Bangkok Hospital publishes its cardiac packages. Coronary angiogram THB 62,100 day-case. Angioplasty with one stent THB 299,000 to 322,000. Coronary artery bypass THB 1,173,000 to 1,437,500. The list is in baht, on the public website, with line-item exclusions and the eight-night length of stay spelt out at the bottom of the page. Asian Hospital in Alabang publishes its 2025 cardiac sheet with the same honesty, in pesos. Cardinal Santos publishes its open-heart package. Three hospitals, three published price lists, three bills the uninsured Western expat can look up in advance.
The other top private hospitals (Bumrungrad International, Samitivej, BNH, St Luke’s BGC, Makati Medical Center) do not publish full cardiac packages. The silence is part of the bill. This piece is the procedure × hospital matrix the published hospitals provide and the academic literature backs, then the US comparator the “fly home” plan never prices, then the medevac line that exceeds either. This is data analysis, not advice; verify any specific with the hospital, your treating physician, and a licensed insurance broker before acting.
The companion piece on how the deposit-at-the-door rule works and where to put the patient through it sits one cluster over. This one is the bill itself.
The procedure × hospital matrix
The published numbers, USD-converted at USD/THB 32.68 and USD/PHP 57 (project ledger May 2026 mid).
| Procedure | Hospital | Local price | USD | Stay | Source |
|---|---|---|---|---|---|
| CAG day-case (transradial) | Bangkok Hospital | THB 62,100 | $1,900 | 0 nights | Bangkok Hospital, package valid to 31 Dec 2026 |
| CAG (transfemoral, 1 night) | Bangkok Hospital | THB 66,700 | $2,041 | 1 night | same |
| CAG (transradial, 1 night) | Bangkok Hospital | THB 69,000 | $2,111 | 1 night | same |
| CAG + PCI + stent (transfemoral) | Bangkok Hospital | THB 299,000 | $9,148 | 2 nights | Bangkok Hospital |
| CAG + PCI + stent (transradial) | Bangkok Hospital | THB 322,000 | $9,853 | 2 nights | same |
| CABG (on/off-pump) Level 1 | Bangkok Hospital | THB 1,173,000 | $35,894 | 8 nights | Bangkok Hospital cardiovascular surgery packages |
| CABG (on/off-pump) Level 2 | Bangkok Hospital | THB 1,437,500 | $43,985 | 8 nights | same |
| MICS CABG (minimally invasive) | Bangkok Hospital | THB 1,725,000 | $52,786 | 7 nights | same |
| Valve repair/replacement L1 | Bangkok Hospital | THB 966,000 | $29,560 | 8 nights | same |
| 3D endoscopic valve | Bangkok Hospital | THB 1,610,500 | $49,281 | 7 nights | same |
| ICU/CCU room-and-board | Bumrungrad International | THB 25,500/night | $780/night | per night | Bumrungrad, effective 1 Jan 2026 |
| ICU/CCU with family area | Bumrungrad International | THB 26,900/night | $823/night | per night | same |
| PCI + 1 stent (base, aggregator) | Bumrungrad International | ~US$7,000 | $7,000 | varies | Bookimed, Medigence aggregator |
| Coronary angiogram | Bumrungrad International | US$2,050–2,250 | $2,050–2,250 | varies | Bookimed |
| CAG outpatient | Asian Hospital (Alabang) | PHP 64,800 | $1,137 | 0 nights | Asian Hospital 2025 cardiac packages |
| CAG upgrade (1 day private + telemetry) | Asian Hospital | PHP 85,000 | $1,491 | 1 night | same |
| CAG STAT (emergency) | Asian Hospital | PHP 109,500 | $1,921 | 1 night | same |
| CAG + PCI + 1 stent (Premium DES) | Asian Hospital | PHP 410,000 | $7,193 | 1 + 1 ICU | same |
| CAG + PCI + 2 stents (Premium DES) | Asian Hospital | PHP 505,000 | $8,860 | 1 + 1 ICU | same |
| CAG + PCI + 3 stents (Premium DES) | Asian Hospital | PHP 600,000 | $10,526 | 1 + 1 ICU | same |
| CAG + PCI + 4 stents (Premium DES) | Asian Hospital | PHP 690,000 | $12,105 | 1 + 1 ICU | same |
| STAT (emergency) surcharge | Asian Hospital | +PHP 30,000 | +$526 | — | same |
| Open-heart surgery (CABG, valve, septal) | Cardinal Santos | PHP 1,200,000 | $21,053 | private room | Cardinal Santos cardiac surgery package |
