Medicare & Medicaid in Virginia (VA)
2026 healthcare costs, coverage, and spending data for Virginia.
$11,977
Spending/Capita
1,572,772
Medicare Enrollees
2,130,363
Medicaid Enrollees
3.1%
Uninsured Rate
Medicare Premiums in Virginia
Part B Premium
$185/mo
Part D Premium (Avg)
$59/mo
Medigap Premium (Avg)
$304/mo
Medicaid Expansion: Yes - Virginia expanded Medicaid under the ACA
Procedure Costs in Virginia
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Liver Transplant | $155,917 | $124,734 | $31,183 |
| Kidney Transplant | $117,194 | $93,755 | $23,439 |
| Coronary Artery Bypass Graft (CABG) | $78,354 | $62,683 | $15,671 |
| Heart Valve Replacement | $73,305 | $58,644 | $14,661 |
| Spinal Fusion | $56,745 | $45,396 | $11,349 |
| Defibrillator Implantation (ICD) | $50,632 | $40,505 | $10,126 |
| Total Hip Replacement | $39,909 | $31,927 | $7,982 |
| Total Knee Replacement | $36,977 | $29,582 | $7,395 |
| Pacemaker Implantation | $32,600 | $26,080 | $6,520 |
| Cardiac Catheterization with Stent | $28,327 | $22,661 | $5,665 |
| Laminectomy | $26,387 | $21,110 | $5,277 |
| Colectomy | $25,341 | $20,273 | $5,068 |
| Carotid Endarterectomy | $23,752 | $19,002 | $4,750 |
| Sepsis Treatment | $21,294 | $17,035 | $4,259 |
| Heart Failure Treatment (Inpatient) | $21,252 | $17,002 | $4,250 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| TURP (Prostate) | $9,409 | $7,527 | $1,882 |
| Lithotripsy (Kidney Stones) | $8,654 | $6,923 | $1,731 |
| Arthroscopic Knee Surgery | $7,061 | $5,649 | $1,412 |
| Endoscopic Sinus Surgery | $6,707 | $5,365 | $1,341 |
| Dialysis Access Surgery | $5,927 | $4,742 | $1,185 |
| Hemorrhoid Surgery | $5,922 | $4,738 | $1,184 |
| Bunionectomy | $5,734 | $4,587 | $1,147 |
| Tonsillectomy | $5,554 | $4,444 | $1,111 |
| Nasal Polyp Removal | $5,086 | $4,069 | $1,017 |
| Septoplasty | $5,062 | $4,050 | $1,012 |
| Carpal Tunnel Release | $4,770 | $3,816 | $954 |
| Adenoidectomy | $4,320 | $3,456 | $864 |
| Bronchoscopy | $4,166 | $3,333 | $833 |
| Pilonidal Cyst Surgery | $4,151 | $3,321 | $830 |
| Ganglion Cyst Removal | $4,022 | $3,218 | $804 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $4,355 | $3,484 | $871 |
| Nuclear Stress Test | $2,205 | $1,764 | $441 |
| MRI Spine (Lumbar) | $1,719 | $1,375 | $344 |
| MRI Brain | $1,429 | $1,143 | $286 |
| MRI Spine (Cervical) | $1,379 | $1,103 | $276 |
| CT Angiography | $1,276 | $1,020 | $255 |
| MRI Knee | $1,202 | $962 | $240 |
| MRI Hip | $1,132 | $906 | $226 |
| MRI Shoulder | $1,048 | $839 | $210 |
| CT Scan Abdomen/Pelvis | $1,041 | $833 | $208 |
| Bone Scan | $873 | $699 | $175 |
| CT Scan Head | $855 | $684 | $171 |
| CT Scan Chest | $822 | $658 | $164 |
| CT Colonography (Virtual) | $749 | $599 | $150 |
| Echocardiogram | $733 | $587 | $147 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $312 | $249 | $62 |
| Allergy Testing | $308 | $247 | $62 |
| Mammogram (Screening) | $296 | $296 | $0 |
| Annual Wellness Visit | $263 | $263 | $0 |
| Bone Density Test (DEXA Scan) | $240 | $192 | $48 |
| Shingles Vaccination | $232 | $232 | $0 |
| Psychiatry Visit | $209 | $167 | $42 |
| Mental Health Counseling | $209 | $167 | $42 |
| Occupational Therapy Session | $185 | $148 | $37 |
| Physical Therapy Session | $184 | $147 | $37 |
| Wound Care Visit | $176 | $141 | $35 |
| Office Visit (New Patient) | $171 | $137 | $34 |
| Skin Cancer Screening | $164 | $131 | $33 |
| Speech Therapy Session | $161 | $128 | $32 |
| Vision Exam (Diabetic) | $148 | $119 | $30 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Vitamin D Level | $56 | $45 | $11 |
| BNP (Heart Failure Marker) | $52 | $42 | $10 |
| PSA (Prostate-Specific Antigen) | $50 | $40 | $10 |
| Thyroid Panel (TSH) | $44 | $35 | $9 |
| Blood Culture | $43 | $34 | $9 |
| Blood Type and Crossmatch | $40 | $32 | $8 |
| Comprehensive Metabolic Panel | $39 | $32 | $8 |
| Glucose Tolerance Test | $39 | $31 | $8 |
| Troponin Level | $32 | $26 | $6 |
| Urine Drug Screen | $31 | $25 | $6 |
| Liver Function Panel | $31 | $25 | $6 |
| Lipid Panel | $31 | $25 | $6 |
| Kidney Function Panel (BUN/Creatinine) | $31 | $25 | $6 |
| C-Reactive Protein (CRP) | $29 | $24 | $6 |
| Basic Metabolic Panel | $29 | $23 | $6 |
Compare Virginia With Other States
Frequently Asked Questions
How much does Medicare spend per person in Virginia?
In 2026, the average Medicare spending per beneficiary in Virginia is $11,977.
How many people are enrolled in Medicare in Virginia?
Virginia has approximately 1,572,772 Medicare beneficiaries.
Did Virginia expand Medicaid?
Yes, Virginia expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in Virginia?
The uninsured rate in Virginia is 3.1%.
What is the average Medigap premium in Virginia?
The average Medigap (Medicare Supplement) premium in Virginia is $304 per month.