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Sugar Separation Test By Chromatography

West Virginia 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 $98 · 10th–90th $32$980%50%10th$98Professionalmedian $31 · 10th–90th $17$330%20%40%10th90th$31$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
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$97.72
Typical High
$97.72
Aetna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$30.90
Typical High
$33.11
CareSource
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
CareSource
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
Cigna
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$57.54
Typical High
$117.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$56.23
Typical High
$186.21
United
Setting
Facility
Modifier
Global
Typical Low
$16.22
Median
$16.22
Typical High
$44.67
United
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$13.80
Typical High
$27.54