Average Medicaid Pregnancy & Prenatal Care Payments
Typical Medicaid Pregnancy & Prenatal Care reimbursement across 2,086 cities
Avg. Medicaid Paid
$194.17
Price Range
$0.00 – $5,861
Total Claims
7.2M
Cities
2086
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.
About This Procedure
Prenatal care services monitor the health of the mother and developing baby throughout pregnancy, including routine exams, ultrasounds, and lab work.
Why do these costs look low?
These figures represent Medicaid reimbursement rates — the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.
Costs by City
| City | Avg. Paid | Min / Max | Claims | Providers |
|---|---|---|---|---|
| Sherman, TX | $173.83 | $58.71 – $236.67 | 763 | 5 |
| Forrest City, AR | $928.62 | $928.62 – $928.62 | 766 | 1 |
| Gaffney, SC | $1,061 | $165.66 – $1,108 | 767 | 2 |
| Eunice, LA | $431.16 | $68.81 – $554.96 | 768 | 4 |
| Boston, MA | $1,347 | $115.72 – $2,047 | 770 | 11 |
| Palm Beach Gardens, FL | $466.57 | $68.61 – $473.93 | 771 | 2 |
| Cooperstown, NY | $159.41 | $9.56 – $3,417 | 772 | 3 |
| Savannah, TN | $139.84 | $5.68 – $226.54 | 777 | 2 |
| Roanoke Rapids, NC | $1,152 | $1,152 – $1,152 | 777 | 1 |
| Sparta, NJ | $203.02 | $203.02 – $203.02 | 778 | 1 |
| Trenton, MI | $559.97 | $496.38 – $717.51 | 779 | 2 |
| St Johnsbury, VT | $75.31 | $75.31 – $75.31 | 780 | 1 |
| Oak Park, IL | $324.57 | $0.00 – $330.89 | 785 | 2 |
| Newburgh, NY | $47.09 | $17.09 – $1,054 | 786 | 3 |
| Imperial, CA | $697.31 | $697.31 – $697.31 | 786 | 1 |
| Covington, TN | $1,258 | $1,258 – $1,258 | 789 | 1 |
| Minocqua, WI | $86.50 | $86.50 – $86.50 | 789 | 1 |
| Middletown, OH | $84.59 | $81.88 – $89.49 | 794 | 2 |
| Fernandina Beach, FL | $68.65 | $68.65 – $68.65 | 799 | 1 |
| Lisle, IL | $944.07 | $944.07 – $944.07 | 802 | 1 |
| Roswell, GA | $1,653 | $1,653 – $1,653 | 802 | 1 |
| Fort Payne, AL | $993.52 | $48.86 – $1,478 | 804 | 3 |
| New Port Richey, FL | $121.60 | $121.60 – $121.60 | 806 | 1 |
| Pico Rivera, CA | $0.00 | $0.00 – $0.00 | 806 | 3 |
| Hopkinsville, KY | $643.94 | $65.86 – $1,057 | 808 | 6 |
| Lexington, KY | $477.62 | $72.66 – $1,269 | 818 | 12 |
| South Miami, FL | $147.59 | $19.47 – $431.70 | 820 | 3 |
| Mesa, AZ | $1,454 | $0.00 – $7,542 | 831 | 12 |
| Milwaukee, WI | $804.74 | $71.48 – $1,671 | 831 | 7 |
| Maryville, IL | $464.43 | $464.43 – $464.43 | 841 | 1 |
| Rumford, ME | $6.97 | $6.97 – $6.97 | 844 | 1 |
| Lakeside Park, KY | $86.40 | $86.40 – $86.40 | 844 | 1 |
| Gansevoort, NY | $102.93 | $102.93 – $102.93 | 848 | 1 |
| Eastvale, CA | $58.27 | $4.03 – $59.24 | 848 | 2 |
| South Williamson, KY | $313.54 | $313.54 – $313.54 | 855 | 1 |
| Kerman, CA | $9.22 | $0.00 – $16.70 | 859 | 4 |
| Paducah, KY | $680.71 | $496.00 – $899.20 | 865 | 3 |
| Hershey, PA | $106.80 | $54.09 – $729.02 | 867 | 5 |
| West Monroe, LA | $513.16 | $66.81 – $533.96 | 870 | 3 |
| Roseville, CA | $120.79 | $0.00 – $671.48 | 871 | 5 |
| Shelby, NC | $584.71 | $13.33 – $1,411 | 873 | 7 |
| Providence, RI | $607.36 | $97.72 – $1,686 | 874 | 13 |
| Kansas City, MO | $587.32 | $107.14 – $912.66 | 875 | 18 |
| Shawnee, OK | $1,817 | $1,631 – $1,852 | 876 | 3 |
| Cape Girardeau, MO | $93.89 | $90.97 – $288.27 | 878 | 2 |
| Larkspur, CA | $60.54 | $60.54 – $60.54 | 880 | 1 |
| Greencastle, IN | $73.69 | $73.69 – $73.69 | 891 | 1 |
| Mandeville, LA | $142.71 | $142.71 – $142.71 | 892 | 1 |
| Columbia, TN | $1,117 | $1,117 – $1,117 | 892 | 1 |
| Royal Palm Beach, FL | $69.52 | $69.52 – $69.52 | 896 | 1 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| 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 averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.