Most CRNAs who leave a W-2 job start as solo 1099 contractors. It's the fastest way to earn more per hour. A group is the step after that, and it changes who gets paid for the anesthesia you provide.
The difference in one sentence
As a 1099 contractor, a facility or staffing company pays you a rate for your time. As a group, you bill the payers for the anesthesia itself, so the money for each case comes to your company first.
| Solo 1099 contractor | Your own CRNA group | |
|---|---|---|
| Who pays you | A facility, practice or staffing company, by the hour or day | Medicare, Medicaid and insurers, for each case |
| Your pay | A negotiated rate, often higher than W-2 | Whatever the cases collect, minus costs |
| Contracts | You sign the facility's terms | You negotiate with facilities, often for a stipend too |
| Billing | None. You send an invoice | Coding, claims, denials and payments, every month |
| Paperwork | A 1099 at year end | A company, payer enrollment, malpractice, payroll |
| Risk | Low. Lose a contract, find another | Higher. Slow months and staffing gaps are yours |
| Upside | Capped by your hours | Grows with cases and with every CRNA you add |
When staying solo makes sense
- You want flexibility more than the highest possible income.
- You work for several facilities, none big enough to need its own anesthesia group.
- You don't want to manage people, payroll or payer contracts.
When a group starts to make sense
- One or more facilities want dependable coverage every day, not just your shifts.
- There's enough case volume for two or more CRNAs.
- You're happy to run a small business, or to pay others to run the parts you don't want to.
From the default numbers in our calculator: 14 cases a day, 9 units a case, $50 a unit, 95% collected, three employed CRNAs. Your numbers will differ, and owners carry risks employees don't.
Taxes are different too
Both solo contractors and group owners pay self-employment tax (Social Security and Medicare) on business income, about 15.3% up to the Social Security wage base. Many group owners form a professional company and take a reasonable salary plus profit, which changes how that tax applies. This is where an accountant earns their fee.
What changes in the first year
The biggest shock for new owners is cash timing. Payer enrollment can take months, and claims take weeks to pay after that, so plan for a gap between your first case and your first payment.
Run your own numbers. The should I start my own CRNA group? calculator compares your W-2 pay with owning a group, and the startup cash calculator shows how much you need to cover the wait for your first payments.
General information, not legal, tax or financial advice. Talk to a healthcare attorney and an accountant before you form a company.
Sources
- IRS: Self-employment tax (Social Security and Medicare taxes)
- BLS Occupational Employment and Wage Statistics, Nurse Anesthetists, May 2025