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Sugar Separation Test By Chromatography

Tennessee 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 $58 · 10th–90th $22$1380%10%10th90th$58Professionalmedian $30 · 10th–90th $15$390%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
$29.51
Median
$60.26
Typical High
$138.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$37.15
BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$7.94
Typical High
$38.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$17.38
Median
$69.18
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$21.88
Typical High
$53.70
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$35.48
Typical High
$38.90
United
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$16.22
Typical High
$27.54