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Utah rates for HCPCS 84375

Sugars, chromatographic, TLC or paper chromatography

Facilitymedian $14 · 10th–90th $2–$780%20%10th90th$14Professionalmedian $29 · 10th–90th $15–$410%20%10th90th$29$2.0$5.0$10.0$20.0$50.0$100.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $10.96 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $28.84 / $40.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $40.74 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $18.62 / $56.23
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $44.67 / $158.49
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $33.11 / $34.67
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $38.90 / $123.03
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $34.67 / $38.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $16.22 / $27.54