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Stoma Cap

New Jersey rates for HCPCS A5055

Stoma cap

Rates data updated July 2026.

How much does Stoma Cap cost?

$1.17

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $1.17 for this service. The price depends on where it is billed: about $1.17 from a physician practice, and about $0.98 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$1.17$0.89 to $1.32
FacilityA hospital or hospital-owned outpatient department$0.98$0.98 to $1.20

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $2Professionalmedian $1 · 10th to 90th $1 to $2
$1$2$5facility $1professional $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
$0.98
Median
$0.98
Typical High
$0.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.59
Median
$0.98
Typical High
$1.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.20
Median
$1.20
Typical High
$1.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.02
Median
$1.02
Typical High
$1.20
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.95
Typical High
$2.63
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.32
Typical High
$1.32
United
Setting
Facility
Modifier
Global
Typical Low
$0.71
Median
$1.00
Typical High
$2.04
United
Setting
Professional
Modifier
Global
Typical Low
$0.78
Median
$1.12
Typical High
$2.00

Where New Jersey 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.

New Jersey· 44th of 51

$1.17

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.