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Sugar Separation Test By Chromatography

Idaho 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 $59 · 10th–90th $39$1170%20%10th90th$59Professionalmedian $39 · 10th–90th $28$760%20%10th90th$39$2.0$5.0$10.0$20.0$50.0$100.0

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
$70.79
Median
$102.33
Typical High
$102.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$44.67
Typical High
$75.86
BCBS
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$75.86
Typical High
$138.04
BCBS
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$33.11
Typical High
$39.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$81.28
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$28.84
Typical High
$56.23
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$51.29
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$46.77
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$67.61
Typical High
$141.25
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$33.11
Typical High
$40.74
Select Health
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$74.13
Select Health
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$38.90
United
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$16.22
Typical High
$37.15