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The other top private hospitals (Bumrungrad International, Samitivej, BNH, St Luke’s BGC, Makati Medical Center) do not publish full cardiac packages.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.
The companion piece on how the deposit-at-the-door rule works and where to put the patient through it sits elsewhere on this site. This one is the bill itself.
The procedure × hospital matrix
The published numbers, USD-converted at USD/THB 33.42 and USD/PHP 62.97 (project FX ledgers, October 2026).
| Procedure | Hospital | Local price | USD | Stay | Source |
|---|---|---|---|---|---|
| CAG day-case (transradial) | Bangkok Hospital | THB 62,100 | $1,858 | 0 nights | Bangkok Hospital, package valid to 31 Dec 2026 |
| CAG (transfemoral, 1 night) | Bangkok Hospital | THB 66,700 | $1,996 | 1 night | same |
| CAG (transradial, 1 night) | Bangkok Hospital | THB 69,000 | $2,065 | 1 night | same |
| CAG + PCI + stent (transfemoral) | Bangkok Hospital | THB 299,000 | $8,947 | 2 nights | Bangkok Hospital |
| CAG + PCI + stent (transradial) | Bangkok Hospital | THB 322,000 | $9,635 | 2 nights | same |
| CABG (on/off-pump) Level 1 | Bangkok Hospital | THB 1,173,000 | $35,099 | 8 nights | Bangkok Hospital cardiovascular surgery packages |
| CABG (on/off-pump) Level 2 | Bangkok Hospital | THB 1,437,500 | $43,013 | 8 nights | same |
| MICS CABG (minimally invasive) | Bangkok Hospital | THB 1,725,000 | $51,616 | 7 nights | same |
| Valve repair/replacement L1 | Bangkok Hospital | THB 966,000 | $28,905 | 8 nights | same |
| 3D endoscopic valve | Bangkok Hospital | THB 1,610,500 | $48,190 | 7 nights | same |
| ICU/CCU room-and-board | Bumrungrad International | THB 25,500/night | $763/night | per night | Bumrungrad, effective 1 Jan 2026 |
| ICU/CCU with family area | Bumrungrad International | THB 26,900/night | $805/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 | $1,029 | 0 nights | Asian Hospital 2025 cardiac packages |
| CAG upgrade (1 day private + telemetry) | Asian Hospital | PHP 85,000 | $1,350 | 1 night | same |
| CAG STAT (emergency) | Asian Hospital | PHP 109,500 | $1,739 | 1 night | same |
| CAG + PCI + 1 stent (Premium DES) | Asian Hospital | PHP 410,000 | $6,511 | 1 + 1 ICU | same |
| CAG + PCI + 2 stents (Premium DES) | Asian Hospital | PHP 505,000 | $8,020 | 1 + 1 ICU | same |
| CAG + PCI + 3 stents (Premium DES) | Asian Hospital | PHP 600,000 | $9,529 | 1 + 1 ICU | same |
| CAG + PCI + 4 stents (Premium DES) | Asian Hospital | PHP 690,000 | $10,958 | 1 + 1 ICU | same |
| STAT (emergency) surcharge | Asian Hospital | +PHP 30,000 | +$476 | — | same |
| Open-heart surgery (CABG, valve, septal) | Cardinal Santos | PHP 1,200,000 | $19,057 | private room | Cardinal Santos cardiac surgery package |
| Open-heart surgery (suite) | Cardinal Santos | PHP 1,300,000 | $20,645 | suite | same |
| Open-heart surgery (presidential suite) | Cardinal Santos | PHP 1,400,000 | $22,234 | presidential | same |
| Blood package (optional) | Cardinal Santos | +PHP 50,000 | +$794 | — | same |
| Private room/night | St Luke’s BGC | PHP 12,000–25,000 | $191–$397 | per night | Medicalpinas room rates 2024 |
| Suite/night | St Luke’s BGC | PHP 35,000–100,000 | $556–$1,588 | per night | same |
| Private room/night | Makati Medical Center | PHP 9,000–15,000 | $143–$238 | per night | same |
| ICU/night (triangulated) | SLMC / Makati Med | PHP 20,000–35,000 | $318–$556 | per night | triangulated; not separately published |
| Mechanical thrombectomy, cost to deliver (public, not a price) | Neurological Institute of Thailand | THB 568,587/patient | $17,013 | one admission | Worakijthamrongchai et al., J Health Syst Res 2022 (2015–2020 data) |
| IV thrombolysis, cost to deliver (public, not a price) | Neurological Institute of Thailand | THB 121,582/patient | $3,638 | one admission | same |
| Single room, all-in | Bumrungrad International | THB 14,700/night | $440/night | per night | Bumrungrad, effective 1 Jan 2026 |
| tPA / alteplase per vial (PH private) | private pharmacy | PHP 40,000–80,000 | $635–$1,270 | — | 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$3,052) 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$4,208 to 6,757). 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 about US$3,811 to 11,752. 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.
