Average Medicaid Pregnancy & Prenatal Care Payments in Durham, NC: $419.74
Avg. Paid
$419.74
Range
$87.41 – $1,078
Total Claims
1,932
Providers
13
Typical Payment Range
Typical Medicaid Pregnancy & Prenatal Care payments fall between $70.83 and $584.62 per claim (median: $133.32). The top 10% of payments exceed $983.55.
Based on per-provider averages across all Medicaid claims in this category.
Prenatal care services monitor the health of the mother and developing baby throughout pregnancy, including routine exams, ultrasounds, and lab work.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Pregnancy & Prenatal Care in Durham, NC
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Brenna Lynne Hughes
2608 Erwin Rd |
$338.15 | 595 | 463 |
|
Maria J Small
1000 Trent Drive |
$632.91 | 534 | 462 |
|
Beverly Allen Gray
203 Baker House |
$197.44 | 306 | 236 |
|
John W. Schmitt
5213 S Alston Ave |
$87.41 | 164 | 142 |
|
Jennifer Bushman Gilner
2100 Erwin Rd |
$671.20 | 147 | 124 |
|
Vanisha Rochelle Wilson
40 Duke Medicine Cir |
$174.41 | 45 | 13 |
|
Sarah Kathleen Dotters-Katz
2301 Erwin Rd |
$1,078 | 29 | 27 |
|
Katherine Elizabeth Robinson
2608 Erwin Rd Ste 200 |
$123.58 | 28 | 28 |
|
Katrina Avery
2100 Erwin Rd |
$723.41 | 26 | 26 |
|
Sarah Ellestad
Duke University Medical Ctr |
$575.15 | 18 | 13 |
|
Brita Boyd
Duke University Medical Ctr |
$589.62 | 14 | 13 |
|
Benjamin Joseph White
2609 N Duke St Ste 204 |
$722.28 | 14 | 13 |
|
Elizabeth Livingston
2100 Erwin Rd |
$687.89 | 12 | 12 |
What to Expect: Pregnancy & Prenatal Care
Prenatal visits occur monthly in the first two trimesters, then more frequently. Early visits include a full health history, blood work, and dating ultrasound. Subsequent visits check blood pressure, weight, urine, and fetal heartbeat. Anatomy ultrasound is done around 20 weeks. Glucose screening occurs at 24-28 weeks. Visits become weekly in the final month.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 59425 | Antepartum care 4-6 visits | $61.80 | 3,944,438 | 4,039 |
| 59426 | Antepartum care 7+ visits | $128.57 | 1,377,597 | 2,059 |
| 59430 | Postpartum care only | $83.88 | 974,460 | 3,800 |
| 59409 | Vaginal delivery only | $603.80 | 683,557 | 3,289 |
| 59514 | Cesarean delivery only | $402.77 | 268,540 | 1,509 |
| 59400 | Routine obstetric care vaginal | $1,660 | 177,823 | 996 |
| 59410 | Vaginal delivery w/postpartum | $808.16 | 68,014 | 583 |
| 59515 | Cesarean delivery w/postpartum | $663.35 | 28,695 | 217 |
| 59510 | Routine obstetric care cesarean | $1,678 | 25,421 | 152 |
| 59612 | VBAC delivery only | $878.81 | 56 | 3 |
| 59620 | Repeat cesarean delivery only | $314.45 | 26 | 1 |
| 59610 | Routine OB care VBAC | — | — | — |
| 59614 | VBAC delivery w/postpartum | — | — | — |
| 59618 | Routine OB care repeat cesarean | — | — | — |
| 59622 | Repeat cesarean w/postpartum | — | — | — |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Pregnancy & Prenatal Care cost in Durham, NC?
Based on public Medicaid payment data, the average Medicaid reimbursement for Pregnancy & Prenatal Care in Durham, NC is $419.74 per claim, based on 1,932 claims from 13 providers. Typical payments fall between $70.83 and $584.62. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Pregnancy & Prenatal Care in Durham, NC?
There are 13 Medicaid providers offering Pregnancy & Prenatal Care related services in Durham, NC according to public payment data.
What is the price range for Pregnancy & Prenatal Care in Durham, NC?
Medicaid reimbursement for Pregnancy & Prenatal Care in Durham, NC ranges from $87.41 to $1,078 per claim, with an average of $419.74. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Pregnancy & Prenatal Care in Other Cities
Indianapolis, IN
Avg $91.13
294,166 claims · 246 providers
Bakersfield, CA
Avg $112.46
262,587 claims · 74 providers
Fresno, CA
Avg $14.81
153,894 claims · 79 providers
New York, NY
Avg $147.67
132,979 claims · 61 providers
Sacramento, CA
Avg $28.38
124,581 claims · 68 providers
Riverside, CA
Avg $77.93
123,836 claims · 33 providers
Fort Wayne, IN
Avg $74.47
106,706 claims · 71 providers
San Bernardino, CA
Avg $92.56
105,560 claims · 25 providers
Other Procedures in Durham, NC
Office Visit
Avg $53.48
1,229,002 claims
Dental Cleaning & Exam
Avg $29.86
790,132 claims
Substance Abuse Treatment
Avg $122.82
746,211 claims
X-Ray
Avg $5.74
576,677 claims
Blood Work & Lab Tests
Avg $13.80
572,218 claims
Speech Therapy
Avg $57.51
491,949 claims
Psychiatric Evaluation
Avg $65.37
472,359 claims
Emergency Room Visit
Avg $105.90
448,598 claims