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Sugar Separation Test By Chromatography

South 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 $49 · 10th–90th $26$1260%5%10%10th90th$49Professionalmedian $30 · 10th–90th $9$400%50%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$30.20
Median
$67.61
Typical High
$125.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$33.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$13.49
Median
$39.81
Typical High
$67.61
BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$8.32
Typical High
$47.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$128.82
Typical High
$223.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$17.78
Typical High
$46.77
Medcost
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$33.11
Typical High
$52.48
United
Setting
Facility
Modifier
Global
Typical Low
$19.50
Median
$38.90
Typical High
$46.77
United
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$18.62
Typical High
$35.48