Medicare & Medicaid in Kentucky (KY)
2026 healthcare costs, coverage, and spending data for Kentucky.
$14,424
Spending/Capita
1,859,991
Medicare Enrollees
2,513,322
Medicaid Enrollees
4.9%
Uninsured Rate
Medicare Premiums in Kentucky
Part B Premium
$185/mo
Part D Premium (Avg)
$41/mo
Medigap Premium (Avg)
$243/mo
Medicaid Expansion: Yes - Kentucky expanded Medicaid under the ACA
Procedure Costs in Kentucky
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Liver Transplant | $170,556 | $136,445 | $34,111 |
| Kidney Transplant | $113,220 | $90,576 | $22,644 |
| Coronary Artery Bypass Graft (CABG) | $69,586 | $55,669 | $13,917 |
| Heart Valve Replacement | $69,356 | $55,485 | $13,871 |
| Spinal Fusion | $62,020 | $49,616 | $12,404 |
| Pacemaker Implantation | $36,405 | $29,124 | $7,281 |
| Defibrillator Implantation (ICD) | $34,879 | $27,903 | $6,976 |
| Total Hip Replacement | $33,172 | $26,538 | $6,634 |
| Sepsis Treatment | $29,709 | $23,767 | $5,942 |
| Colectomy | $29,531 | $23,625 | $5,906 |
| Total Knee Replacement | $26,362 | $21,089 | $5,272 |
| Hip Fracture Repair | $25,385 | $20,308 | $5,077 |
| Mastectomy | $23,824 | $19,059 | $4,765 |
| Stroke Treatment (Acute) | $23,639 | $18,911 | $4,728 |
| Carotid Endarterectomy | $22,710 | $18,168 | $4,542 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Arthroscopic Knee Surgery | $9,837 | $7,870 | $1,967 |
| Endoscopic Sinus Surgery | $8,264 | $6,611 | $1,653 |
| TURP (Prostate) | $8,026 | $6,420 | $1,605 |
| Lithotripsy (Kidney Stones) | $6,512 | $5,210 | $1,302 |
| Septoplasty | $5,345 | $4,276 | $1,069 |
| Dialysis Access Surgery | $5,079 | $4,063 | $1,016 |
| Bunionectomy | $4,951 | $3,961 | $990 |
| Carpal Tunnel Release | $4,733 | $3,786 | $947 |
| Pilonidal Cyst Surgery | $4,534 | $3,627 | $907 |
| Tonsillectomy | $4,423 | $3,538 | $885 |
| Hemorrhoid Surgery | $4,151 | $3,321 | $830 |
| Nasal Polyp Removal | $4,027 | $3,222 | $805 |
| Cataract Surgery (Outpatient) | $3,575 | $2,860 | $715 |
| Ganglion Cyst Removal | $3,522 | $2,817 | $704 |
| Adenoidectomy | $3,368 | $2,694 | $674 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $2,755 | $2,204 | $551 |
| Nuclear Stress Test | $1,950 | $1,560 | $390 |
| MRI Spine (Lumbar) | $1,639 | $1,311 | $328 |
| MRI Hip | $1,576 | $1,261 | $315 |
| MRI Spine (Cervical) | $1,369 | $1,095 | $274 |
| MRI Knee | $1,304 | $1,043 | $261 |
| MRI Brain | $1,289 | $1,031 | $258 |
| CT Angiography | $1,131 | $905 | $226 |
| CT Scan Chest | $1,004 | $803 | $201 |
| CT Scan Abdomen/Pelvis | $958 | $766 | $192 |
| CT Colonography (Virtual) | $911 | $729 | $182 |
| MRI Shoulder | $910 | $728 | $182 |
| CT Scan Head | $883 | $706 | $177 |
| Bone Scan | $828 | $662 | $166 |
| Arterial Doppler | $555 | $444 | $111 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $386 | $309 | $77 |
| Allergy Testing | $301 | $241 | $60 |
| Mammogram (Screening) | $291 | $291 | $0 |
| Annual Wellness Visit | $276 | $276 | $0 |
| Bone Density Test (DEXA Scan) | $246 | $197 | $49 |
| Wound Care Visit | $234 | $187 | $47 |
| Mental Health Counseling | $223 | $178 | $45 |
| Psychiatry Visit | $218 | $174 | $44 |
| Vision Exam (Diabetic) | $180 | $144 | $36 |
| Shingles Vaccination | $175 | $175 | $0 |
| Office Visit (New Patient) | $166 | $133 | $33 |
| EKG (Electrocardiogram) | $163 | $130 | $33 |
| Office Visit (Established Patient) | $160 | $128 | $32 |
| Occupational Therapy Session | $152 | $122 | $30 |
| Speech Therapy Session | $150 | $120 | $30 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| BNP (Heart Failure Marker) | $62 | $50 | $12 |
| Vitamin D Level | $50 | $40 | $10 |
| Blood Culture | $45 | $36 | $9 |
| Blood Type and Crossmatch | $43 | $34 | $9 |
| Thyroid Panel (TSH) | $42 | $34 | $8 |
| Liver Function Panel | $39 | $31 | $8 |
| Comprehensive Metabolic Panel | $36 | $29 | $7 |
| Troponin Level | $36 | $29 | $7 |
| Hemoglobin A1C | $34 | $28 | $7 |
| Glucose Tolerance Test | $34 | $27 | $7 |
| Iron Studies (Ferritin) | $33 | $27 | $7 |
| Lipid Panel | $33 | $27 | $7 |
| Pap Smear Lab Processing | $32 | $26 | $6 |
| Urine Drug Screen | $32 | $25 | $6 |
| PSA (Prostate-Specific Antigen) | $32 | $25 | $6 |
Compare Kentucky With Other States
Frequently Asked Questions
How much does Medicare spend per person in Kentucky?
In 2026, the average Medicare spending per beneficiary in Kentucky is $14,424.
How many people are enrolled in Medicare in Kentucky?
Kentucky has approximately 1,859,991 Medicare beneficiaries.
Did Kentucky expand Medicaid?
Yes, Kentucky expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in Kentucky?
The uninsured rate in Kentucky is 4.9%.
What is the average Medigap premium in Kentucky?
The average Medigap (Medicare Supplement) premium in Kentucky is $243 per month.