Medicare & Medicaid in South Carolina (SC)
2026 healthcare costs, coverage, and spending data for South Carolina.
$8,280
Spending/Capita
1,204,024
Medicare Enrollees
1,638,699
Medicaid Enrollees
7.5%
Uninsured Rate
Medicare Premiums in South Carolina
Part B Premium
$185/mo
Part D Premium (Avg)
$72/mo
Medigap Premium (Avg)
$293/mo
Medicaid Expansion: No - South Carolina has not expanded Medicaid
Procedure Costs in South Carolina
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Kidney Transplant | $139,006 | $111,205 | $27,801 |
| Liver Transplant | $131,604 | $105,284 | $26,321 |
| Coronary Artery Bypass Graft (CABG) | $91,404 | $73,123 | $18,281 |
| Heart Valve Replacement | $86,710 | $69,368 | $17,342 |
| Spinal Fusion | $56,319 | $45,056 | $11,264 |
| Total Knee Replacement | $38,898 | $31,119 | $7,780 |
| Defibrillator Implantation (ICD) | $35,018 | $28,014 | $7,004 |
| Hip Fracture Repair | $30,725 | $24,580 | $6,145 |
| Total Hip Replacement | $29,852 | $23,882 | $5,970 |
| Colectomy | $25,939 | $20,751 | $5,188 |
| Pacemaker Implantation | $25,793 | $20,635 | $5,159 |
| Laminectomy | $24,897 | $19,918 | $4,979 |
| Mastectomy | $23,422 | $18,737 | $4,684 |
| Carotid Endarterectomy | $23,032 | $18,426 | $4,606 |
| Cardiac Catheterization with Stent | $21,074 | $16,859 | $4,215 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Arthroscopic Knee Surgery | $9,596 | $7,676 | $1,919 |
| TURP (Prostate) | $8,056 | $6,445 | $1,611 |
| Endoscopic Sinus Surgery | $7,109 | $5,688 | $1,422 |
| Hemorrhoid Surgery | $6,210 | $4,968 | $1,242 |
| Lithotripsy (Kidney Stones) | $5,768 | $4,615 | $1,154 |
| Dialysis Access Surgery | $5,206 | $4,165 | $1,041 |
| Bunionectomy | $5,075 | $4,060 | $1,015 |
| Nasal Polyp Removal | $4,964 | $3,971 | $993 |
| Carpal Tunnel Release | $4,722 | $3,778 | $944 |
| Septoplasty | $4,643 | $3,714 | $929 |
| Tonsillectomy | $4,300 | $3,440 | $860 |
| Bronchoscopy | $4,065 | $3,252 | $813 |
| Trigger Finger Release | $3,690 | $2,952 | $738 |
| Breast Biopsy | $3,643 | $2,915 | $729 |
| Pilonidal Cyst Surgery | $3,630 | $2,904 | $726 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $3,352 | $2,681 | $670 |
| Nuclear Stress Test | $2,243 | $1,794 | $449 |
| CT Angiography | $1,709 | $1,367 | $342 |
| MRI Spine (Cervical) | $1,427 | $1,142 | $285 |
| MRI Knee | $1,379 | $1,103 | $276 |
| MRI Spine (Lumbar) | $1,362 | $1,089 | $272 |
| MRI Shoulder | $1,345 | $1,076 | $269 |
| CT Scan Abdomen/Pelvis | $1,244 | $995 | $249 |
| Bone Scan | $1,220 | $976 | $244 |
| MRI Hip | $1,188 | $950 | $238 |
| MRI Brain | $1,179 | $943 | $236 |
| CT Colonography (Virtual) | $997 | $798 | $199 |
| CT Scan Chest | $992 | $793 | $198 |
| CT Scan Head | $874 | $699 | $175 |
| Fluoroscopy | $680 | $544 | $136 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $411 | $329 | $82 |
| Psychiatry Visit | $309 | $248 | $62 |
| Allergy Testing | $299 | $239 | $60 |
| Annual Wellness Visit | $297 | $297 | $0 |
| Mammogram (Screening) | $269 | $269 | $0 |
| Mental Health Counseling | $230 | $184 | $46 |
| Bone Density Test (DEXA Scan) | $187 | $149 | $37 |
| Physical Therapy Session | $186 | $149 | $37 |
| Office Visit (Established Patient) | $184 | $147 | $37 |
| Shingles Vaccination | $178 | $178 | $0 |
| Wound Care Visit | $174 | $139 | $35 |
| Skin Cancer Screening | $166 | $133 | $33 |
| Office Visit (New Patient) | $165 | $132 | $33 |
| Vision Exam (Diabetic) | $160 | $128 | $32 |
| Occupational Therapy Session | $155 | $124 | $31 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| BNP (Heart Failure Marker) | $58 | $47 | $12 |
| Blood Culture | $57 | $45 | $11 |
| Blood Type and Crossmatch | $51 | $41 | $10 |
| PSA (Prostate-Specific Antigen) | $43 | $35 | $9 |
| Glucose Tolerance Test | $41 | $33 | $8 |
| Vitamin D Level | $41 | $33 | $8 |
| Thyroid Panel (TSH) | $41 | $32 | $8 |
| Lipid Panel | $40 | $32 | $8 |
| Iron Studies (Ferritin) | $38 | $30 | $8 |
| Complete Blood Count (CBC) | $37 | $30 | $7 |
| Comprehensive Metabolic Panel | $36 | $29 | $7 |
| B12 Level | $36 | $29 | $7 |
| Pap Smear Lab Processing | $36 | $29 | $7 |
| Hemoglobin A1C | $34 | $27 | $7 |
| Urine Drug Screen | $34 | $27 | $7 |
Compare South Carolina With Other States
Frequently Asked Questions
How much does Medicare spend per person in South Carolina?
In 2026, the average Medicare spending per beneficiary in South Carolina is $8,280.
How many people are enrolled in Medicare in South Carolina?
South Carolina has approximately 1,204,024 Medicare beneficiaries.
Did South Carolina expand Medicaid?
No, South Carolina has not expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in South Carolina?
The uninsured rate in South Carolina is 7.5%.
What is the average Medigap premium in South Carolina?
The average Medigap (Medicare Supplement) premium in South Carolina is $293 per month.