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Sugar Separation Test By Chromatography

Colorado 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 $105 · 10th–90th $30$1950%10%10th90th$105Professionalmedian $30 · 10th–90th $16$360%20%40%10th90th$30$2.0$10.0$50.0$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
$24.55
Median
$85.11
Typical High
$218.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$30.20
Typical High
$36.31
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$117.49
Typical High
$194.98
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$16.22
Typical High
$28.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$27.54
Typical High
$102.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$20.89
Typical High
$46.77
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$4.17
Median
$33.88
Typical High
$79.43
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$107.15
Typical High
$107.15
Select Health
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$72.44
Typical High
$81.28
Select Health
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$27.54
Typical High
$38.90
United
Setting
Facility
Modifier
Global
Typical Low
$17.38
Median
$38.90
Typical High
$58.88
United
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$16.22
Typical High
$28.84