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Sugar Separation Test By Chromatography

Nebraska 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 $72 · 10th–90th $24$1660%10%10th90th$72Professionalmedian $26 · 10th–90th $23$2570%20%10th90th$26$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
$40.74
Median
$102.33
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$257.04
BCBS
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$63.10
Typical High
$123.03
BCBS
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$60.26
Typical High
$64.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$75.86
Typical High
$93.33
Medica
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$38.90
Typical High
$186.21
Medica
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$23.44
Typical High
$42.66
Midlands
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$79.43
Midlands
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$23.99
United
Setting
Facility
Modifier
Global
Typical Low
$16.22
Median
$35.48
Typical High
$38.90
United
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$23.44
Typical High
$56.23