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Sugar Separation Test By Chromatography

Washington, DC 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 $72 · 10th–90th $30$2400%20%10th90th$72Professionalmedian $30 · 10th–90th $30$790%50%90th$30$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
$29.51
Median
$138.04
Typical High
$239.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$29.51
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$100.00
Typical High
$218.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$66.07
Typical High
$147.91
Cigna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$44.67
Typical High
$302.00
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$79.43
United
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$46.77
Typical High
$75.86
United
Setting
Professional
Modifier
Global
Typical Low
$2.95
Median
$17.38
Typical High
$36.31