Bangkok Hospital does not publish what this costs. It publishes its cardiac packages and no stroke price, and Bumrungrad publishes none either. What is published is the cost of the same treatment to the state. The Neurological Institute of Thailand, the Ministry of Public Health’s own stroke centre, costed its thrombectomy patients at THB 568,587 each, about US17,013, for the procedure and the single admission, on 2015 to 2020 data. Rehabilitation and later complications are excluded. That is a cost to deliver, with no private margin in it, and it is the nearest published number to the bill he will be handed.
The room lines a private hospital adds are published, at Bumrungrad. Four nights in its ICU are THB 102,000 in room, service and meals. Ten nights in a single room are THB 147,000 (US$4,399). Neither line contains a drug, a scan or a physician’s fee. Then the complications: haemorrhagic conversion, pneumonia, decubitus, the 5.3 percent symptomatic intracerebral haemorrhage rate documented in the Thai thrombectomy cohort. Each adds to a total that neither hospital puts in writing before the patient is on the table.
The Manila equivalent at SLMC BGC or Makati Medical Center is no better documented: no published stroke price was located for either. The private rooms run PHP 12,000 to 25,000 a night (US$191 to 397) against Bumrungrad’s THB 14,700, and the imaging and physician lines are denominated in pesos. The alteplase vial is not cheaper: PHP 40,000 to 80,000 in a private pharmacy, free only at the government hospitals a foreign retiree is rarely taken to.
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 Thailand’s public neurological institute delivers at a cost of about US17,013, admission included) 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 | BKK / MNL self-pay No hospital-published price located (BKK or MNL); Thai public cost to deliver ~US$17,000 | US uninsured (chargemaster) US$60,000–150,000+ | SE Asia advantage Not computable without a published private price |
| ACS + PCI + 1–3 drug-eluting stents | BKK / MNL self-pay US$6,500–9,600 (published packages) | US uninsured (chargemaster) ~US$53,384 (uninsured AMI average) | SE Asia advantage 5–8× cheaper |
| Coronary artery bypass (CABG) | BKK / MNL self-pay US$19,000–52,000 (published packages) | US uninsured (chargemaster) US$70,000–200,000+ (chargemaster) | SE Asia advantage 3–4× cheaper |
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 twice. First the Bangkok course, at a price the hospital did not publish. Then roughly US$150,000 for the medevac, the middle of the published band, before the US rehab bill begins. The flight alone, self-paid out of capital that was meant to last twenty-five years, is three years of runway at a US$50,000 annual draw. That is the fallback that was supposed to be free.
ICU-jet medevac Bangkok to the US, middle of the US$120,000–180,000 band. At a $50k annual draw that is three years off a 25-year runway, before the Bangkok course or the US rehab bill.
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.
The bills are the bills
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 published cardiac packages is three to eight times higher; on the stroke, none of these hospitals publishes the number to compare. 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.