The growing numbers of American medical tourists tend to be people who do not have insurance or whose insurance does not adequately cover the procedure they need. Their destination often depends on their cultural ties, Mr. Edelheit said. Spanish-speaking patients might favor Latin America, for example, he said.

While five years ago most American patients who went abroad for cheaper care went to countries like India and Thailand and over the border to Mexico, many are now going to Europe, where care at top hospitals frequently costs a fraction of what is charged in the United States. There are private facilitators who help make the arrangements, pairing patients with doctors and hospitals and arranging travel plans.

In the last few years, governments and hospitals in Europe have entered the field and are now promoting their services.

“The idea is to make it easier for patients from overseas — whether from North America, Russia or the Middle East — to see Europe as a solution because of its high quality and reasonable prices,” said Balazs Stumpf-Biro, the executive director of the European Medical Travel Alliance, an industry group.

People from the East Coast tend to head to Europe, while many from the West Coast go to Asian countries like South Korea or Thailand, Mr. Stumpf-Biro said. “The numbers are really growing because of the costs in the U.S.,” he added, “but the main driving factor is quality and a common background.”