go back

Sugar Separation Test By Chromatography

North Carolina 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 $35 · 10th–90th $25$1290%10%10th90th$35Professionalmedian $31 · 10th–90th $16$480%50%10th90th$31$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
$24.55
Median
$34.67
Typical High
$123.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$30.90
Typical High
$51.29
BCBS
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$69.18
Typical High
$89.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$17.78
Typical High
$25.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$20.89
Median
$75.86
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$18.20
Typical High
$52.48
Medcost
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$16.22
Typical High
$72.44
Medcost
Setting
Facility
Modifier
Global
Typical Low
$19.50
Median
$28.18
Typical High
$45.71
Medcost
Setting
Professional
Modifier
Global
Typical Low
$6.31
Median
$6.31
Typical High
$7.08
United
Setting
Facility
Modifier
Global
Typical Low
$14.45
Median
$32.36
Typical High
$45.71
United
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$16.22
Typical High
$38.90
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21