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Stoma Cap

Illinois rates for HCPCS A5055

Stoma cap

Rates data updated October 2026.

How much does Stoma Cap cost?

$1.29

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $1.29 for this service. The price depends on where it is billed: about $1.23 from a physician practice, and about $4.47 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1.23$1.00 to $1.55
FacilityA hospital or hospital-owned outpatient department$4.47$2.09 to $9.77

How much rates vary

Facilitymedian $4 · 10th to 90th $1 to $17Professionalmedian $1 · 10th to 90th $1 to $2
$1$2$5$10$20facility $4professional $1

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$0.93
Median
$1.12
Typical High
$2.04
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.93
Median
$1.12
Typical High
$1.62
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.14
Median
$0.17
Typical High
$0.25
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.09
Median
$0.11
Typical High
$0.16
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$3.31
Median
$5.37
Typical High
$17.78
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$0.93
Median
$1.55
Typical High
$1.55
Cigna
Setting
Facility
Modifier
None
Typical Low
$1.20
Median
$1.20
Typical High
$1.29
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.02
Median
$1.02
Typical High
$1.38
Hally Health
Setting
Professional
Modifier
None
Typical Low
$1.70
Median
$2.51
Typical High
$4.90
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$2.63
Median
$2.63
Typical High
$2.63
Molina
Setting
Professional
Modifier
None
Typical Low
$1.70
Median
$1.70
Typical High
$1.70
United
Setting
Professional
Modifier
None
Typical Low
$0.78
Median
$1.00
Typical High
$2.34

Where Illinois sits

The same service costs 2.1 times more in Kansas than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 26th of 51

$1.29

KS $2.14KY $1.00

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.