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Sugar Separation Test By Chromatography

New Jersey 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 $63 · 10th–90th $35$2820%10%20%10th90th$63Professionalmedian $23 · 10th–90th $14$560%10%20%10th90th$23$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$38.02
Median
$51.29
Typical High
$234.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$14.45
Median
$23.44
Typical High
$56.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$85.11
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$23.44
Typical High
$58.88
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$19.50
Typical High
$27.54
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$10,471.29
Typical High
$23,988.33
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$23.44
Typical High
$34.67
United
Setting
Facility
Modifier
Global
Typical Low
$18.20
Median
$38.90
Typical High
$79.43
United
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$21.38
Typical High
$28.84