Aetna negotiated rates in New Mexico
How Aetna's New Mexico rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in New Mexico at a glance
What the data shows
Aetna ranks 3rd of 4 payers in New Mexico with a rate index of 94 (100 = the New Mexico market median), across 205 procedure codes.
Aetna has the highest median for only 2% of codes in New Mexico; UnitedHealthcare leads with an index of 132 in the files analyzed.
Aetna's New Mexico rates sit 7% above its own national level, the 13th highest of its 51 states.
Largest premium over the New Mexico market: CPT 88312 (Special stains group 1) at 186% of market; largest discount: CPT 99457 (Rpm tx mgmt 1st 20 min) at 52%.
How the four payers compare in New Mexico
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 132 | 1 | 78% | 471 | |
| Cigna | 112 | 2 | 20% | 464 | |
| Aetna | 94 | 3 | 2% | 406 | |
| Blue Cross Blue Shield | 74 | 4 | 0% | 562 |
Where Aetna pays most and least against the New Mexico market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 88312 Special stains group 1 | $126 | $68 | +86% | 37 |
| 88313 Special stains group 2 | $90 | $53 | +69% | 23 |
| 65820 Goniotomy | $1,295 | $957 | +35% | 15 |
| 73610 X-ray exam of ankle | $48 | $36 | +32% | 64 |
| 73562 X-ray exam of knee 3 | $53 | $41 | +30% | 63 |
| 65756 Corneal trnspl endothelial | $2,073 | $1,600 | +30% | 47 |
| 66991 Xcapsl ctrc rmvl insj 1+ | $1,198 | $928 | +29% | 51 |
| 73564 X-ray exam knee 4 or more | $60 | $47 | +28% | 62 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 99457 Rpm tx mgmt 1st 20 min | $28 | $55 | -48% | 51 |
| 99454 Rem mntr physiol param 16-30 | $46 | $78 | -41% | 52 |
| 51700 Irrigation of bladder | $43 | $69 | -38% | 16 |
| 99487 Cplx chrnc care 1st 60 min | $84 | $131 | -36% | 33 |
| 22558 Arthrd ant ntrbd min dsc lum | $1,511 | $2,282 | -34% | 20 |
| 92201 Opscpy extnd rta draw uni/bi | $21 | $30 | -32% | 38 |
| 96372 Ther/proph/diag inj sc/im | $16 | $24 | -32% | 67 |
| 92133 Cptrzd oph dx img pst sgm on | $34 | $50 | -32% | 53 |
Where Aetna pays above and below its national level
Highest states
| State | Index | Prov. | |
|---|---|---|---|
| Alaska | 306 | 211 | |
| Idaho | 152 | 491 | |
| Washington | 142 | 708 | |
| Mississippi | 138 | 608 | |
| Montana | 136 | 80 |
Lowest states
| State | Index | Prov. | |
|---|---|---|---|
| Indiana | 80 | 698 | |
| South Dakota | 82 | 147 | |
| Florida | 82 | 758 | |
| Minnesota | 84 | 774 | |
| North Dakota | 85 | 211 |
Frequently asked questions
Does Aetna pay more or less than the other payers in New Mexico?
Aetna ranks 3rd of 4 in New Mexico with an index of 94. It is highest on 2% of codes.
Are Aetna's New Mexico rates above or below its national level?
About 7% above.
Which procedure does Aetna pay most above market in New Mexico?
CPT 88312 (Special stains group 1), at 186% of the New Mexico median.
Methodology
- Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
- Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
- Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
- Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
- Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
- Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.
Is your Aetna contract at market in New Mexico?
Compare your negotiated rates for these codes with New Mexico medians for each payer.