Medicare & Medicaid in Washington (WA)
2026 healthcare costs, coverage, and spending data for Washington.
$9,870
Spending/Capita
1,357,208
Medicare Enrollees
1,842,945
Medicaid Enrollees
3.0%
Uninsured Rate
Medicare Premiums in Washington
Part B Premium
$185/mo
Part D Premium (Avg)
$33/mo
Medigap Premium (Avg)
$129/mo
Medicaid Expansion: Yes - Washington expanded Medicaid under the ACA
Procedure Costs in Washington
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Kidney Transplant | $148,949 | $119,159 | $29,790 |
| Liver Transplant | $145,003 | $116,002 | $29,001 |
| Coronary Artery Bypass Graft (CABG) | $88,119 | $70,495 | $17,624 |
| Heart Valve Replacement | $77,017 | $61,614 | $15,403 |
| Defibrillator Implantation (ICD) | $40,951 | $32,761 | $8,190 |
| Total Knee Replacement | $40,403 | $32,323 | $8,081 |
| Spinal Fusion | $37,681 | $30,145 | $7,536 |
| Laminectomy | $32,194 | $25,755 | $6,439 |
| Total Hip Replacement | $26,825 | $21,460 | $5,365 |
| Colectomy | $25,789 | $20,631 | $5,158 |
| Cardiac Catheterization with Stent | $25,420 | $20,336 | $5,084 |
| Sepsis Treatment | $24,078 | $19,262 | $4,816 |
| Pacemaker Implantation | $23,625 | $18,900 | $4,725 |
| Carotid Endarterectomy | $21,460 | $17,168 | $4,292 |
| Mastectomy | $19,516 | $15,613 | $3,903 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| TURP (Prostate) | $9,881 | $7,905 | $1,976 |
| Lithotripsy (Kidney Stones) | $7,244 | $5,795 | $1,449 |
| Dialysis Access Surgery | $6,826 | $5,461 | $1,365 |
| Arthroscopic Knee Surgery | $6,235 | $4,988 | $1,247 |
| Endoscopic Sinus Surgery | $6,017 | $4,814 | $1,203 |
| Tonsillectomy | $5,279 | $4,223 | $1,056 |
| Bunionectomy | $5,231 | $4,184 | $1,046 |
| Hemorrhoid Surgery | $4,697 | $3,757 | $939 |
| Septoplasty | $4,610 | $3,688 | $922 |
| Carpal Tunnel Release | $4,585 | $3,668 | $917 |
| Nasal Polyp Removal | $4,328 | $3,462 | $866 |
| Pilonidal Cyst Surgery | $4,045 | $3,236 | $809 |
| Cataract Surgery (Outpatient) | $3,810 | $3,048 | $762 |
| Bronchoscopy | $3,653 | $2,922 | $731 |
| Breast Biopsy | $3,580 | $2,864 | $716 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $2,770 | $2,216 | $554 |
| MRI Spine (Cervical) | $1,713 | $1,370 | $343 |
| MRI Brain | $1,690 | $1,352 | $338 |
| Nuclear Stress Test | $1,664 | $1,332 | $333 |
| CT Angiography | $1,526 | $1,220 | $305 |
| MRI Knee | $1,477 | $1,181 | $295 |
| MRI Shoulder | $1,314 | $1,051 | $263 |
| MRI Spine (Lumbar) | $1,274 | $1,019 | $255 |
| MRI Hip | $1,216 | $973 | $243 |
| CT Scan Chest | $983 | $787 | $197 |
| CT Scan Head | $979 | $783 | $196 |
| CT Scan Abdomen/Pelvis | $958 | $766 | $192 |
| Bone Scan | $776 | $621 | $155 |
| CT Colonography (Virtual) | $756 | $604 | $151 |
| Echocardiogram | $661 | $529 | $132 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $418 | $334 | $84 |
| Allergy Testing | $246 | $197 | $49 |
| Mammogram (Screening) | $234 | $234 | $0 |
| Wound Care Visit | $233 | $186 | $47 |
| Mental Health Counseling | $226 | $180 | $45 |
| Psychiatry Visit | $223 | $178 | $45 |
| Annual Wellness Visit | $194 | $194 | $0 |
| Office Visit (New Patient) | $189 | $151 | $38 |
| Speech Therapy Session | $186 | $149 | $37 |
| Shingles Vaccination | $186 | $186 | $0 |
| Bone Density Test (DEXA Scan) | $170 | $136 | $34 |
| Office Visit (Established Patient) | $157 | $126 | $31 |
| Occupational Therapy Session | $150 | $120 | $30 |
| Skin Cancer Screening | $150 | $120 | $30 |
| Podiatry Visit | $142 | $113 | $28 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| BNP (Heart Failure Marker) | $60 | $48 | $12 |
| Vitamin D Level | $57 | $46 | $11 |
| Blood Type and Crossmatch | $51 | $41 | $10 |
| Blood Culture | $46 | $37 | $9 |
| Liver Function Panel | $43 | $34 | $9 |
| Iron Studies (Ferritin) | $41 | $33 | $8 |
| Lipid Panel | $39 | $31 | $8 |
| Glucose Tolerance Test | $37 | $30 | $7 |
| Troponin Level | $37 | $30 | $7 |
| Thyroid Panel (TSH) | $37 | $29 | $7 |
| PSA (Prostate-Specific Antigen) | $36 | $29 | $7 |
| Comprehensive Metabolic Panel | $35 | $28 | $7 |
| B12 Level | $33 | $27 | $7 |
| Pap Smear Lab Processing | $29 | $23 | $6 |
| Stool Occult Blood Test | $28 | $28 | $0 |
Compare Washington With Other States
Frequently Asked Questions
How much does Medicare spend per person in Washington?
In 2026, the average Medicare spending per beneficiary in Washington is $9,870.
How many people are enrolled in Medicare in Washington?
Washington has approximately 1,357,208 Medicare beneficiaries.
Did Washington expand Medicaid?
Yes, Washington expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in Washington?
The uninsured rate in Washington is 3.0%.
What is the average Medigap premium in Washington?
The average Medigap (Medicare Supplement) premium in Washington is $129 per month.