Next, for a time, it determined that paying for the services of both an extender and an anesthesiologist was worth at most 140 percent of the rate it would pay to the doctor alone—“split 50-50 between the two parties”; the percentage was ratcheted down in the following years. (Many bills still include full freight charges for both the anesthesiologist and the extender because doctors know that commercial insurers aren’t as vigilant or as parsimonious as Medicare.)
