Medicare & Medicaid in Ohio (OH)
2026 healthcare costs, coverage, and spending data for Ohio.
$14,083
Spending/Capita
2,045,620
Medicare Enrollees
2,760,827
Medicaid Enrollees
6.1%
Uninsured Rate
Medicare Premiums in Ohio
Part B Premium
$185/mo
Part D Premium (Avg)
$84/mo
Medigap Premium (Avg)
$127/mo
Medicaid Expansion: Yes - Ohio expanded Medicaid under the ACA
Procedure Costs in Ohio
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Liver Transplant | $188,726 | $150,981 | $37,745 |
| Kidney Transplant | $145,326 | $116,261 | $29,065 |
| Heart Valve Replacement | $64,285 | $51,428 | $12,857 |
| Spinal Fusion | $61,567 | $49,253 | $12,313 |
| Coronary Artery Bypass Graft (CABG) | $58,141 | $46,513 | $11,628 |
| Defibrillator Implantation (ICD) | $51,155 | $40,924 | $10,231 |
| Total Hip Replacement | $32,009 | $25,607 | $6,402 |
| Colectomy | $31,112 | $24,889 | $6,222 |
| Sepsis Treatment | $29,214 | $23,371 | $5,843 |
| Total Knee Replacement | $28,450 | $22,760 | $5,690 |
| Cardiac Catheterization with Stent | $28,371 | $22,697 | $5,674 |
| Hip Fracture Repair | $26,910 | $21,528 | $5,382 |
| Pacemaker Implantation | $26,598 | $21,278 | $5,320 |
| Laminectomy | $24,434 | $19,547 | $4,887 |
| Lumbar Disc Surgery | $22,751 | $18,201 | $4,550 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Endoscopic Sinus Surgery | $8,055 | $6,444 | $1,611 |
| Lithotripsy (Kidney Stones) | $7,871 | $6,297 | $1,574 |
| Arthroscopic Knee Surgery | $7,280 | $5,824 | $1,456 |
| TURP (Prostate) | $7,191 | $5,753 | $1,438 |
| Septoplasty | $6,668 | $5,334 | $1,334 |
| Tonsillectomy | $6,337 | $5,070 | $1,267 |
| Dialysis Access Surgery | $5,850 | $4,680 | $1,170 |
| Bunionectomy | $5,060 | $4,048 | $1,012 |
| Adenoidectomy | $4,624 | $3,699 | $925 |
| Carpal Tunnel Release | $4,412 | $3,529 | $882 |
| Hemorrhoid Surgery | $4,289 | $3,431 | $858 |
| Pilonidal Cyst Surgery | $4,177 | $3,341 | $835 |
| Nasal Polyp Removal | $3,770 | $3,016 | $754 |
| Trigger Finger Release | $3,726 | $2,980 | $745 |
| Cataract Surgery (Outpatient) | $3,197 | $2,557 | $639 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $3,970 | $3,176 | $794 |
| Nuclear Stress Test | $2,435 | $1,948 | $487 |
| MRI Spine (Lumbar) | $1,715 | $1,372 | $343 |
| CT Angiography | $1,663 | $1,330 | $333 |
| MRI Brain | $1,642 | $1,314 | $328 |
| MRI Spine (Cervical) | $1,625 | $1,300 | $325 |
| MRI Knee | $1,447 | $1,157 | $289 |
| CT Scan Abdomen/Pelvis | $1,415 | $1,132 | $283 |
| MRI Shoulder | $1,410 | $1,128 | $282 |
| Bone Scan | $1,203 | $962 | $241 |
| MRI Hip | $1,191 | $953 | $238 |
| CT Colonography (Virtual) | $804 | $643 | $161 |
| CT Scan Chest | $779 | $623 | $156 |
| CT Scan Head | $753 | $602 | $151 |
| Fluoroscopy | $553 | $443 | $111 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $365 | $292 | $73 |
| Allergy Testing | $330 | $264 | $66 |
| Mammogram (Screening) | $274 | $274 | $0 |
| Psychiatry Visit | $241 | $193 | $48 |
| Wound Care Visit | $238 | $190 | $48 |
| Office Visit (New Patient) | $225 | $180 | $45 |
| Mental Health Counseling | $214 | $171 | $43 |
| Shingles Vaccination | $206 | $206 | $0 |
| Annual Wellness Visit | $192 | $192 | $0 |
| Bone Density Test (DEXA Scan) | $159 | $128 | $32 |
| Occupational Therapy Session | $143 | $115 | $29 |
| Skin Cancer Screening | $141 | $113 | $28 |
| Office Visit (Established Patient) | $129 | $103 | $26 |
| EKG (Electrocardiogram) | $129 | $103 | $26 |
| Physical Therapy Session | $127 | $101 | $25 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| BNP (Heart Failure Marker) | $56 | $45 | $11 |
| Vitamin D Level | $51 | $41 | $10 |
| Thyroid Panel (TSH) | $45 | $36 | $9 |
| Blood Culture | $43 | $34 | $9 |
| Glucose Tolerance Test | $41 | $33 | $8 |
| PSA (Prostate-Specific Antigen) | $40 | $32 | $8 |
| Blood Type and Crossmatch | $39 | $31 | $8 |
| Urine Drug Screen | $36 | $29 | $7 |
| Lipid Panel | $35 | $28 | $7 |
| B12 Level | $34 | $27 | $7 |
| Iron Studies (Ferritin) | $34 | $27 | $7 |
| Hemoglobin A1C | $34 | $27 | $7 |
| Complete Blood Count (CBC) | $33 | $26 | $7 |
| Comprehensive Metabolic Panel | $32 | $25 | $6 |
| Troponin Level | $31 | $25 | $6 |
Compare Ohio With Other States
Frequently Asked Questions
How much does Medicare spend per person in Ohio?
In 2026, the average Medicare spending per beneficiary in Ohio is $14,083.
How many people are enrolled in Medicare in Ohio?
Ohio has approximately 2,045,620 Medicare beneficiaries.
Did Ohio expand Medicaid?
Yes, Ohio expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in Ohio?
The uninsured rate in Ohio is 6.1%.
What is the average Medigap premium in Ohio?
The average Medigap (Medicare Supplement) premium in Ohio is $127 per month.