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Stoma Plug or Seal

Pennsylvania rates for HCPCS A5081

Stoma plug or seal, any type

Rates data updated July 2026.

How much does Stoma Plug or Seal cost?

$2.82

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $2.82 for this service. The price depends on where it is billed: about $2.82 from a physician practice, and about $6.03 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 9 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$2.82$2.24 to $3.16
FacilityA hospital or hospital-owned outpatient department$6.03$2.29 to $17.78

How much rates vary

Facilitymedian $6 · 10th to 90th $2 to $25Professionalmedian $3 · 10th to 90th $2 to $5
$10$100$1K$10Kfacility $6professional $3

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
$2.29
Median
$2.29
Typical High
$3.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.04
Median
$2.82
Typical High
$4.37
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$4.68
Typical High
$4.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$6.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.91
Median
$2.19
Typical High
$2.19
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$6.17
Typical High
$8.91
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$4.68
Median
$4.68
Typical High
$4.68
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$2.29
Median
$2.82
Typical High
$4.68
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.24
Median
$3.24
Typical High
$3.24
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$2.29
Typical High
$3.63
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$2.04
Median
$2.82
Typical High
$3.80
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$7.59
Median
$16.98
Typical High
$26.92
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$3.31
Median
$4.37
Typical High
$4.37
United
Setting
Facility
Modifier
Global
Typical Low
$1.55
Median
$2.09
Typical High
$2.95
United
Setting
Professional
Modifier
Global
Typical Low
$1.62
Median
$2.29
Typical High
$4.79

Where Pennsylvania sits

The same service costs 2.6 times more in Hawaii 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.

Pennsylvania· 28th of 51

$2.82

HI $5.50CO $2.09

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.