On learning he needed heart surgery last spring, Larry Shaw's first question was: How much?

The surgeon's fee, between $1,500 and $2,000, was within Shaw's means as a self-insured businessman. But the angioplasty, including placement of a thin tube in a clogged artery, would require a one-night hospital stay. He called the closest major medical center to his Dallas home. Estimated charge: $47,000, not including anesthesia.

Shaw's next calls were to Thailand and India.

The price at Bangkok's private Bumrungrad International Hospital: $6,400, including a two-night stay, surgeon's fees, anesthesiologist and drugs. The Apollo hospital in New Delhi $4,600.

A few weeks later, in late June, Shaw and his wife, Kathy, are more than 9,000 miles from home, walking the marble floors of a Bangkok hospital lobby that looks like the entrance to a newly renovated Hilton. Shaw, by economic necessity, is joining an ever-growing trend: medical travel, sometimes referred to as medical tourism.