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Sugar Separation Test By Chromatography

Indiana 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 $39$1170%20%40%90th$39Professionalmedian $32 · 10th–90th $10$350%20%40%10th90th$32$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
$31.62
Median
$43.65
Typical High
$117.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$31.62
Typical High
$35.48
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$117.49
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.47
Median
$15.49
Typical High
$28.84
CareSource
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$38.90
Typical High
$74.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$35.48
Typical High
$56.23
United
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$38.90
Typical High
$44.67
United
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$16.98
Typical High
$42.66