Coverage, Fees & Service Areas

Smiling baby in yellow with a heart sticker on their cheek

Insurance

The following plans are likely covered with minimal cost sharing:

AETNA: PPO, POS, OAP, EPO
BLUE CROSS BLUE SHIELD: PPO, EPO, Excellus, Anthem, Federal Employee Plan
CIGNA: PPO, POS, OAP, EPO
UNITED HEALTH CARE & UMR

I am in network through Lactation Consultants of America. Being in network means a sizable portion of your care should be covered, though it may not be 100% coverage. Please contact your insurance to verify benefits prior to your visit if you're concerned about out-of-pocket costs. See the bottom of this page for a guide to help with your call.

Smiling mother holding her baby close, facing the camera

Self Pay

Consultations may be paid out-of-pocket at the time of service. After each visit, I will provide you with a superbill that you can submit to your insurance company for potential reimbursement.

Pricing (Home Visit/Virtual):
Initial Postpartum Visit ($200/$125)
Initial Postpartum - Twins/Multiples ($250/$175)
Follow-up Visit ($175/$125)
Prenatal & Induced Lactation Planning ($150/$125)

*I DO accept HSA and FSA payments*

New York State WIC logo indicating that active WIC participants may qualify for discounted lactation consults

WIC Discount

If you are an active WIC participant, you may be eligible to receive a 40% discount on your consult. Please reach out to inquire.

Pricing at 40% Off (Home Visit/Virtual):
Initial Postpartum Visit ($120/$75)
Initial Postpartum - Multiples ($150/$105)
Follow Visit ($105/$75)
Prenatal Planning ($90/$75)

Check Your Insurance coverage by completing this form

 

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Home visits in Ontario, Seneca, Yates and Wayne counties. 

Syracuse area consults available on a limited basis.

Telehealth anywhere in the world!

Book An Appointment

Places frequently served: Geneva, Canandaigua, Newark, Phelps, Clifton Springs, Waterloo, Seneca Falls, Victor, 
Farmington, Bloomfield, Hopewell, Stanley, Shortsville, Gorham, and Rushville

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Travel Fees

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I offer home visits within a 45 minute radius from Seneca Castle, NY (using Google Maps to calculate).

Visits are available on a limited basis in Syracuse, NY and nearby suburbs. (Please contact me directly to book for this region.)

Here is a breakdown of my travel fees:
*No fee up to 35 minutes from Seneca Castle
*$35 for 35-45 minutes away or Syracuse area visits

Travel fees are not reimbursable through insurance.

 

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Tips for Verifying Insurance Coverage

According to the Affordable Care Act, you are entitled to lactation care.
That being said, insurance companies don't always have your best interests in mind and I cannot guarantee coverage from your insurance provider.

The best way to avoid surprise bills is to check your insurance benefits at least 48 hours ahead of your appointment. To check your coverage, call the number on the back of your insurance card and ask this question:

“Do I have in-network coverage for lactation services under CPT code S9443 (lactation class) with diagnosis Z39.1,
billed as professional services (not facility)?”

Ask for a call reference number - this helps hold the plan accountable. If you're unsure or the patient representative is confused, you can reach out for help to me at ellen@nourishingpathwayslactation.com or contact Patient Relations at patient.relations@lcsofamerica.com. Please expect 2-3 business days for a lactation coverage check.