Most expensive medical procedures in the U.S., ranked

What would it look like if the approximately 11.4 million people insured through the ACA suddenly lost health coverage? Let's do the math:

Without insurance, nearly half of these pricey medical procedures cost more than the average American's annual median household income. And every single procedure on this list costs at least four times more than the median American household savings.

Health care data company Arcadia ran the numbers, and these are the 50 most expensive medical procedures in the U.S., on average, ranked from lowest to highest. 

50. Kidney transplant

The average retail price for a kidney transplant in the United States is $46,760.

Cheyenne HanLee and Gavin Geragawa met on Tinder. Just over two years later, he saved her by donating one of his kidneys.

49. Endovascular procedures on the skull, meninges and brain

These procedures treat aneurysms and artery disorders inside the skull.

Before insurance, hospitals charge an average of $46,763.

48. Bowel-to-bowel fusion

The average retail price of a bowel-to-bowel fusion operation in the United States is $47,114.

47. Spinal cord surgery

Hospitals charge an average of $47,166 for spinal cord surgeries, not including fusions of the vertebrae.

46. Total removal of the spleen

The average sticker price for spleen removal is $47,860.

45. Cardiac ablation

Doctors use radio waves to cauterize heart tissue that causes arrhythmia.

Procedures like this cost an average of $47,895 before insurance.

44. Inserting hepatic shunt

In this procedure, doctors insert a tube that allows blood to flow freely through the liver.

Hospitals charge an average of $47,939 for this surgery.

43. Replace or revise brain shunt

Brain shunts allow cerebrospinal fluid to safely drain out of the skull, reducing excess pressure on the brain.

The average price for a revision or replacement of a brain shunt is $49,355.

42. Surgical treatment for cranial lesion

Cranial lesions are any kind of abnormal tissue on the skull — like bone cysts or inflamed bone tissue from a bacterial infection. 

Surgical treatment for these lesions cost an average of $50,189, before insurance.

41. Skin graft

The average price for skin grafting in the United States is $51,170, before insurance.

Here, a Cambodian woman pulls at her scarf after having skin graft stitches removed. She was the victim of an acid attack that severely burned the tissue on her face.

40. Vascular embolization

Using a radiology scan for guidance, a doctor navigates a catheter to the site of a damaged blood vessel and injects a clotting agent to stop bleeding.

These procedures cost an average of $51,351, before insurance.

39. Cranial shunt

Surgery to install a cranial shunt costs an average of $51,434, before insurance.

Zach Lederer was diagnosed with a brain tumor when he was in sixth grade. After surgery, he had a cranial shunt inserted to allow excess fluid to drain from his skull. Years later, he was able to play high-school football.

38. Ileostomy

An ileostomy is a surgical procedure that links the small intestine to the abdominal wall to reroute digestive waste into an external ostomy system.

Procedures like this cost an average of $51,683.

37. Surgical removal of pelvic structures

In these surgeries, often done to treat advanced cancers, doctors remove reproductive organs, the bladder or rectum or both, pelvic lymph nodes, and occasionally part of the colon.

Before insurance, this procedure costs an average of $51,888.

36. Removal of pacemaker or defibrillator

Having a pacemaker or defibrillator removed costs an average of $52,005.

35. Complex brain aneurysm repair

Hospitals charge an average of $52,041 for this emergency brain surgery.

34. Partial removal of the colon

Before insurance, the average price for this procedure is $52,353.

33. Endovascular repair of the abdominal aorta

The part of the aorta that passes to through the abdomen is a vascular superhighway that helps keep our kidneys, intestines and lower limbs functioning.

Repairs to this very important blood vessel cost an average of $53,776.

32. Gallbladder surgery

Surgeries to treat gallbladder problems cost an average of $54,041 before insurance. 

One of the most common gallbladder surgeries is a cholecystectomy. Doctors insert a camera and other equipment through a tiny incision in the abdomen to locate and remove the gallbladder.

31. Laparoscopic procedures on the esophagus

One common laparoscopic surgery helps treat stubborn acid reflux. The Nissen fundoplication reinforces the valve between the esophagus and the stomach.

Before insurance, these esophageal surgeries cost an average of $55,200.

30. Facial bone surgery

Surgery on the facial bones will run you $55,986, on average.

29. Blood vessel repair

Repairs to damaged blood vessels cost an average of $57,710, before insurance.

28. Inserting a pacemaker or defibrillator

Getting a pacemaker or defibrillator costs $58,281 on average. More than 200,000 pacemakers are implanted in the United States every year. 

That's more than $11.6 billion in hospital bills, before insurance.

