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Stoma Cap

South Dakota rates for HCPCS A5055

Stoma cap

Rates data updated October 2026.

How much does Stoma Cap cost?

$1.66

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $1.66 for this service. The price depends on where it is billed: about $1.66 from a physician practice, and about $2.29 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1.66$1.32 to $2.19
FacilityA hospital or hospital-owned outpatient department$2.29$1.45 to $2.29

How much rates vary

Facilitymedian $2 · 10th to 90th $1 to $4Professionalmedian $2 · 10th to 90th $1 to $3
$1$2$5$10$20$50facility $2professional $2

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$1.45
Median
$1.45
Typical High
$1.45
Aetna
Setting
Professional
Modifier
None
Typical Low
$1.35
Median
$1.35
Typical High
$1.74
Cigna
Setting
Facility
Modifier
None
Typical Low
$1.20
Median
$1.20
Typical High
$2.24
Cigna
Setting
Professional
Modifier
None
Typical Low
$2.19
Median
$2.24
Typical High
$2.82
Medica
Setting
Facility
Modifier
None
Typical Low
$1.38
Median
$2.29
Typical High
$3.72
Medica
Setting
Professional
Modifier
None
Typical Low
$0.79
Median
$1.15
Typical High
$9.77
Midlands
Setting
Professional
Modifier
None
Typical Low
$2.19
Median
$2.19
Typical High
$2.24
Midlands
Setting
Professional
Modifier
None
Typical Low
$1.82
Median
$1.82
Typical High
$3.55
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$1.70
Median
$2.00
Typical High
$2.29
United
Setting
Professional
Modifier
None
Typical Low
$0.71
Median
$0.95
Typical High
$1.51
Wellmark
Setting
Professional
Modifier
None
Typical Low
$1.62
Median
$1.62
Typical High
$1.62

Where South Dakota 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.

South Dakota· 15th of 51

$1.66

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.