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Xylose Absorption Test

Wisconsin 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 $28 · 10th–90th $10$760%10%10th90th$28Professionalmedian $15 · 10th–90th $6$490%10%20%10th90th$15$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
$15.49
Median
$35.48
Typical High
$35.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$15.49
Typical High
$46.77
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$34.67
Typical High
$35.48
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$51.29
CareSource
Setting
Facility
Modifier
Global
Typical Low
$8.71
Median
$8.71
Typical High
$8.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$38.02
Typical High
$60.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$14.79
Median
$19.50
Typical High
$40.74
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$10.47
Median
$25.70
Typical High
$95.50
Medica
Setting
Facility
Modifier
Global
Typical Low
$10.23
Median
$11.75
Typical High
$100.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$7.24
Median
$9.77
Typical High
$26.92
Molina
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$32.36
Typical High
$64.57
Network Health
Setting
Facility
Modifier
Global
Typical Low
$15.49
Median
$15.49
Typical High
$33.88
Network Health
Setting
Professional
Modifier
Global
Typical Low
$9.77
Median
$21.38
Typical High
$36.31
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$10.23
Median
$10.47
Typical High
$16.60
Quartz
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$33.11
Typical High
$48.98
Quartz
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$100.00
Quartz
Setting
Professional
Modifier
Global
Typical Low
$6.17
Median
$7.76
Typical High
$32.36
Security Health
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$27.54
Security Health
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$70.79
United
Setting
Facility
Modifier
Global
Typical Low
$6.46
Median
$10.47
Typical High
$28.84
United
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$10.00
Typical High
$29.51