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Stoma Cap

Illinois rates for HCPCS A5055

Stoma cap

Rates data updated July 2026.

How much does Stoma Cap cost?

$1.35

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $1.35 for this service. The price depends on where it is billed: about $1.32 from a physician practice, and about $2.04 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1.32$1.12 to $1.70
FacilityA hospital or hospital-owned outpatient department$2.04$1.12 to $5.37

How much rates vary

Facilitymedian $2 · 10th to 90th $1 to $11Professionalmedian $1 · 10th to 90th $1 to $2
$1$2$5$10$20facility $2professional $1

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$2.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.93
Median
$1.17
Typical High
$2.04
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3.16
Median
$5.37
Typical High
$17.38
BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.93
Median
$1.55
Typical High
$1.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.20
Median
$1.20
Typical High
$2.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.02
Median
$1.02
Typical High
$2.24
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1.70
Median
$3.72
Typical High
$4.90
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$2.63
Median
$2.63
Typical High
$2.63
United
Setting
Facility
Modifier
Global
Typical Low
$0.68
Median
$2.04
Typical High
$2.04
United
Setting
Professional
Modifier
Global
Typical Low
$0.71
Median
$1.00
Typical High
$1.78

Where Illinois sits

The same service costs 2.1 times more in Kansas than in Colorado. 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· 27th of 51

$1.35

KS $2.14CO $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.