Cocoon Self-pay Fee Sheet
As of December 9th, 2021
We strive to be up-front about the costs of our services so you can plan. Our professional services can be reimbursable according to the terms of your individual insurance coverage for out of network providers. We recommend contacting your insurance carrier to see what their out of network reimbursement rules are. If your insurance carrier reimburses you then your total out of pocket costs will be significantly less. This means you are likely to be reimbursed for a fair amount of what you will have paid us, and your out of pocket cost should be significantly less than our total fees. The exact numbers change as often as insurance companies decide to change their rules. When you call your carrier, make the nice person on the phone stop and explain any terms or rules you do not understand.
The itemized professional service fees here are used to calculate your cost in case of transfer in or out of our care part way through pregnancy. If you were to transfer out of our care your fees will be calculated according to the itemized cost of care listed below. Any difference in what was already paid would be refunded to you and if the total itemized cost of care exceeded what you had already paid, no additional monies will be owed.
Pregnancy and Birth Bundle: $5,700
Includes prenatal visits, phone calls, birth, newborn, and postpartum visits as outlined below.
Meet & Greet Consultation: Complementary
We have a casual chat over a cup of tea while we cover all the things you have on your mind as you consider your birth options. You will share enough health information with us to help us know you are a good candidate for community birth, and we will show you around and answer questions. Once we have come to mutual agreement to move forward at Cocoon you will be given access to our patient portal and we will schedule your first official visit, the Initial Pregnancy Intake. Bring anyone you want with you for this and all future visits, barring circumstances that might restrict this for health and safety reasons. Cocoon does not have handicapped access yet.
Initial Pregnancy Intake: $350
This is usually an hour and a half face-to-face visit. During the visit we will take and review health history, share extensive individualized question and answer time, discuss nutrition, help with intake paperwork, do a physical exam (if needed, and with your express permission), review any materials from prior providers, and order/collect labs and an ultrasound as appropriate. Prior to and after this visit we will review your records, perform administrative onboarding duties and plan for your personalized care. This fee is the same no matter when you start your care with Cocoon.
Return Prenatal Visit: $150 per visit
A full term pregnancy will have approximately 13 prenatal visits that each last 30-60 minutes. During these visits your vital signs are recorded; urine is checked for signs of common issues; we chat about whatever is on your mind and whatever else is relevant to the current stage of the pregnancy; listen to the baby’s heartbeat, and do a “belly check” to monitor growth.
Admission to BnB room in active labor or with water broken: $2,500
Labor support, monitoring, clinical decision making; attending the birth on site or transferring to a higher level of care if needed or desired, postpartum stabilization and recovery for births on site, stitches if needed. May include IV placement, administration of fluids or antibiotics. I will go with you in case of transfer (unless I have somebody else in labor) if you wish, to provide labor support and give in-person report to the receiving providers, assuming hospital policy permits this.
Admission to BnB room for reasons other than above: $150 per hour
This is only charged if later you end up transferring out for whatever reason.
Problem visits or early labor checks: $250
Phone calls, emails, patient portal chats: No charge. We like to keep in touch!
Postpartum Visits $250 each
We come visit you at your home 24-36 hours after the birth. Around day 3 after the birth we see you and baby in the office or via telehealth. We check on your physical and emotional recovery, screen for and address postpartum complications, help with breastfeeding, and assess your support systems and big sibling adjustment.
Anyone breastfeeding for the first time or needing any additional support has a two week office visit, and everyone has a six week office visit to check on your recovery, mood, breastfeeding, and discuss/start any family planning you are interested in. We can provide whatever family planning (except sterilizations) you want, with IUD’s and Nexplanon being billed separately from pregnancy care.
Newborn Care: $1000
Delivery and stabilization in the early hours after birth, plus a newborn home visit and an office/telehealth visit during your postpartum visits:
Includes newborn exam, weight, and measurements; breastfeeding help; routine newborn medications; birth certificate paperwork; tons of teaching and preparation for going home with baby; and we provide records for your baby’s healthcare provider all before you leave Cocoon. During the 1 & 3 day postpartum visits we provide ongoing breastfeeding support, newborn testing (metabolic and congenital heart defect), assess for jaundice, and finish up any remaining birth certificate paperwork (sometimes you need time to be sure about the name, after all). Sometimes the baby needs to be seen by their ongoing care provider on Day 1, in which case we’ll check in with you by phone and coordinate the routine screens with their office.
Cocoon does not endorse or facilitate newborn circumcision for either gender. Should you seek to circumcise your baby, inquire at your pediatric provider’s office or your synagogue during the pregnancy. Female circumcision is forbidden by law.
Birth and Breakfast Room Fee: $1,000
This partially offsets paying your nurses/birth assistant; stocking supplies, medications and equipment; time spent maintaining emergency backup arrangements and relationships; ongoing emergency drills and safety measures; housekeeping, laundry, and maintenance; rent, utilities, etc. You and your supporters will have use of the space including the kitchen and backyard, and the constant presence of midwifery and/or nursing TLC for active labor, birth, and until you and the baby are medically stable and ready to go home between 4 and 23 hours after the birth.
It’s likely you could pay for this fee from a healthcare savings or flex spending account, so study the rules governing your particular account to know how to best use this resource.
If somebody else arrives needing to have their baby during your recovery time, we’ll get creative and make sure everyone gets the care and space they need. If we get snowed-in together, we’ll “discharge” you from our care, then host you as our guests at no additional charge until the roads are safe to go home.
Lactation Services: Fees as listed below
Breastfeeding and lactation help included in the Cocoon Birth Fee for our clients up to 6 weeks. Services are available to everyone and Cocoon Birth Clients after 6 weeks: $150 the 1st visit (60-90 min) and $75 for repeat visits (45-60 min)
Blood draws, IV placement: $50
IV administration: $150 each, plus medication cost
Injections: $25 each, plus medication cost
Non-stress tests: $75 each
Office microscopy testing: $50 each
Office urine tests: $5 each
Lab test fees and ultrasounds
Invoiced by the facility conducting the actual testing. If you have insurance, these fees are paid according to the terms of your coverage.
Annual exam, New client: $300
Annual exam, Return client: $225
Primary care problem (for example: ear or sinus infection): $100-200 depending on complexity
Gyn problem, New client: $200
Gyn problem, Return client: $100-200 depending on complexity
IUD or Nexplanon placement and/or removal: $300 each, $450 to swap out an old unit for a new one
The device will be ordered and paid for separately through your insurance plan and varies from one plan to the next. They’re all different, so we’ll figure it out together in order to have your device on-hand for the visit.
Energy healing: $100
Wellness visits, counseling on health questions, preconception counseling without a physical exam: $200
“The Talk”: Suggested $100.00 donation to our teen birth control and single mom fund, but no charge if you’re a kid seeking this on your own (I might ask you to do me a favor though, like light housekeeping or yard work etc). “The Talk” is a confidential and individualized sex and safety chat for young people, regardless of their sexual experience. Parent attendance is optional and according to the young person’s preference. This is a sex positive get-together where we laugh a lot; answer all your weirdest and most embarrassing questions; share information on sexual health and infections, family planning, safer sexual practices, pleasure, coercion and consent, etc. We address recreational substance use as well, because this can impact sexual safety and judgement. People have a wide range of gender and sexual self-expression, so any young person is welcome to come for “The Talk”, regardless of what sort of genitals they have. We strive to cover the whole range, while admitting that we learn something new all the time.