Most aluminum caps have sharp square corners front and back, and don't really "fit" the shape of the vehicle very well. A cab height fiberglass cap which matches the truck's bodywork can actually improve MPG highway. If you have to have a ladder rack, I would either try to get a low profile aerodynamically shaped ladder rack, or get an easily removable one.
An extra height fiberglass cap probably won't be that different than a cab height aluminum one. One has worse CD, the other has more frontal area. Adding a ladder rack to that won't help either.
So basically, aeroshell is best. If you could at all utilize a cab height shell, I would try to make that work. If you don't need the extra capacity every day, but only on occasion, you might even consider getting a small trailer.
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