UnitedHealthcare negotiated rates in New Mexico
How UnitedHealthcare's New Mexico rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
UnitedHealthcare in New Mexico at a glance
What the data shows
UnitedHealthcare ranks 1st of 4 payers in New Mexico with a rate index of 132 (100 = the New Mexico market median), across 228 procedure codes.
UnitedHealthcare has the highest median for 78% of codes in New Mexico.
UnitedHealthcare's New Mexico rates sit 9% above its own national level, the 20th highest of its 51 states.
Largest premium over the New Mexico market: CPT 52224 (Cystoscopy and treatment) at 369% of market; largest discount: CPT 88305 (Tissue exam by pathologist) at 65%.
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 UnitedHealthcare pays most and least against the New Mexico market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 52224 Cystoscopy and treatment | $1,370 | $371 | +269% | 27 |
| 52332 Cystoscopy and treatment | $816 | $276 | +196% | 27 |
| 43255 Egd control bleeding any | $1,099 | $377 | +192% | 45 |
| 43239 Egd biopsy single/multiple | $748 | $271 | +176% | 45 |
| 11102 Tangntl bx skin single les | $160 | $60 | +167% | 27 |
| 52648 Laser surgery of prostate | $3,365 | $1,259 | +167% | 27 |
| 11104 Punch bx skin single lesion | $201 | $76 | +163% | 27 |
| 64566 Neuroeltrd stim post tibial | $178 | $68 | +162% | 27 |
Furthest below market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 88305 Tissue exam by pathologist | $43 | $66 | -35% | 72 |
| 88313 Special stains group 2 | $46 | $53 | -13% | 45 |
| 88342 Imhchem/imcytchm 1st antb | $64 | $72 | -11% | 27 |
| 73030 X-ray exam of shoulder | $34 | $36 | -6% | 86 |
| 72100 X-ray exam l-s spine 2/3 vws | $39 | $41 | -6% | 86 |
| 73564 X-ray exam knee 4 or more | $44 | $47 | -6% | 86 |
| 88312 Special stains group 1 | $64 | $68 | -5% | 72 |
| 73560 X-ray exam of knee 1 or 2 | $34 | $35 | -3% | 86 |
Where UnitedHealthcare pays above and below its national level
Frequently asked questions
Does UnitedHealthcare pay more or less than the other payers in New Mexico?
UnitedHealthcare ranks 1st of 4 in New Mexico with an index of 132. It is highest on 78% of codes.
Are UnitedHealthcare's New Mexico rates above or below its national level?
About 9% above.
Which procedure does UnitedHealthcare pay most above market in New Mexico?
CPT 52224 (Cystoscopy and treatment), at 369% 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 UnitedHealthcare contract at market in New Mexico?
Compare your negotiated rates for these codes with New Mexico medians for each payer.