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Sugar Separation Test By Chromatography

Vermont 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 $151 · 10th–90th $14$3470%20%10th90th$151Professionalmedian $34 · 10th–90th $23$460%50%10th90th$34$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
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$33.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$346.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$44.67
Typical High
$56.23
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$38.90
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$6.31
Median
$6.31
Typical High
$6.31
United
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$13.80
United
Setting
Professional
Modifier
Global
Typical Low
$16.60
Median
$27.54
Typical High
$85.11