| Open-heart surgery (suite) | Cardinal Santos | PHP 1,300,000 | $22,807 | suite | same |
| Open-heart surgery (presidential suite) | Cardinal Santos | PHP 1,400,000 | $24,561 | presidential | same |
| Blood package (optional) | Cardinal Santos | +PHP 50,000 | +$877 | — | same |
| Private room/night | St Luke’s BGC | PHP 12,000–25,000 | $210–439 | per night | Medicalpinas room rates 2024 |
| Suite/night | St Luke’s BGC | PHP 35,000–100,000 | $614–1,754 | per night | same |
| Private room/night | Makati Medical Center | PHP 9,000–15,000 | $158–263 | per night | same |
| ICU/night (triangulated) | SLMC / Makati Med | PHP 20,000–35,000 | $350–614 | per night | triangulated; not separately published |
| Mechanical thrombectomy (named BKK private) | Bangpakok 9 / Sikarin / Kasemrad | US$6,400–13,100 | $6,400–13,100 | varies | Medigence per-hospital |
| Mechanical thrombectomy (Thailand range) | Bangkok private hospitals | THB 260,000–460,000 | $8,000–14,000 | varies | Medijourney aggregator |
| IV thrombolysis (tPA at top BKK) | named published-package hospitals | US$3,300–6,600 | $3,300–6,600 | — | Medigence |
| tPA / alteplase per vial (PH private) | private pharmacy | PHP 40,000–80,000 | $700–1,400 | — | Medicalpinas; Philippine Stroke Society |
The shape of the matrix matters as much as any single number. The hospitals that publish the most run their pricing as a comparator product, calibrated for medical-tourism enquiries from people who will read the line items before they fly in. The hospitals that publish the least run their pricing as a discovery process at admission, calibrated for the patient who is already on the trolley. The expat planning a worst case should plan against the Bangkok Hospital and Asian Hospital schedules, because those are the bills he can actually verify; the Bumrungrad, Samitivej and St Luke’s bills will land in the same band — with more variance and less negotiation room.
What ICU days cost
The Sribundit Thai academic baseline for acute ischaemic stroke at a tertiary government hospital (n=335, 2008 prices) put mean direct medical cost at THB 42,400 (about US$1,211 at 2008 FX), with mean length of stay 5.7 days; 57 percent of the cost was room and routine, 23 percent imaging. That is the public-system floor for what an event of this severity costs to deliver before private-hospital margins, drug-eluting devices, branded pharmaceuticals and physician fees are added.
The Bumrungrad ICU room rate of THB 25,500 to 27,200 per night, effective 1 January 2026, is room-and-board only. A four-night ICU stay at Bumrungrad bills about THB 102,000 (US$3,120) before the ventilator, before the antibiotics, before the heparin, before the consulting cardiologist or neurologist, before the daily imaging, before the dialysis if the kidneys fail under the strain of the event. The realised ICU day-rate all-in lands closer to US$1,500–3,000 per night at the top private hospitals once those lines are included, with wide variance. The published room rate is the floor of the floor.
The PhilHealth gap
The Philippine half of this story has a second wall the Thai half does not have. PhilHealth’s case-rate ceiling for acute coronary syndrome with PCI is PHP 39,750. The Philippine Journal of Cardiology peer-reviewed study puts the actual cost of that hospitalisation at PHP 265,000 to 425,500 (US$4,650 to 7,465). PhilHealth pays a tenth of the bill. The remainder is out of pocket or borne by private cover.
PhilHealth raised its CABG case rate in March 2025 to PHP 660,000 to 960,000 from a prior PHP 550,000. Read against the Cardinal Santos open-heart package of PHP 1.2 to 1.4 million, the gap is between PHP 240,000 and 740,000, or roughly US$4,200 to 13,000. That gap is the part of the bill the “I have PhilHealth, I’m fine” plan does not anticipate. PhilHealth pays the case rate. The hospital sends the rest.
