Average Medicaid Pregnancy & Prenatal Care Payments in Philadelphia, PA: $323.65
Avg. Paid
$323.65
Range
$0.00 – $1,635
Total Claims
7,377
Providers
58
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 Philadelphia, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Lily Kathryn Pemberton
3400 Spruce St |
$66.80 | 1,011 | 838 |
|
Sonia Therese Shubert
3400 Spruce St |
$0.00 | 925 | 741 |
|
Sabrina N Sukhan
801 Spruce St. |
$750.55 | 858 | 845 |
|
The Visiting Nurse Association Of Greater Philadelphia
4601 Market St |
$233.83 | 634 | 618 |
|
Elizabeth Clement
3400 Spruce St |
$131.18 | 522 | 516 |
|
Philip J. Horn
1 Penn Blvd |
$95.71 | 452 | 438 |
|
Erin Elizabeth Dainty
3400 Spruce St |
$484.05 | 346 | 337 |
|
Michelle E Duncan
3401 N Broad St |
$1,428 | 259 | 257 |
|
David M. Jaspan
5401 Old York Rd |
$103.23 | 257 | 256 |
|
John Robert Myers
101 E Olney Ave |
$248.34 | 252 | 246 |
|
Allison Brooke Stevens
3400 Spruce St |
$40.51 | 150 | 123 |
|
Shwetha Sudheendra Shrivatsa
4510 Frankford Ave |
$239.26 | 143 | 105 |
|
Joel R Kramer
7901 Bustleton Ave |
$722.31 | 132 | 128 |
|
Celeste P Durnwald
800 Walnut St Fl 11 |
$130.44 | 127 | 126 |
|
Andrew J Loh
2 Penn Blvd |
$242.75 | 124 | 123 |
|
Joy Alison Cooper
3400 Spruce St |
$60.87 | 107 | 93 |
|
Jenny Ann Graber
9807 Bustleton Ave |
$355.77 | 89 | 86 |
|
Mary Rebecca Deagostino-Kelly
3701 Market St Fl 3 |
$97.25 | 68 | 68 |
|
Adi Hirshberg
3400 Spruce St |
$1,476 | 60 | 60 |
|
Betsy Batejan
1427 Vine St |
$86.21 | 53 | 52 |
|
Raquel Inniss
9331 Old Bustleton Ave Ste 201 |
$232.14 | 42 | 42 |
|
Elana Mcdonald
3380 Memphis St |
$237.80 | 41 | 41 |
|
Ahpaffs,Llc
1010 W Lehigh Ave |
$0.00 | 41 | 35 |
|
Amanda Schieler
5501 Old York Rd |
$702.93 | 40 | 40 |
|
Leah Eboso Ahoya
3401 N Broad St |
$89.55 | 38 | 36 |
|
Lev Belder
7901 Bustleton Ave |
$137.23 | 38 | 38 |
|
Stephanie H Ewing
700 Spruce St |
$644.70 | 37 | 37 |
|
Samuel Joseph Needles
7901 Bustleton Ave Ste 100 |
$136.33 | 35 | 30 |
|
Kavous Emami
9807 Bustleton Ave |
$138.41 | 32 | 31 |
|
Cheryl Yondorf
5501 Old York Rd |
$1,617 | 27 | 27 |
|
Henry H. Su
841 E Hunting Park Ave |
$0.00 | 27 | 27 |
|
Olufolakemi Adetutu Akinkunmi
800 Spruce St |
$1,319 | 26 | 26 |
|
Osnat Geifman-Holtzman
201 N 9Th St Ste A |
$89.59 | 26 | 26 |
|
Laniece A Coleman
833 Chestnut St Fl 1 |
$1,440 | 25 | 25 |
|
Daphne Landau
3400 Spruce Street |
$569.92 | 19 | 16 |
|
Jayne Henderson Brown
4510 Frankford Ave |
$223.68 | 19 | 19 |
|
Hadja Idiatou Diallo
800 Walnut St |
$0.00 | 18 | 13 |
|
Elizabeth S. Liveright
833 Chestnut Street |
$1,252 | 17 | 16 |
|
Delana Wardlaw
4350 Germantown Ave |
$205.88 | 17 | 17 |
|
Nimidia Oviedo
136 Diamond St |
$250.00 | 16 | 16 |
|
Talia Maas
834 Chestnut St |
$1,546 | 15 | 15 |
|
Maggie Power
3701 Market St |
$1,455 | 14 | 14 |
|
Mary Elise Lynch
5501 Old York Rd # Lifter1 |
$96.32 | 14 | 12 |
|
Yvonne D Prioleau
801 Spruce St |
$1,112 | 13 | 12 |
|
Gregg D Alleyne
216 N Broad St |
$346.86 | 13 | 13 |
|
Agatha Berger
833 Chestnut St Fl 1 |
$195.81 | 13 | 12 |
|
Trisha L Acri
7198 Castor Ave |
$0.00 | 13 | 13 |
|
Tanise Louden Branche
3401 N Broad St |
$1,635 | 12 | 12 |
|
Hyun-Joo Lee
5401 Old York Rd Bldg Suite410 |
$1,595 | 12 | 12 |
|
Sindhu Kikkeri Srinivas
3400 Spruce St |
$1,489 | 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 Philadelphia, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Pregnancy & Prenatal Care in Philadelphia, PA is $323.65 per claim, based on 7,377 claims from 58 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 Philadelphia, PA?
There are 58 Medicaid providers offering Pregnancy & Prenatal Care related services in Philadelphia, PA according to public payment data.
What is the price range for Pregnancy & Prenatal Care in Philadelphia, PA?
Medicaid reimbursement for Pregnancy & Prenatal Care in Philadelphia, PA ranges from $0.00 to $1,635 per claim, with an average of $323.65. 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 Philadelphia, PA
Office Visit
Avg $47.22
5,853,067 claims
Substance Abuse Treatment
Avg $57.23
5,131,687 claims
Psychiatric Evaluation
Avg $69.22
3,688,209 claims
Emergency Room Visit
Avg $135.52
3,661,931 claims
X-Ray
Avg $9.69
1,822,183 claims
Behavioral & Mental Health Therapy
Avg $119.23
1,618,868 claims
Blood Work & Lab Tests
Avg $6.85
1,492,079 claims
Dental Cleaning & Exam
Avg $29.51
1,399,541 claims