Uninsured but Undaunted, a Surgical Patient Searched the Globe for a Deal - KFF Health News
Skip to main content
Trump 2.0BackTrump 2.0
Agency Watch
State Watch
Rural Health Payout
Public HealthBackPublic Health
Vaccines
CDC & Disease
Environmental Health
All Public Health
Audio ReportsBackAudio Reports
What the Health?
Healthcare Helpline
KFF Health News Minute
An Arm and a Leg
Health Hub
HealthQ
Silence in Sikeston
Epidemic
All Audio
Special ReportsBackSpecial Reports
Bill Of The Month
Common Ground
Diagnosis: Debt
The Body Shops
Priced Out
Guns, Race, and Profit
Broken Rehab
Dead Zone
Denied
Opioid Settlement Tracking
Eleven Minutes
All Special Reports
More TopicsBackMore Topics
Elections
Healthcare Costs
Insurance
Prescription Drugs
Health Industry
Immigration
Reproductive Health
Technology
Rural Health
Race and Health
Aging
Mental Health
Affordable Care Act
Medicare
Medicaid
Children’s Health
All Topics
Medicare Advantage Billing Probe
School Vaccine Mandates
Weight Loss Drugs Coverage
Opioid Settlement Money
Abortion Pill Access
Search
Search for:
Bill of the Month
Uninsured but Undaunted, a Surgical Patient Searched the Globe for a Deal
He shopped around for the best price for a hernia repair — and saved thousands by traveling out of state.
Ronmel Rangel of Portland, Maine, doesn’t have health insurance. He shopped around for an acceptable price on hernia surgery<br>with the help of his doctor after a local hospital gave him an estimate of $23,000. He found better deals in other states. (Brianna Soukup for KFF Health News)
Bill of the Month
Uninsured but Undaunted, a Surgical Patient Searched the Globe for a Deal
He shopped around for the best price for a hernia repair — and saved thousands by traveling out of state.
By Paula Andalo
July 29, 2026
Republish
Disponible en Español
This story also ran on The Washington Post. It can be republished for free.
Send Us Your Medical Bills<br>Do you have a confusing or outrageous medical bill you want to share? Tell us about it.<br>Share Your Bill
Around the end of last year, Ronmel Rangel, 63, began to feel a familiar discomfort in his lower abdomen. Twenty-five years earlier, while living in his native Venezuela, he had undergone surgery to repair a hernia on the right side of his groin.
Now, the same pain had returned — on the left.
This time, Rangel was in the U.S. and lacked health insurance. In 2019, he moved to Portland, Maine, where one of his daughters lives.
As a green-card holder, he qualified to purchase health insurance through the Affordable Care Act marketplace. But he quickly realized that the premiums for someone his age were beyond his budget. He decided to go without insurance, even though it had been a priority for him.
Instead, Rangel signed up for a plan at a concierge practice where patients pay as little as $70 a month for services, including unlimited office visits and minor procedures such as stitches and biopsies.
But when Rangel was diagnosed with a hernia, surgery became unavoidable. Ben Hagopian, his primary care physician, helped him compile a list of hospitals and surgical centers to consider. Rangel has a PhD in management, a field he pursued while serving in the navy in Venezuela. Armed with that knowledge and a naturally inquisitive mind, he began researching prices.
His efforts paid off when the bill came.
Email Sign-Up
Subscribe to KFF Health News' free Morning Briefing.
Your Email Address
Sign Up
The Medical Service
Rangel had what is called an inguinal hernia, which occurs when the contents of the abdomen bulge through a weak spot in the lower abdominal wall. The condition is relatively common, particularly among older adults.
In most cases, surgery is required to fix the muscle wall and can be performed as an outpatient procedure. There are three main surgical approaches to repair an inguinal hernia: open, laparoscopic, and robot-assisted. Studies have shown that the three approaches have similarly low rates of hernia recurrence and are safe and effective.
Rangel underwent an open repair, an approach often preferred by physicians for recurrent hernias. He said his operation lasted less than two hours, and he walked out of the surgical center shortly afterward.
The Bill
$2,900: The flat rate Rangel ultimately paid for his hernia repair at an outpatient surgery center in Maryland, including the surgeon’s fee and anesthesia. He said he also paid around $1,800 to travel to the surgery center from his home in Maine, including airfare, meals, and lodging for him and his wife.
The Billing Problem: No Insurance — But Time To Shop
Because Rangel did not have insurance, he had no protections from high costs — except time and his ability to shop for an acceptable price for his procedure.
Rangel’s first stop was a nonprofit hospital close to home. He scheduled a consultation with a surgeon with MaineHealth, the state’s largest health system, and...