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Based on public Medicaid payment data.

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 β€” 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
Lawrenceburg, IN $82.05 $80.02 – $88.27 11,602 4
Louisville, KY $206.82 $50.64 – $892.08 11,661 39
Shreveport, LA $354.92 $0.00 – $1,357 11,704 32
Southaven, MS $101.00 $85.27 – $379.05 11,727 10
Laredo, TX $353.31 $90.89 – $601.81 11,793 14
Brookhaven, MS $96.84 $93.83 – $102.48 11,943 4
Voorhees, NJ $125.08 $11.84 – $1,454 11,956 20
Atwater, CA $90.31 $89.83 – $97.47 12,028 4
El Cajon, CA $44.33 $24.93 – $60.38 12,097 7
Rancho Curamonga, CA $96.02 $96.02 – $96.02 12,147 1
Lancaster, CA $103.08 $7.86 – $298.67 12,262 14
Delano, CA $92.55 $37.58 – $648.60 12,566 8
New Square, NY $48.71 $36.08 – $82.68 12,705 7
Raleigh, NC $652.19 $0.00 – $1,109 12,730 32
Lansing, MI $594.40 $64.42 – $650.38 12,734 7
Greenville, SC $647.25 $1.87 – $1,110 12,755 41
Mishawaka, IN $85.68 $49.19 – $92.83 13,304 17
Santa Ana, CA $126.52 $0.00 – $492.44 13,327 15
Galveston, TX $510.79 $77.90 – $865.88 13,394 25
Fishers, IN $88.44 $0.00 – $138.22 13,430 12
Avon, IN $93.84 $47.57 – $129.54 13,560 24
Crown Point, IN $83.20 $64.87 – $90.98 13,662 13
Austin, TX $101.26 $17.10 – $1,480 13,847 47
Van Nuys, CA $160.12 $1.32 – $1,323 14,256 10
Newburgh, IN $94.99 $34.90 – $1,089 14,304 14
Hanford, CA $6.34 $0.00 – $56.29 14,799 9
Dearborn, MI $635.20 $0.00 – $933.46 14,840 9
Reedley, CA $24.90 $0.00 – $77.02 14,892 14
National City, CA $87.16 $58.45 – $436.29 14,963 6
Ann Arbor, MI $567.81 $60.48 – $1,090 15,045 6
Porterville, CA $27.10 $0.00 – $242.83 15,087 7
Brooklyn, NY $1,753 $19.21 – $3,309 15,368 79
Royal Oak, MI $558.45 $15.98 – $561.08 15,514 2
Natchez, MS $57.20 $33.56 – $94.13 15,562 3
Gary, IN $65.75 $60.29 – $89.18 15,569 4
Shelbyville, IN $69.92 $67.30 – $131.06 15,704 5
Lucedale, MS $108.64 $19.48 – $114.17 15,751 3
Yuba City, CA $75.76 $0.00 – $664.20 15,873 14
Clarksdale, MS $172.07 $139.39 – $186.16 15,953 6
La Porte, IN $92.93 $57.58 – $98.72 15,975 7
San Antonio, TX $334.89 $0.00 – $676.96 16,263 79
New Albany, IN $93.95 $68.01 – $97.58 16,351 11
Gulfport, MS $61.17 $17.38 – $116.19 16,537 14
Anaheim, CA $87.26 $0.00 – $438.07 16,576 17
Camden, NJ $118.05 $0.00 – $730.73 16,592 15
Jasper, IN $74.58 $68.97 – $92.91 17,017 5
Laurel, MS $127.09 $15.38 – $1,313 17,104 12
Lake Station, IN $112.43 $112.43 – $112.43 17,188 1
Ocean Springs, MS $97.57 $10.53 – $106.34 17,240 9
Mccomb, MS $42.77 $0.00 – $147.81 17,379 10

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 β€” β€” β€”
59614 VBAC delivery w/postpartum β€” β€” β€”
59618 Routine OB care repeat cesarean β€” β€” β€”
59622 Repeat cesarean w/postpartum β€” β€” β€”

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.