 | $91.81 | |||
| United | Jun–Jul 2026 | 64,475 | $76 | $81.29 | |||
| Anthem | Jun–Jul 2026 | 79,978 | $80 | $87.50 |
- Source
- Negotiated or fee-schedule amounts 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.
Confirm coverage for your codes, payers and markets.
How do specific anesthesia providers compare?
Compare named provider unit rates with the selected payer's median and percentile distribution.
National: Anesthesia provider conversion-factor rates by payer
| Provider entity | State | Size | $ per anesthesia unit | Gap to median | Position in Aetna range |
|---|---|---|---|---|---|
| ARS TREATMENT CENTERS PCNPI 1003013152 · Tax ID 825452716 | PA | 357 | $15 | -$64.87 | Below P25 |
| HELMI, LTD., A PROFESSIONAL LLCNPI 1811329295 · Tax ID 461202623 | NV | 11 | $19 | -$60.87 | Below P25 |
| J. FELDMANNPI 1306845169 | IL | - | $22.50 | -$57.37 | Below P25 |
| UNIVERSITY PHYSICIANS, PLLCNPI 1003836818 · Tax ID 208512947 | CT | 2,945 | $52 | -$27.87 | Below P25 |
| ELYRIA ANESTHESIA INCORPORATEDNPI 1710922463 · Tax ID 341086687 | OH | 49 | $71 | -$8.87 | P25 to median |
| RWJ BARNABAS HEALTH INCNPI 1972638229 · Tax ID 223452311 | NJ | 4,729 | Above P75 |
Choose one state to replace the mixed-state examples with payer-specific provider rates for available 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 | Aetna | Cigna | United | Anthem |
|---|---|---|---|---|
Case rate · 4 codes | ||||
00731Anesthesia for upper gastrointestinal endoscopy | $392.59 | $460.31 | $103.19 | $532.58 |
00811Anesthesia for lower intestinal endoscopy | $329.58 | $368.50 | $103.19 | $459.39 |
00812Anesthesia for screening colonoscopy | $329.87 | $368.69 | $103.19 | $458.26 |
00813Anesthesia for combined upper and lower GI endoscopy | $377.54 | $460.31 | $103.19 | $542.58 |
Delivery-specific case rate · 2 codes | ||||
01961Anesthesia for cesarean delivery only | $604.59 | $914.70 | $80.30 | $988.84 |
01967Neuraxial labor analgesia for vaginal delivery | $504.48 | $944.55 | $80.30 | $929.49 |
Per service · 1 code | ||||
64447Continuous femoral nerve block injection | $202.46 | $170.06 | $217.13 | $167.94 |
Per day · 1 code | ||||
01996Daily management of continuous epidural or subarachnoid drug administration | $291.74 | $278 | $243.71 | $304.35 |
Per service or reported amount · 5 codes | ||||
01999Unlisted anesthesia procedure | $84.70 | $562.08 | $80.30 | $127,014.94 |
64999Unlisted nervous-system procedure | $1,157.83 | $2,513.32 | Not available | $3.80 |
99100Anesthesia qualifying circumstance for extreme age | $143.48 | $90.87 | $58.75 | $62 |
99199Unlisted special service, procedure, or report | $4,069.94 | $1,456.77 | $43.94 | $2.07 |
99214Established patient office visit, moderate complexity | $137.63 | $173.47 | $198.47 | $166.43 |
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Book a 20-min scoping call No trial or data preparation required.How to read these anesthesia rates
Benchmarks calculated by PayerPrice from health plan price transparency files. CMS price transparency requirements.
- Published rates, not paymentsThese figures summarize negotiated rates reported by health plans. They are not claim payments, patient prices or a provider's verified contract.
- Average vs. medianThe average combines eligible billing-entity rates; the median is the middle rate. A large gap between them can signal that high or low rates are pulling the average.
- What a provider row meansA billing entity may be a clinician, practice, facility or health system. A named row does not always represent one individual provider.
- Compare like for likeMatch the code, billing component, setting, payment unit, network and reporting period. Facility, drug and other service payments may be separate.
Calculation details and specialty-specific notes
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 source
- Each value is a negotiated professional anesthesia rate published in a payer machine-readable file, not a paid claim, billed charge, or facility payment.
- Rate calculation
- Conversion-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. The calculation targets the lowest and highest 2% of entity rates for removal, rounded down to whole entities. Tied boundary values stay together, so fewer rates may be removed. A payer, code and geography cohort is published only when at least 10 billing entities remain after trimming. A missing benchmark does not mean the rate is zero.
- Provider entity
- Named examples use payer-file NPI and TIN records and may represent an individual clinician, anesthesia group, health system, or another billing entity. Each NPI and TIN combination contributes one representative rate: its most frequent normalized value. When multiple values are equally frequent, those values are averaged.
- Comparable rates
- Match 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. Benchmarks keep the payer, service code, geography, reporting period and billing unit separate. Different services or payment units are not blended into one rate.
Compare Anesthesia rates in your market
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- Match the billing detailsWe align services, settings and payment units.
- Compare the ratesReview payer and provider rates for your selected market.
We'll explain what's available, flag gaps and help define the comparison.
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Explore anesthesia rates by state
Choose a state to compare payer reference averages for common services.
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.