Everyone pays the discount fee of $2,500.00 by the 34th week of pregnancy, whether or not they have maternity insurance.   After the birth, I send a superbill to my billing service, and they submit the claim.   When I receive the reimbursement from your insurance company, I will reimburse you what you paid me minus the billing service fee of 8%.  If your insurance company reimburses more than the amount you paid me, plus the 8% service charge (due to itemization), I will reimburse you the amount you paid me, and I will keep the extra and pay the billing fee out of my portion.