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Sugar Separation Test By Chromatography

North Dakota 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 $28 · 10th–90th $28$710%20%40%90th$28Professionalmedian $66 · 10th–90th $28$890%10%10th90th$66$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
$27.54
Median
$27.54
Typical High
$70.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$27.54
Typical High
$117.49
BCBS
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$77.62
Typical High
$89.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$57.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$46.77
Typical High
$186.21
Medica
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$19.50
Typical High
$66.07
United
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
United
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$28.84
Typical High
$56.23