The problem is that most payments coming from third-party payers, such as Aetna, Cigna, Humana, Anthem and United Healthcare (UHC), are based on rates negotiated in a contract with the individual anesthesia group. In other words, they are not uniform for all. Some groups may receive better reimbursement rates than others. But we now have a way of determining a broad anesthesia CF for commercial payers that is generally applicable per region; and it’s ascertained by way of a national survey.
Background of Survey
The Committee on Economics of the American Society of Anesthesiologists (ASA) has released the results of the 2025 commercial CF survey. Each spring, ASA members are solicited to submit the CFs from their group practice’s five largest commercial contracts. The CF and demographic data represent the national and regional results reported as being in effect during the 2024 calendar year.
The survey was circulated to all ASA members from April through July 2025. The results reflect 805 individual contracts reported by 172 practices. The survey requested that participants only report data from contracts that were in effect prior to January 31, 2025. In addition, all survey responses were anonymized upon receipt and aggregated before analysis or dissemination of the results. Results were aggregated nationally, as well as by Major and Minor Geographic Regions as identified by the Medical Group Management Association (MGMA). Reimbursement for the services of thousands of anesthesiologists, anesthetists and anesthesiologist assistants were represented in the survey, so it promises to provide an effective and relatively accurate reflection of reimbursement averages in commercial cases.
Survey Findings
Based on the 2025 survey results, the national average commercial CF was $82.43 and the national median was $76.00. In contrast, the 2024 national Medicare CF for anesthesia services was $20.77, or 25.2% of the contemporaneous mean commercial CF reported. So, the first thing of note is there is a significant variance between federal and commercial reimbursement rates, overall. The second thing to note is that less than half of the total case and unit volumes (44% and 43%, respectively) were attributed to commercial contracts.
About 73% of respondents indicated that they had at least one flat fee contract. The most common clinical service involved was labor & delivery (167 respondents), with endoscopy (27 respondents), cataracts (three respondents), and “other” (29 respondents) reported somewhat less frequently. Among the 1,032 commercial contracts for which data was provided, 75% provided payment for physical status modifiers, compared to 79% in the 2024 survey. Qualifying circumstance modifiers (e.g., patient age, emergency) were paid by 72% of the 1,064 contracts for which data were available. Thirty percent of the 164 practices that answered the question reported that they participated in some form of bundled payment arrangement.
The year-over-year increase in the reported mean (from $80.70 in 2024 to $82.43 in 2025, +2.1%) and median (from $74.59 in 2024 to $76.00 in 2025, +1.9%) national CF is reassuring after both figures fell by more than 5% in the 2024 survey. While there has been recent concern that insurers, enabled by the No Surprises Act (NSA), were using aggressive tactics to (a) drive down negotiated rates or (b) push anesthesia groups out of network, group practices have since demonstrated significant positive outcomes. This has been accomplished through “arbitrating out-of-network payments through the NSA’s independent dispute resolution (IDR) process, and these results may have now slowed or reversed the erosion of commercial CFs,” according to the survey’s authors.
For detailed information on the overall commercial CF in your state or region, as well as new Medicare Advantage rates, we encourage you to review the many charts provided in the survey. You can access the survey results by checking out the November 2025 edition of the ASA Monitor, Volume 89, Number 11 (asamonitor.org).