Blue Cross Blue Shield · New Mexico · commercial in-network
Blue Cross Blue Shield negotiated rates in New Mexico
How Blue Cross Blue Shield's New Mexico rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in New Mexico at a glance
Across 227 procedure codes for 8 specialties
Rate index vs state market
74
26% below the New Mexico median
Rank in state
4 of 4
UHC 132 · Cigna 112 · Aetna 94 · BCBS 74
vs own national
74
BCBS's level vs its national median
Codes where highest
0%
of 227 codes
What the data shows
Generated from New Mexico and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 4th of 4 payers in New Mexico with a rate index of 74 (100 = the New Mexico market median), across 227 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 0% of codes in New Mexico; UnitedHealthcare leads with an index of 132 in the files analyzed.
3
Blue Cross Blue Shield's New Mexico rates sit 26% below its own national level, the 47th highest of its 51 states.
4
Largest premium over the New Mexico market: CPT 92012 (Intrm oph exam est patient) at 102% of market; largest discount: CPT 91110 (Gi trc img intral esoph-ile) at 17%.
5
In New Mexico, BCBS rates come from 38 licensee file sets; the largest is BCBS NM (453 sampled providers).
How the four payers compare in New Mexico
Rate index: 100 = the state four-payer median for the same codes
| 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 Blue Cross Blue Shield pays most and least against the New Mexico market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 92012 Intrm oph exam est patient | $77 | $76 | +2% | 64 |
| 93298 Rem interrog dev eval scrms | $46 | $46 | +0% | 79 |
| 93297 Rem interrog dev eval icpms | $46 | $46 | +0% | 75 |
| 64566 Neuroeltrd stim post tibial | $68 | $68 | +0% | 31 |
| 52224 Cystoscopy and treatment | $371 | $371 | +0% | 30 |
| 99202 Office o/p new sf 15 min | $67 | $69 | -3% | 30 |
| 17000 Destruct premalg lesion | $65 | $67 | -3% | 30 |
| 14301 Tis trnfr any 30.1-60 sq cm | $1,043 | $1,081 | -4% | 29 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 91110 Gi trc img intral esoph-ile | $199 | $1,166 | -83% | 53 |
| 93925 Lower extremity study | $62 | $299 | -79% | 81 |
| 92242 Fluorescein&icg angiography | $63 | $291 | -78% | 64 |
| 93971 Extremity study | $39 | $160 | -76% | 108 |
| 93970 Extremity study | $59 | $237 | -75% | 189 |
| 78452 Ht muscle image spect mult | $138 | $533 | -74% | 166 |
| 88313 Special stains group 2 | $14 | $53 | -73% | 53 |
| 93880 Extracranial bilat study | $68 | $248 | -72% | 275 |
Where Blue Cross Blue Shield pays above and below its national level
Index vs the payer's own national median (100 = national)
Highest states
| State | Index | Prov. | |
|---|---|---|---|
| Alaska | 243 | 290 | |
| Wisconsin | 192 | 733 | |
| Minnesota | 171 | 671 | |
| North Dakota | 148 | 329 | |
| Wyoming | 145 | 256 |
Lowest states
| State | Index | Prov. | |
|---|---|---|---|
| Maryland | 63 | 758 | |
| Arizona | 66 | 479 | |
| Texas | 69 | 1,003 | |
| District of Columbia | 69 | 484 | |
| New Mexico | 74 | 562 |
Blue Cross Blue Shield licensees in New Mexico
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| BCBS NM | 453 |
| BCBS TX | 166 |
| Community Insurance Company | 74 |
| HealthKeepers, Inc. | 44 |
| Healthy Alliance Life Insurance Company | 30 |
| Matthew Thornton Health Plan, Inc. | 18 |
| Anthem (Elevance) | 14 |
| BCBS IL | 11 |
| Blue Shield of California Life & Health Insurance Company | 10 |
| BS CA | 10 |
| Premera | 8 |
| BCBS MI | 8 |
| BCBS NC | 7 |
| BCBS MN | 7 |
| Regence | 7 |
| BCBS MT | 6 |
| Wellmark | 5 |
| Horizon Healthcare of New Jersey | 5 |
| Compcare Health Services Insurance Corporation | 5 |
| BCBS NJ (Horizon) | 5 |
| BCBS AZ | 5 |
| BCBS OK | 4 |
| BCBS HI | 4 |
| BCBS KS | 4 |
| Capital BC | 4 |
| Capital BlueCross | 4 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 4 |
| Carefirst BCBS | 3 |
| BCBS MA | 3 |
| Blue Cross and Blue Shield of Nebraska | 3 |
| Blue Cross Blue Shield of North Dakota | 2 |
| Blue Cross Blue Shield of Wyoming | 2 |
| BCBS TN | 2 |
| BCBS MS | 1 |
| BCBS RI | 1 |
| Excellus BCBS | 1 |
| HMO Missouri, Inc. | 1 |
| BCBS Kansas City | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in New Mexico?
Blue Cross Blue Shield ranks 4th of 4 in New Mexico with an index of 74. It is highest on 0% of codes.
Are Blue Cross Blue Shield's New Mexico rates above or below its national level?
About 26% below.
Which procedure does Blue Cross Blue Shield pay most above market in New Mexico?
CPT 92012 (Intrm oph exam est patient), at 102% of the New Mexico median.
Methodology
How these numbers are calculated
- 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 Blue Cross Blue Shield contract at market in New Mexico?
Compare your negotiated rates for these codes with New Mexico medians for each payer.