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Sugar Separation Test By Chromatography

New Mexico 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 $39 · 10th–90th $17$1260%10%10th90th$39Professionalmedian $30 · 10th–90th $16$2570%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
Facility
Modifier
Global
Typical Low
$58.88
Median
$117.49
Typical High
$125.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$46.77
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$34.67
Typical High
$48.98
Providence
Setting
Facility
Modifier
Global
Typical Low
$17.38
Median
$30.20
Typical High
$42.66
Providence
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$34.67
Typical High
$47.86
United
Setting
Facility
Modifier
Global
Typical Low
$14.45
Median
$35.48
Typical High
$58.88
United
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$12.02
Typical High
$26.92