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Sugar Separation Test By Chromatography

Kansas 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 $68 · 10th–90th $28$1050%10%10th90th$68Professionalmedian $34 · 10th–90th $26$560%20%10th90th$34$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
$33.88
Median
$61.66
Typical High
$91.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$33.88
Typical High
$38.90
BCBS
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$100.00
Typical High
$104.71
BCBS
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$56.23
Typical High
$56.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$38.02
Typical High
$89.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$32.36
Typical High
$70.79
Medica
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$67.61
Medica
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$16.60
Typical High
$40.74
United
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$38.90
Typical High
$46.77
United
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$16.98
Typical High
$41.69