South Dakota’s medical cannabis program was designed to provide safe, legal access for qualifying patients. Yet current dispensary prices for flower — the most common form of medicine — remain dramatically higher than in mature recreational markets like Colorado and Washington. This price gap directly burdens patients, limits access, and undermines the voter-approved goal of a patient-first system.
This article compares benchmark prices for eighths (3.5 grams) and ounces (28 grams) of cannabis flower across the three states using the most recent available dispensary menus, state reports, and market analyses as of April 2026. The data shows South Dakota patients consistently pay 30–100%+ more for comparable product.
Methodology of Research
Prices were compiled from publicly available dispensary menus, state regulatory reports, and independent market analyses during the week of April 27–30, 2026. South Dakota prices reflect medical-only dispensaries in Sioux Falls, Rapid City, and other locations. Colorado and Washington prices reflect recreational market averages from mature, competitive markets. All figures are retail prices before tax. Data sources include direct menu screenshots, state DOH/MMJ program reports, and third-party cannabis market trackers. Where ranges are given, they represent typical mid-to-high quality flower. All sources are cited in footnotes.
1/8 oz (3.5 g) Flower
• South Dakota (medical only): $35–$55 per eighth¹
• Colorado (recreational): $15–$25 per eighth²
• Washington (recreational): $16–$26 per eighth³
1 oz (28 g) Flower
• South Dakota: $300–$420 per ounce⁴
• Colorado: $200–$260 per ounce⁵
• Washington: $230–$290 per ounce⁶
These benchmarks reflect average or typical retail prices for mid-to-high quality flower. South Dakota’s limited competition, high regulatory fees, and medical-only structure keep prices elevated, while Colorado and Washington benefit from mature recreational markets, oversupply, and aggressive competition.⁷
Why South Dakota Prices Are Higher
South Dakota operates a strictly medical program with tight licensing limits, high annual fees (recently increased nearly 70%), and residency requirements that restrict new entrants.⁸ Colorado and Washington, by contrast, have long-established recreational markets with hundreds of cultivators and retailers driving prices down through competition and economies of scale.⁹
State reports and market analyses confirm the disparity:
• South Dakota’s average ounce price for high-quality flower hovers around $335–$351.¹⁰
• Colorado’s mature market has pushed average ounce prices down to approximately $241.¹¹
• Washington maintains similarly competitive pricing around $232–$234 per ounce.¹²
The price gap is not due to product quality differences alone — it stems from structural factors: limited supply, high compliance costs passed to patients, and lack of recreational competition.¹³
Patient Impact in South Dakota
Higher prices directly reduce access. South Dakota patients are limited to 3 ounces every 14 days.¹⁴ At current rates, that monthly supply can cost $900–$1,200+ for many patients — a significant burden for those on fixed incomes or with chronic conditions.¹⁵
In Colorado and Washington, the same quantity generally costs significantly less, freeing up patient resources and improving access.¹⁶
Policy Implications and Path Forward
The data underscores the need for greater competition, fee reform, and alignment with federal developments (including Schedule I changes) to lower prices and fulfill the patient-focused mandate of Initiated Measure 26.¹⁷
South Dakota patients deserve medicine at prices comparable to other legal markets. Transparency, more licenses, and reduced barriers are essential to making the program truly work for those it was created to serve.
Footnotes
¹ The Flower Shop (Sioux Falls) Menu, April 2026 (eighth prices $35–$55 range); Cannabis Health Rapid City Menu, April 2026; SD DOH Medical Cannabis Program Dispensary Data, April 2026.
² Cannabis Business Times, “How Much Does a Gram, Ounce of Cannabis Flower Cost in 2026” (Jan. 13, 2026), https://www.cannabisbusinesstimes.com/business-issues-benchmarks/sales-trends/news/15814457/how-much-does-a-gram-ounce-of-cannabis-flower-cost-in-2026; Headset.io Colorado Market Report, March 2026.
³ Headset.io Washington Cannabis Prices and Trends (March 2026 data); Washington State Liquor and Cannabis Board Market Reports, April 2026.
⁴ Oxford Treatment Center, “The Average Cost of Marijuana by State” (Jan. 14, 2026), https://oxfordtreatment.com/substance-abuse/marijuana/average-cost-of-marijuana/ (SD high-quality ounce ~$335–$351); SD DOH Program Data, April 2026.
⁵ Cannabis Business Times supra note 2 (Colorado average ounce ~$200–$260); Headset.io Colorado Market Report, March 2026.
⁶ Oxford Treatment Center supra note 4 (Washington high-quality ounce ~$233).
⁷ South Dakota Searchlight, “South Dakota Medical Marijuana Businesses Are Facing a $3,690 Fee Increase” (July 29, 2024); Cannabis Benchmarks, U.S. Cannabis Spot Price Index reports (2026 data).
⁸ S.D. Codified Laws § 34-20G-1 et seq.; ARSD 44:90; South Dakota Searchlight supra note 7.
⁹ Cannabis Business Times supra note 2; Headset.io State Market Reports (Colorado and Washington, 2026).
¹⁰ Oxford Treatment Center supra note 4.
¹¹ Cannabis Business Times supra note 2.
¹² Headset.io supra note 3.
¹³ South Dakota Department of Health Medical Cannabis Program Data & Statistics (April 2026); Cannabis Benchmarks reports (2026).
¹⁴ S.D. Codified Laws § 34-20G-71 (purchase limits).
¹⁵ Patient cost calculations based on average SD ounce prices × typical monthly usage for qualifying patients.
¹⁶ Comparative calculations using Colorado and Washington averages from sources cited above.
¹⁷ Initiated Measure 26 (2020); South Dakota Medical Cannabis Program Data & Statistics (April 2026).
¹⁸ South Dakota Searchlight, Annual Fees for Medical Marijuana Businesses Will Jump 70 Percent (Aug. 20, 2024), https://southdakotasearchlight.com/2024/08/20/annual-fees-for-medical-marijuana-businesses-will-jump-70-percent/.
¹⁹ Cannabis Business Times supra note 2.
²⁰ Headset.io State Market Reports (2026).
²¹ Oxford Treatment Center supra note 4.
²² S.D. Codified Laws ch. 34-20G.
²³ ARSD 44:90:03:05 (management plan requirements).
²⁴ South Dakota Department of Health Medical Cannabis Program Annual Report (FY 2024).
²⁵ Washington State Liquor and Cannabis Board Market Reports (April 2026).
²⁶ Colorado Department of Revenue, Marijuana Enforcement Division Data (2026).
²⁷ Cannabis Business Times, Sales Trends and Benchmarks (Jan. 2026).
²⁸ Headset.io, U.S. Cannabis Price Index (March 2026).
²⁹ South Dakota Medical Cannabis Program Patient Access Data (April 2026).
³⁰ Initiated Measure 26, South Dakota (2020); SDCL § 34-20G-1 (findings and purpose).
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