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Sugar Separation Test By Chromatography

Georgia 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 $39 · 10th–90th $25$690%10%20%10th90th$39Professionalmedian $28 · 10th–90th $15$460%10%20%10th90th$28$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
$23.99
Median
$37.15
Typical High
$72.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$30.90
Typical High
$46.77
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$43.65
Typical High
$54.95
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$23.44
Typical High
$45.71
CareSource
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$23.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$63.10
Typical High
$117.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$19.50
Typical High
$58.88
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$54.95
Typical High
$74.13
United
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$35.48
Typical High
$44.67
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$16.98
Typical High
$58.88