27. Bone grafting

NBA star Kevin Durant had bone graft surgery on a foot in 2015. Hospitals charge an average of $59,018 for these procedures, before insurance.

26. Intraoperative neural monitoring

This procedure takes place during other brain surgeries to monitor neural function.

Intraoperative neural monitoring will add an average of $60,497 to your hospital bill, before insurance.

25. Removal of heart lesions

Removing abnormal heart tissues — like the ones caused by congenital disease — costs an average of $61,410.

24. Exploratory laparotomy

Sometimes doctors use surgery as a diagnostic tool. During these procedures, a patient's abdomen is opened and organs are examined for disease or injury.

These surgeries cost an average of $61,957.

23. Craniotomy

In a craniotomy, bone from the skull is temporarily removed to expose part of the brain.

Before insurance, hospitals charge $66,935 on average for this procedure.

22. Spinal fusion

Spinal fusions cost an average of $67,826, before insurance.

21. Repair of the descending thoracic aorta

This graphic shows a potentially deadly dilation of the descending thoracic aorta. Repairing damage to this major blood vessel is considered a life-saving procedure. 

The surgery costs an average of $68,766, before insurance.

20. Vascular bypass graft

Vascular bypass grafting redirects blood around damaged arteries by connecting healthy blood vessels.

These procedures cost an average of $70,846, before insurance.

Here, vascular surgical students practice bypass grafting on a model of a human leg.

19. Small intestine repair

Surgical repairs to the small intestine cost an average of $72,757.

18. Breast reconstruction surgery

Hospitals charge an average of $73,100 for breast reconstruction surgery.

17. Mitral valve replacement

Hospitals charge an average of $73,154 to replace the mitral valve, a valve in the left side of the heart.

16. Laminectomy

During a laminectomy, doctors remove the rear section of bone from one or more vertebrae. This procedure costs an average of $73,363, before insurance.

15. Mitral valve repair

Repair to the mitral valve of the heart costs $74,144, before insurance.

14. Lumbar spine surgery

Hospitals charge an average of $75,361 for surgery on the lower section of the spine.

13. Coronary artery bypass graft

The coronary arteries provide blood and nutrients to the heart. Sometimes these arteries get clogged with plaque. This surgery improves circulation by rerouting blood around a blocked or narrowed part of the artery with a healthy vessel from elsewhere.

Hospitals charge an average of $77,177 for this procedure.

12. Carotid artery stent

As with the coronary arteries, carotid arteries — which supply blood to the brain — can grow clogged. To combat this, doctors will sometimes insert a mesh metal tube into the artery, propping open the pathway so blood can safely make its way through to the brain.

This procedure costs an average of $77,529.

11. Video EEG monitoring

This procedure is often a precursor to surgery for epilepsy. It also can help doctors properly differentiate epilepsy from other disorders. Brain waves are monitored with electrodes, while video captures the patient's movements and behavior at the same time.

Video EEG monitoring costs an average of $77,664, before insurance.

10. Tricuspid valve repair

The tricuspid is one of the two main valves on the right side of the heart. Repairing a damaged tricuspid valve costs an average of $82,431.

9. Tricuspid valve replacement

Replacing the tricuspid valve costs an average of $82,631, before insurance.

8. Transcatheter aortic valve replacement

This relatively new and minimally invasive procedure, known as TAVR, delivers a fully collapsible replacement valve to the heart with a catheter (instead of via open heart surgery). 

Hospitals charge an average of $85,279 for this surgery.

7. Aortic graft

This procedure costs an average of $92,939, before insurance.

6. Liver transplant

A liver transplant costs $101,240, more than twice as much as a kidney transplant.

5. Tracheostomy

This procedure creates an opening in the front of the neck to allow a breathing tube to be inserted into the windpipe.

Hospitals charge an average of $102,399 for a tracheostomy, before insurance.

4. Decompressive craniotomy

This procedure uses a novel technique to relieve pressure inside the skull while maintaining a bone flap, so that brain tissue is not totally exposed. According to some studies, this procedure leads to fewer complications than a traditional decompressive craniectomy, which fully removes a portion of skull.

Hospitals charge an average of $112,984 for this procedure.

3. Partial removal of the esophagus

Occasionally, in the case of large tumors, doctors will remove part of the esophagus.

This procedure costs an average of $113,756.

2. Aortic valve replacement

Hospitals charge an average of $135,984 for this heart surgery.

Here, two first-year medical students practice an aortic valve replacement procedure on a pig's heart.

1. Exploratory chest surgery

The most expensive single medical procedure in America is exploratory chest surgery. Hospitals charge an average of $137,533 for similar pre-diagnostic surgeries.