A Filipino on PhilHealth survives this gap by family, by HMO, by mortgage on the house. A Western expat without an HMO and without local family pays it cash before the patient is discharged — or watches the patient sit in the bed under the Anti-Hospital Deposit Law until the bill is resolved.
The stroke episode all-in
Build the bill for a single specific case. A 64-year-old Western expat in Bangkok wakes with right-sided weakness and dysphasia at 06:00. He arrives at Bangkok Hospital ER at 07:10. Non-contrast CT and CT angiogram are negative for haemorrhage; the angiogram shows a left M1 occlusion. IV alteplase is given at 07:35 (door-to-needle 25 minutes; the Thai mothership-model median is 38 ± 23 minutes per the published thrombolytic-paradigm study). The patient is taken to the angiography suite for mechanical thrombectomy at 08:15, TICI 2b reperfusion at 08:55. He goes to neuro-ICU at 09:40.
The procedural component bills at roughly US$8,000 to 14,000 for the thrombectomy, US$3,300 to 6,600 for the tPA, US$2,000 to 3,500 for the door imaging. Four days in neuro-ICU at all-in US$1,500 to 3,000 per night runs US$6,000 to 12,000. Ten days on the stroke ward at all-in US$400 to 800 per night runs US$4,000 to 8,000. Inpatient rehab is a long tail of US$2,000 to 10,000 depending on whether he walks out clean. The bill at discharge: roughly US$25,000 to 55,000 all-in, before complications. Add complications (haemorrhagic conversion, pneumonia, decubitus, the 5.3 percent symptomatic intracerebral haemorrhage rate documented in the Thai thrombectomy cohort) and the bill tracks toward the US$60,000 ceiling.
The Manila equivalent at SLMC BGC or Makati Medical Center lands a little lower, mainly because the private rooms publish at PHP 12,000 to 25,000 a night (US$210 to 440) vs the Bangkok all-in ward rate, and the imaging and physician lines are denominated in pesos. Plan against US$13,000 to 45,000 all-in for the same event. The tPA, the dollar consumables and the imaging equipment do not differ much across the strait.
The mortality data the hospitals do not publish
Bangkok Hospital, Samitivej, Bumrungrad, St Luke’s BGC and Makati Medical Center do not publish 30-day case fatality rates for stroke or AMI on their public pages. The procedural-success rates they cite (Bumrungrad’s “99 percent PCI success rate” is the example) are procedural success — not patient survival. The two are different events.
The Thai academic literature, when it speaks at all, says this. A Thai mechanical-thrombectomy cohort recorded 8.3 percent in-hospital mortality after the procedure and 5.3 percent symptomatic intracerebral haemorrhage. Door-to-needle time for IV thrombolysis in Thai delivery models split sharply by transfer pathway: mothership 38 ± 23 minutes, drip-and-ship 63 ± 44 minutes, ship-and-drip 146.5 ± 62 minutes. The Bangkok private hospitals operate as mothership. The Phuket, Pattaya, Chiang Mai and provincial cases route as drip-and-ship or ship-and-drip and pay the time-to-treatment penalty.
This is the half of the bill that does not show up on the invoice. The bill at Bangkok Hospital is precise. The 30-day survival curve is not advertised. Plan against both.
The go-home fallacy
The other comparator that does not show up on the published list is what the same event costs to treat in the United States uninsured. The most recent isolated study of uninsured US AMI hospitalisations put the average bill at US$53,384, approximately three times the all-payer mean of about US$20,000. The US chargemaster mechanic is documented in a peer-reviewed hospital price transparency examination: hospital cash and self-pay prices average 60 percent above negotiated insurer rates, and chargemaster list prices average 164 percent above. Uninsured US patients are billed at chargemaster unless they negotiate down to cash.
