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Sugar Separation Test By Chromatography

Maryland 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 $16 · 10th–90th $13$600%10%20%10th90th$16Professionalmedian $30 · 10th–90th $17$480%20%10th90th$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$29.51
Typical High
$47.86
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$28.18
Typical High
$35.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$25.12
Typical High
$50.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$28.84
Typical High
$69.18
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$44.67
Typical High
$58.88
United
Setting
Facility
Modifier
Global
Typical Low
$14.45
Median
$16.22
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$2.95
Median
$17.38
Typical High
$27.54
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$26.92
Typical High
$58.88