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Sugar Separation Test By Chromatography

Connecticut 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 $56 · 10th–90th $35$1100%10%20%10th90th$56Professionalmedian $18 · 10th–90th $15$420%50%10th90th$18$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
$38.90
Median
$56.23
Typical High
$109.65
Aetna
Setting
Professional
Modifier
Global
Typical Low
$14.45
Median
$17.78
Typical High
$41.69
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$61.66
Typical High
$104.71
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$23.44
Typical High
$42.66
Cigna
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$39.81
Typical High
$141.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$28.84
Typical High
$56.23
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$27.54
Typical High
$51.29
United
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$23.44
Typical High
$67.61