US ischaemic stroke direct medical cost runs US$30,000 to 120,000 per patient (AHA / Resolve). Thrombectomy episodes (the same procedure the Bangkok hospital prices at US$8,000 to 14,000) run US$60,000 to 150,000 or more in a US hospital. The American Heart Association puts US national stroke-related cost at US$56.2 billion for 2019–20. Roughly 70 to 90 percent of uninsured US emergency hospitalisations meet the WHO definition of catastrophic health spending. The “fly home” plan does not price the bill that arrives once he lands.
| Event | BKK / MNL self-pay | US uninsured (chargemaster) | SE Asia advantage |
|---|---|---|---|
| Ischaemic stroke + thrombectomy + ICU + ward | US$15,000–60,000 (BKK); US$13,000–45,000 (MNL) | US$60,000–150,000+ | 4–6× cheaper |
| ACS + PCI + 1–3 drug-eluting stents | US$7,000–10,500 (published packages) | ~US$53,384 (uninsured AMI average) | 5–7× cheaper |
| Coronary artery bypass (CABG) | US$21,000–53,000 (published packages) | US$70,000–200,000+ (chargemaster) | 3–4× cheaper |
Source: Bangkok Hospital, Asian Hospital and Cardinal Santos published 2025–2026 packages; Resolve Medical Bills uninsured-AMI synthesis; AHA / Resolve US stroke direct cost; hospital price transparency examination (PMC9464687) · checked 2026-05-30
The retiree who priced his “I’ll just go home” assumption against the all-payer mean (US$20,000) instead of the uninsured chargemaster (US$53,384, or worse) made a four-times error. The retiree who priced it against a single-payer counterpart (NHS, Medicare-eligible) when he is not single-payer eligible made an infinite-times error. Most do.
The repatriation tail
On top of either bill sits the flight. Travel Care Air’s 2026 guide puts an ICU-equipped air ambulance from Bangkok or Manila to the United States at US$120,000 to 180,000. A commercial-flight stretcher with medical escort, only available if the patient is stable enough to fly without a ventilator, runs US$25,000 to 30,000. Allianz Partners, International SOS and Medical Air Service quote similar bands.
Ordinary expat health insurance does not pay either. Only specific IPMI policies with explicit emergency-evacuation cover, certain credit-card travel-medical extensions, and the dedicated medevac-membership products (MedjetAssist, AirMed International) do. The retiree who said “I’ll just fly home if it goes wrong” priced the wrong country bill, then forgot the flight.
A 64-year-old who hits an ischaemic stroke at Bangkok Hospital, has a successful thrombectomy, spends fourteen days in ICU and ward, recovers to walking with a frame, and is then flown ICU-jet to the US for further rehab pays: roughly US$45,000 for the BKK course, roughly US$150,000 for the medevac, before the US rehab bill begins. That is a US$195,000 episode on what was supposed to be a free fallback. Self-paid out of capital that was meant to last twenty-five years — the episode shortens the runway by roughly four years at a US$50,000 annual draw. Add the rehab bill on landing.
BKK Hospital course (~$45k) + ICU-jet medevac to the US (~$150k), before the US rehab bill starts. At a $50k annual draw that is roughly four years off a 25-year runway, paid for one stroke.
The trend, behind the bill
The trajectory under all of this is the medical-cost trend rate. Aon’s 2026 APAC report puts gross trend at 11.3 percent for 2026 (net 8.9 percent) against a global average of 9.7 percent, with cardiovascular disease named a top cost driver. WTW’s November 2025 outlook projects APAC double-digit medical trend persisting through 2026 at a 14 percent headline. WTW’s 2025 Global Medical Trends Survey put the Philippine medical-cost rise at 18.3 percent for 2025, second-highest in APAC, and the Philippine HMO industry posted PHP 4.27 billion of losses in 2023 from claim and benefit surges.
The bills in the matrix above are 2025 and 2026 numbers. Compound them at 11 to 14 percent a year for a decade and the Bangkok Hospital CABG package of THB 1.44 million in 2026 prices is THB 4.1 to 5.3 million by 2036. The matrix is a snapshot, not a forecast. The trajectory under the snapshot is the line the article cannot draw, but the retiree should.
