A vacation abroad usually has Americans daydreaming about the Eiffel Tower or Venetian canals. But more and more, they now have visions of operating rooms and all the money they can save by getting a nose job in Singapore.  Medical tourism is on the rise in the U.S. People are heading to foreign soil for just about every medical procedure out there, at a fraction of the price.

"We live in a society where health care companies know that Americans will pay significantly more for these services and other countries simply won't," says Jonathan Edelheit, president of West Palm Beach, Fla.-based Medical Tourism Association, Inc. "Therefore, we pay a premium on treatment, drugs, medical supplies and everything else. Most times we're paying premiums on the exact same products they have in other countries."

Edelheit says tourists can save as much as 90% on a medical procedure. According to the association's magazine, heart valve replacement surgery costs $159,000 in the U.S. and $9,000 in India. A spinal fusion procedure costs $63,000 here and $9,000 in Singapore. A $44,000 U.S. hip replacement runs about $12,000 in Thailand.