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Xylose Absorption Test

Missouri rates for HCPCS 84620

A test of how well the small intestine takes up nutrients. The patient drinks a measured dose of xylose, a simple sugar the body absorbs without having to digest it, and blood and/or urine is then checked to see how much got through. Low levels suggest the lining of the small bowel is not absorbing properly.

Rates data updated July 2026.

Facilitymedian $18 · 10th–90th $13$300%20%10th90th$18Professionalmedian $13 · 10th–90th $6$280%5%10%10th90th$13$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
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$21.88
Typical High
$28.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$12.59
Typical High
$28.18
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$45.71
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$10.23
Typical High
$32.36
BCBS
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$23.44
Typical High
$26.92
Cigna
Setting
Facility
Modifier
Global
Typical Low
$15.49
Median
$25.12
Typical High
$66.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.31
Median
$12.30
Typical High
$30.90
Medica
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$22.39
Typical High
$100.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$7.76
Typical High
$15.49
United
Setting
Facility
Modifier
Global
Typical Low
$6.76
Median
$12.88
Typical High
$15.49
United
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$8.71
Typical High
$16.60