Paying for your care

Aetna Commercial Plans

 

Star Lactation is a contracted provider with Aetna (except medicaid plans).  Most, but not all, Aetna plans provide some coverage for lactation care. It is always prudent to call Aetna to ensure Star Lactation is in network with your plan, and that your plan covers lactation services.  Some HMO Aetna plans require OB/PCP referral. Provider details: Havener Ventures DBA Star Lactation, NPI # 1710510045, EIN # 842943443.

 

Aetna commonly requires "cost sharing" for lactation visits. Cost sharing includes copays, coinsurance, and amounts applied to deductibles.  Historically, cost shares have averaged $50-$70 a visit; usually, cost shares start at your fourth visit, but we can not guarantee this. We do our best with coding to reduce cost shares, but only book a visit if you are comfortable with cost sharing.​ NOTE: If you were told by Aetna that you have 6 free visits, please note this is not accurate.  Aetna covers 6 uses of the billing code S9443 in a 12 month period.  In order for us to be paid appropriately for our expertise and long visit times, when billing for your visits, we use S9443 for parent and baby per visit, in addition to a counseling code. This means the S9443 code will be used up after your 3rd visit.  If you did prenatal visits through Aeroflow or another company, you will have less of these codes available, and will likely have more cost sharing. 

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Anthem BCBS Commercial Plans

 

Star Lactation is in network with Anthem BCBS plans (except medicaid plans).  Anthem plans nearly always require "cost sharing" for lactation visits. Cost sharing includes copays, coinsurance, and amounts applied to deductibles.  If your deductible has not been met, Anthem may apply all or a portion of your lactation visit to deductible.  We do our best with coding to reduce cost shares, but only book a visit if you are able to pay any cost shares.​ NOTE: If you were told by an Anthem rep that you have unlimited coverage for lactation visits, please note this is not accurate.  They are referring to use of the lactation class code S9443, which reimburses approximately $15.  In order for us to be paid appropriately for our expertise and long visit times, when billing for your visits, we bill for both mother and baby (assuming baby is at visit) and we bill S9443 in addition to a counseling or time code. If you have any questions about coverage, we suggest you reach out to Anthem to inquire about coverage and remaining deductibles. Provider details: Havener Ventures DBA Star Lactation, NPI # 1710510045, EIN # 842943443. 

 

Cigna - check coverage here

 

Star Lactation is an independent contractor with Wildflower, an insurance billing company that works exclusively with Cigna to provide lactation coverage for its members. If your plan works with Wildflower, you can receive at least 6 covered visits at no cost to you (no cost sharing). Wildflower will bill Cigna directly for any services that Star Lactation provides. After your visit(s), Cigna will send you an Explanation of Benefits (EOB).  Note that if at the time of your visit, your insurance policy has lapsed and Wildflower does not cover the visit, you will be responsible for Star Lactation's cash rate.

 

Sentara Commercial Plans

 

Star Lactation is in network with Sentara.  Sentara does not typically assess any cost sharing.  We always suggest that you reach out to Sentara to inquire about visits, coverage and any cost sharing. Provider details: Havener Ventures DBA Star Lactation, NPI # 1710510045, EIN # 842943443.  

 

Tri-Care East

 

Star Lactation is a Tricare East Certified Provider.  Tricare typically covers 6 lactation visits for mothers with no cost sharing. Tricare does not cover care for the infant.  Since we do care for both mother and baby at visits, we do require Tricare families to pay a $50 per visit fee for baby's portion of the visit.  An invoice will be sent upon booking, to be paid prior to visit. Note: if baby is not present at visit, no infant charge will be required.

 

United Health Care Commercial Plans

 

Star Lactation participates with United Healthcare. We have found that most, but not all, UHC plans cover lactation care. Gate HMO and Freedom Plans are not typically covered. It is always prudent to call UHC to ensure Star Lactation is in network with your plan, and that your plan covers lactation services. ( Provider details: Havener Ventures DBA Star Lactation, NPI # 1710510045, EIN # 842943443.) Historically, UHC pays visits without requiring any cost sharing (copays, coinsurance, deductibles), however we cannot guarantee this.  Should you have a visit and your plan is not covered, you will be responsible for the cash pay rate and will be invoiced accordingly. IMPORTANT NOTE: Beginning September 1, 2026, UHC has stated that it will no longer cover lactation care for your infant. Since we do care for both mother and baby at visits, as of 9/1/26, we will require UHC families to pay a $50 per visit fee for baby's portion of the visit. 

 

Self Pay

 

If your insurance plan is not listed above, you can pay for your visit via cash, credit card or HSA card.  If paying by card, your payment is due prior to visit. If you would prefer to pay cash at visit, please let us know.  We can provide a  superbill after your visit that you can submit to your insurance company for possible reimbursement.  Self pay fees are below:

• 60 minute initial consultations (one baby) are $150.   

• 45 minute follow ups (one baby) are $100. 

• 45 minute prenatal consultations are $100.  

• 45 minute online consultations are $80. 

• 30 minute flange fittings are $60 (two Medela, Spectra/Ameda flanges included with price)​

• MEDICAID visits are $40. Must be booked with Emily Morris.