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Sugar Separation Test By Chromatography

Arkansas rates for HCPCS 84375

Separates the different sugars present in a sample so that each can be identified on its own, using a technique that spreads them out across a plate or paper according to how they travel. It is used when a person may not be digesting or handling particular sugars normally, including in the investigation of inherited disorders of sugar metabolism.

Rates data updated July 2026.

Facilitymedian $45 · 10th–90th $31$600%50%10th90th$45Professionalmedian $31 · 10th–90th $7$490%20%10th90th$31$2.0$5.0$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$48.98
Typical High
$48.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$7.24
Median
$30.90
Typical High
$48.98
BCBS
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$60.26
BCBS
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$58.88
Typical High
$58.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$18.20
Median
$33.11
Typical High
$72.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$24.55
Typical High
$56.23
United
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$35.48
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$16.60
Typical High
$37.15