Now through into the first quarter and the roughly 400 hospitals that make up our own births statistics, this downward trajectory on price did not continue.
To give me one quick insight into how this rebound in trends impacted our results, our revenue for the quarter, excluding the CARES money we recorded, was over $30 million ahead of our internal expectations, which translated into meaningful year-over-year growth in adjusted EBITDA versus the expectation we shared with you in February that it could easily be down versus 2020.
Looking ahead to our full year 2021 expectations, we expect that our 2021 adjusted EBITDA will be at or above $220 million.
I said last quarter that we'll listen closely at our 2019 adjusted EBITDA of $265 million before the pandemic as the best available benchmark for how our business is recovering as well as backing out our estimate that the 2020 impact of the pandemic was roughly $40 million to $50 million.
If you look at the first quarter of 2021, our adjusted EBITDA of $45 million was still below the first quarter of 2019.
And when we reported -- and that's when we also reported $50 million in adjusted EBITDA.
And when you exclude the roughly $4 million in contribution from the CARES fund we recorded this quarter, we were roughly 18% below Q1 2019.
Now I've talked for a couple of quarters about my confidence that we can achieve a run rate of $270 million in adjusted EBITDA once we move past the impact of COVID-19 pandemic.
Since MEDNAX first began caring for mothers and babies in their most challenging times about 40 years ago, the only absolute imperative that our founder and Board member, Dr. Medel, prescribed has been take great care of the patient.
In two weeks, as we did even during the depth of the pandemic last year, we will be holding our Annual Medical Directors Meeting, where over 2,000 clinicians will actively participate and will learn from research, quality and clinical experts.
At the top line, our net revenue grew by $5.5 million or just over 1% year-over-year.
We recorded about $8 million in revenue from the provided relief fund established by the CARES Act during the quarter.
Overall, same unit revenue increased by 2.5% year-over-year, or 3.6% after excluding the additional calendar day in February 2020 for the 2020 leap year.
Same unit volumes declined 2.5% year-over-year or 1.4% adjusted for the leap year, compared to a 6.6% year-over-year decline in the 2020 fourth quarter.
Our first quarter same unit volume was down approximately 3% as compared to the same period in 2019, with hospital-based volume down to a greater degree than office-based volume.
On the pricing side, we had a couple of favorable items in addition to our usual rate growth, which has been typically in the 1% to 2% range based on managed care and administrative fee revenues.
First, the cares revenue we recorded added little under 2% to our pricing growth.
On the expense side, our practice level, salary, wage and benefit expense was up by $2.7 million or about 85 basis points year-over-year.
Our G&A expense was down nearly $1 million year-over-year, despite incurring approximately $5 million of costs related to transitional services we provided to the buyers of our anesthesia and radiology medical groups.
We ended the quarter with $270 million in cash and net debt of $730 million, implying leverage just north of three times.

Summary:
Overall, same unit revenue increased by 2.5% year-over-year, or 3.6% after excluding the additional calendar day in February 2020 for the 2020 leap year.
Same unit volumes declined 2.5% year-over-year or 1.4% adjusted for the leap year, compared to a 6.6% year-over-year decline in the 2020 fourth quarter.