Medicare & Medicaid in South Dakota (SD)
2026 healthcare costs, coverage, and spending data for South Dakota.
$13,396
Spending/Capita
1,224,124
Medicare Enrollees
1,665,498
Medicaid Enrollees
4.1%
Uninsured Rate
Medicare Premiums in South Dakota
Part B Premium
$185/mo
Part D Premium (Avg)
$57/mo
Medigap Premium (Avg)
$278/mo
Medicaid Expansion: Yes - South Dakota expanded Medicaid under the ACA
Procedure Costs in South Dakota
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Liver Transplant | $154,393 | $123,515 | $30,879 |
| Kidney Transplant | $125,853 | $100,682 | $25,171 |
| Heart Valve Replacement | $99,495 | $79,596 | $19,899 |
| Coronary Artery Bypass Graft (CABG) | $69,622 | $55,697 | $13,924 |
| Spinal Fusion | $57,744 | $46,195 | $11,549 |
| Defibrillator Implantation (ICD) | $53,824 | $43,059 | $10,765 |
| Total Hip Replacement | $39,857 | $31,885 | $7,971 |
| Total Knee Replacement | $30,772 | $24,618 | $6,154 |
| Pacemaker Implantation | $29,869 | $23,895 | $5,974 |
| Laminectomy | $29,335 | $23,468 | $5,867 |
| Sepsis Treatment | $24,697 | $19,758 | $4,939 |
| Colectomy | $24,564 | $19,651 | $4,913 |
| Lumbar Disc Surgery | $24,038 | $19,230 | $4,808 |
| Carotid Endarterectomy | $23,797 | $19,037 | $4,759 |
| Mastectomy | $23,568 | $18,855 | $4,714 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Arthroscopic Knee Surgery | $8,833 | $7,066 | $1,767 |
| Endoscopic Sinus Surgery | $7,568 | $6,055 | $1,514 |
| Bunionectomy | $6,874 | $5,499 | $1,375 |
| Septoplasty | $6,746 | $5,397 | $1,349 |
| TURP (Prostate) | $6,503 | $5,202 | $1,301 |
| Dialysis Access Surgery | $5,580 | $4,464 | $1,116 |
| Lithotripsy (Kidney Stones) | $5,250 | $4,200 | $1,050 |
| Tonsillectomy | $4,924 | $3,939 | $985 |
| Adenoidectomy | $4,558 | $3,647 | $912 |
| Pilonidal Cyst Surgery | $4,280 | $3,424 | $856 |
| Hemorrhoid Surgery | $4,057 | $3,246 | $811 |
| Bronchoscopy | $3,906 | $3,124 | $781 |
| Carpal Tunnel Release | $3,782 | $3,026 | $756 |
| Varicose Vein Treatment | $3,591 | $2,872 | $718 |
| Nasal Polyp Removal | $3,482 | $2,786 | $696 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $3,435 | $2,748 | $687 |
| Nuclear Stress Test | $2,352 | $1,882 | $470 |
| CT Angiography | $1,854 | $1,483 | $371 |
| MRI Brain | $1,788 | $1,430 | $358 |
| MRI Spine (Cervical) | $1,500 | $1,200 | $300 |
| CT Scan Abdomen/Pelvis | $1,457 | $1,166 | $291 |
| MRI Hip | $1,250 | $1,000 | $250 |
| CT Scan Chest | $1,065 | $852 | $213 |
| MRI Spine (Lumbar) | $1,052 | $841 | $210 |
| MRI Shoulder | $1,046 | $836 | $209 |
| MRI Knee | $1,025 | $820 | $205 |
| CT Scan Head | $906 | $725 | $181 |
| Bone Scan | $782 | $626 | $156 |
| CT Colonography (Virtual) | $751 | $601 | $150 |
| Echocardiogram | $630 | $504 | $126 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $346 | $277 | $69 |
| Mammogram (Screening) | $310 | $310 | $0 |
| Allergy Testing | $253 | $202 | $51 |
| Mental Health Counseling | $223 | $178 | $45 |
| Annual Wellness Visit | $212 | $212 | $0 |
| Psychiatry Visit | $208 | $167 | $42 |
| Wound Care Visit | $182 | $146 | $36 |
| Physical Therapy Session | $176 | $141 | $35 |
| Shingles Vaccination | $176 | $176 | $0 |
| Office Visit (New Patient) | $174 | $140 | $35 |
| Vision Exam (Diabetic) | $167 | $134 | $33 |
| Bone Density Test (DEXA Scan) | $163 | $130 | $33 |
| EKG (Electrocardiogram) | $161 | $129 | $32 |
| Office Visit (Established Patient) | $157 | $126 | $31 |
| Occupational Therapy Session | $136 | $109 | $27 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| BNP (Heart Failure Marker) | $55 | $44 | $11 |
| Vitamin D Level | $54 | $43 | $11 |
| Glucose Tolerance Test | $46 | $37 | $9 |
| Troponin Level | $45 | $36 | $9 |
| Blood Culture | $45 | $36 | $9 |
| Blood Type and Crossmatch | $44 | $35 | $9 |
| Lipid Panel | $42 | $34 | $9 |
| Iron Studies (Ferritin) | $39 | $31 | $8 |
| Hemoglobin A1C | $37 | $30 | $7 |
| Thyroid Panel (TSH) | $37 | $29 | $7 |
| Urine Drug Screen | $34 | $27 | $7 |
| Comprehensive Metabolic Panel | $34 | $27 | $7 |
| B12 Level | $31 | $25 | $6 |
| Complete Blood Count (CBC) | $31 | $25 | $6 |
| PSA (Prostate-Specific Antigen) | $30 | $24 | $6 |
Compare South Dakota With Other States
Frequently Asked Questions
How much does Medicare spend per person in South Dakota?
In 2026, the average Medicare spending per beneficiary in South Dakota is $13,396.
How many people are enrolled in Medicare in South Dakota?
South Dakota has approximately 1,224,124 Medicare beneficiaries.
Did South Dakota expand Medicaid?
Yes, South Dakota expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in South Dakota?
The uninsured rate in South Dakota is 4.1%.
What is the average Medigap premium in South Dakota?
The average Medigap (Medicare Supplement) premium in South Dakota is $278 per month.