Si está utilizando SQL 2005 o mejor, este es un buen cálculo de mediana simple para una sola columna en una tabla:
SELECT
(
(SELECT MAX(Score) FROM
(SELECT TOP 50 PERCENT Score FROM Posts ORDER BY Score) AS BottomHalf)
+
(SELECT MIN(Score) FROM
(SELECT TOP 50 PERCENT Score FROM Posts ORDER BY Score DESC) AS TopHalf)
) / 2 AS Median