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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 — 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
Tupelo, MS $90.53 $21.04 – $112.83 34,001 21
Orange, CA $145.98 $0.00 – $782.19 34,193 41
Chicago, IL $201.75 $0.00 – $1,818 35,631 86
Elgin, IL $80.72 $0.01 – $1,007 35,869 6
Bloomington, IN $92.76 $0.51 – $119.58 36,918 29
Lafayette, IN $79.24 $48.80 – $143.59 37,768 45
Palm Springs, CA $84.18 $3.74 – $770.74 39,312 10
Evansville, IN $85.21 $58.07 – $100.03 39,357 22
Terre Haute, IN $85.94 $54.53 – $114.92 41,927 13
Dallas, TX $513.76 $0.00 – $1,281 42,317 76
Ventura, CA $76.87 $5.74 – $2,871 43,864 32
Oxnard, CA $61.21 $0.00 – $281.63 46,403 24
Hattiesburg, MS $92.22 $41.28 – $139.93 54,548 30
Houston, TX $368.81 $0.00 – $1,207 55,750 200
Flowood, MS $106.92 $12.30 – $134.68 55,784 12
Stockton, CA $159.11 $0.00 – $839.02 55,846 24
Jackson, MS $110.82 $0.00 – $605.47 57,818 44
Murrieta, CA $67.97 $56.99 – $135.99 58,548 22
Detroit, MI $635.01 $113.82 – $1,448 65,776 14
Los Angeles, CA $88.85 $0.00 – $834.23 75,307 103
Pomona, CA $94.14 $0.00 – $110.84 75,884 16
Apple Valley, CA $132.33 $56.23 – $415.15 76,046 21
Indio, CA $86.89 $57.54 – $105.28 78,619 7
Modesto, CA $102.12 $0.00 – $462.34 81,574 42
Salinas, CA $90.18 $60.17 – $681.26 82,256 42
Merced, CA $111.35 $63.12 – $371.85 85,269 19
San Diego, CA $62.05 $0.00 – $646.18 95,677 106
Colton, CA $93.63 $0.00 – $261.13 98,223 20
San Bernardino, CA $92.56 $0.00 – $539.29 105,560 25
Fort Wayne, IN $74.47 $36.20 – $529.35 106,706 71
Riverside, CA $77.93 $0.24 – $881.21 123,836 33
Sacramento, CA $28.38 $0.00 – $776.99 124,581 68
New York, NY $147.67 $9.51 – $2,919 132,979 61
Fresno, CA $14.81 $0.00 – $213.44 153,894 79
Bakersfield, CA $112.46 $0.00 – $685.07 262,587 74
Indianapolis, IN $91.13 $26.49 – $741.59 294,166 246

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.