Cold close
The bills are the bills. Bangkok Hospital writes them down. So does Asian Hospital. So does Cardinal Santos. The rest of the top tier prefers the discovery process at admission. The numbers above are the floor of what the uninsured Western expat pays at the top private hospitals in Thailand and the Philippines for the two acute events that end most expat runways. The US comparator on the same events is roughly four to six times higher. The medevac to get there is US$120,000 to 180,000 on top, payable by no standard cover.
The retiree who skipped IPMI because “I’m healthy” or “I’ll just go home if it goes wrong” priced none of this. The bill is published. The plan was not.
Questions
What does a stroke cost at a top private hospital in Bangkok?
A serious ischaemic stroke with intravenous thrombolysis (tPA), mechanical thrombectomy, three to five days of ICU and one to two weeks of ward at Bumrungrad, Bangkok Hospital or Samitivej runs roughly US$15,000 to 60,000 self-pay. The thrombectomy procedure alone is in the US$8,000–14,000 band; tPA at the named published-package hospitals runs US$3,300–6,600; Bumrungrad ICU room-and-board is THB 25,500 to 27,200 (~US$780–832) per night before drugs, ventilator and physicians; ward, imaging and rehab fill the rest. The Sribundit 2017 Thai academic study put the Thai public-system baseline at THB 42,400 (~US$1,211) at 2008 prices, which is the public-system floor and not the private-hospital bill.
What does a heart attack with stents cost at a top private hospital?
Bangkok Hospital publishes a CAG plus PCI plus stent package at THB 299,000 to 322,000 (~US$9,150–9,850) for the two-night CCU and IPD stay. Asian Hospital in Alabang publishes one stent at PHP 410,000 (~US$7,193) for the Premium DES tier, two stents PHP 505,000 (~US$8,860), three stents PHP 600,000 (~US$10,530) and four stents PHP 690,000 (~US$12,100), with a PHP 30,000 STAT emergency surcharge. Bumrungrad does not publish cardiac packages; aggregators put a single-stent PCI base at about US$7,000, plus 30 to 40 percent for drug-eluting stents, 35 to 40 percent per additional vessel and 25 percent for emergency or ICU presentation. The Philippine Journal of Cardiology peer-reviewed cost study puts ACS with PCI at PHP 265,000 to 425,500 (~US$4,650–7,465).
What does CABG cost at a top private hospital in SE Asia?
Bangkok Hospital publishes a CABG package, on-pump or off-pump, at THB 1,173,000 to 1,437,500 (~US$35,900–44,000) across eight nights; minimally invasive MICS CABG at THB 1,725,000 (~US$52,800) across seven nights. Cardinal Santos in Manila publishes a single open-heart surgical package covering CABG and valve surgery at PHP 1,200,000 (private room), 1,300,000 (suite) or 1,400,000 (presidential suite), about US$21,000 to 24,600, with an optional PHP 50,000 blood package. PhilHealth raised its CABG case rate in March 2025 to PHP 660,000 to 960,000, well below the Cardinal Santos private package; the gap is borne out of pocket or by private cover.
How does the SE Asia bill compare to going back to the US uninsured?
The most recent isolated study of uninsured US AMI hospitalisations put the average bill at US$53,384, against an all-payer mean of approximately US$20,000. US ischaemic stroke direct medical cost runs US$30,000 to 120,000 per patient; thrombectomy episodes reach US$60,000 to 150,000 or higher. US hospital cash and self-pay prices average 60 percent above negotiated insurer prices; chargemaster list prices average 164 percent above negotiated. Uninsured US patients are billed at chargemaster unless they negotiate, and 70 to 90 percent of uninsured US emergency hospitalisations meet the WHO definition of catastrophic health spending. The same event in Bangkok or Manila costs the uninsured expat roughly one quarter to one sixth of the US chargemaster bill.
How much does air-ambulance repatriation cost?
An ICU-equipped air ambulance from Bangkok or Manila to the United States runs approximately US$120,000 to 180,000. A commercial-flight stretcher with medical escort, available only if the patient is stable enough, runs US$25,000 to 30,000. Standard expat health cover does not pay either; only specific IPMI and travel-medical policies with explicit emergency-evacuation cover do. The repatriation cost is the line that exceeds the entire SE Asia hospital course and that the "I will fly home if it goes wrong" plan never accounts for.