To price a medical tourism package, add every direct cost of the stay (procedure, inpatient and hotel nights, companion, transfers, coordinator time, aftercare), add a complication-and-revision reserve taken from your own records, then divide by what is left of each unit of price after payment fees, cost of sale and your target margin: price = cost ÷ (1 − margin − fees − cost of sale). An agency commission is paid out of the price, so it is divided out once more: a 15% commission on the retail price needs a price 17.6% higher to leave you the same money (1 ÷ 0.85), and a 20% commission equals a 25% mark-up on the net rate (0.20 ÷ 0.80). This calculator does the arithmetic for three price tags (direct patient, agency at a flat commission, agency on volume tiers) and adds margin, break-even patients per month, discount headroom, what an agency patient who later books direct costs or saves you, and how the price moves with the reserve, occupancy and the exchange rate. It runs in your browser; the link carries your figures and nothing is sent.
Tool
A hospital that sells a treatment abroad is really selling a bundle: the procedure, the nights in the ward and the hotel, the airport car, an interpreter, the follow-up calls and a promise about what happens if something needs correcting. Each part has a cost, and a part you forget to price comes out of your margin. This calculator puts the whole bundle on one bar and shows the price tag it needs for every way a patient can reach you.
The calculator sits at the top of this page. On the left, nine cost lines fill one stacked bar; on the right, three hanging price tags (direct patient, agency at a flat commission and agency on volume tiers) show the price, the margin, the break-even volume and the discount headroom of each channel. Pick a pricing policy, test the tag swap for an agency patient who books direct, and watch the sensitivity strip move. Only the values you change are written into the page address, so an untouched calculator keeps a clean link.
Start with cost, not with a competitor’s brochure. Add the nine direct lines of the table below, then add the complication-and-revision reserve as a percentage of that total. That is the cost of delivering the package. Three more percentages sit on top, all measured against what you receive: payment and exchange fees, the cost of selling the package, and the margin you want. Because they are shares of the price and not of cost, the price is cost ÷ (1 − margin − fees − cost of sale). With the placeholder figures, a direct cost of €5,800 plus a 3% reserve gives €5,974; at a 25% margin, 2% fees and 6% cost of sale the direct patient price is €8,917.
A commission is a share of the retail price the patient pays. A mark-up is added on top of a net rate. A margin is a share of what you receive. Mixing them up is an easy pricing mistake in agency deals: a 20% commission is not a 20% mark-up. The conversion is mark-up = commission ÷ (1 − commission), and the retail price you need for the same money is 1 ÷ (1 − commission) times higher.
There are two ways to run an agency channel. In the retail model you publish one price, the patient pays it and the agency keeps its commission, so you receive the retail price minus the commission (net settlement). In the net-rate model you quote the agency a net price and the agency adds its own mark-up before the patient sees it. The arithmetic is the same once you convert, but control is not: with a retail price you decide what the patient sees, with a net rate the agency does, and a high mark-up can make your own direct price look cheaper than the agency’s. The calculator has a switch for each model; in the net-rate model the tag shows the net rate you quote and, underneath, what the patient pays.
A flat rate is easy to explain and to audit. Tiers reward volume and let you start low with a new agency. They come in two forms, and the contract must say which. With whole-volume tiers, the rate of the tier the agency reaches applies to every patient that month. With bands, each rate applies only to the patients inside its band. With the placeholder tiers (patients 1 to 5 at 10%, 6 to 10 at 12%, 11 and above at 15%), 8 patients in a month pay 12% on all of them under whole-volume tiers, but 10.75% on average under bands (5 × 10% + 3 × 12%) ÷ 8. Define what counts as a month and as a patient (booked, treated or paid) in writing; the clinic contract checklist lists the clauses that depend on it.
Agree the commission face to face: agencies join Health onMESSE free, so you can compare their volumes and terms in scheduled meetings before you commit to a tier table.
Every hospital that works with agencies has to answer this, and each answer has a cost. The calculator lets you test four policies and read every channel’s margin under each.
A tag swap happens when a patient an agency introduced books with you directly the next time, for a second procedure, a revision or a friend. What it costs or earns you depends on three contract terms: whether you pay a commission on repeat bookings for a tail period, whether the patient can see two different prices, and whether an exclusivity or non-circumvention clause applies. For one swapped patient the calculator shows the price gap the patient sees, your margin change if you keep the commission, your margin change if the commission is still due, and the commission that leaves the agency channel; it then multiplies by the share of agency patients you expect to swap. See exclusivity and referral fee in the glossary.
The reserve is the money you set aside per package for complications and revisions that you treat without charge. It is your estimate, not an industry rate: it depends on your procedure mix, your surgeons, your patient selection and the terms of your complication clause, so no figure is given here. To derive it, take a period of at least twelve months, add up what every complication, revision and unplanned return that you treated free of charge cost you (treatment, nights, materials and travel you paid, at cost and not at price), and divide by the total direct cost of the packages you delivered in the same period. For example, €18,000 of free corrective care in a year in which you delivered 300 packages with a direct cost of €5,800 each is €18,000 ÷ €1,740,000 = 1%. The helper under the reserve field does this sum for you.
Three things shift a package price without any change in the clinical work. Occupancy: a theatre and a ward cost money whether or not the bed is full, so a cost per night worked out at a high occupancy understates the cost when beds are empty. The calculator treats the facility line and the inpatient nights as partly fixed (you set the share) and re-spreads the fixed part when occupancy changes. Exchange rate: if most of your costs are in your own currency but you quote in another, a stronger local currency raises your costs in the quote currency at once; you set the share of costs in your own currency and the strip shows the price you would need at plus or minus 5% and 10%. A price-change clause in the offer is how you handle it, within whatever rules your market has. Payment fees: card, transfer and conversion fees are a percentage of what you receive; take the number from your own statements. They also set the payment schedule: a deposit paid by card and a balance by transfer cost different amounts.
A price is only as good as the list of what it covers. The ten points below describe good practice for a written package offer, not a legal requirement in any particular country. They follow the principles that clear invoices and clear information on prices, authorisation status and insurance cover are what a cross-border patient is owed (Article 4(2)(b) of Directive 2011/24/EU) and that planned medical treatment abroad is treated as a commercial arrangement between the patient and the provider (GOV.UK, Foreign, Commonwealth & Development Office): the written terms are the patient’s main recourse. See inclusions and exclusions, cancellation policy and treatment quotation in the glossary.
Rules on prices differ by country, and this page does not apply them to you. Two examples show what to look for. In Türkiye, Article 11 of the Regulation on International Health Tourism and Tourist Health (Turkish Official Gazette, 26 April 2025, No. 32882) provides that the Ministry of Health determines the price of health services provided under international health tourism and that facilities follow the Ministry’s price-tariff procedures; Article 12 requires an invoice with an itemised breakdown and unit prices, and requires an intermediary to itemise its own charges for accommodation, transport, transfer, interpreting and consultancy. In the EU, Directive 2011/24/EU on patients’ rights in cross-border healthcare requires providers to give clear invoices and clear information on prices (Article 4(2)(b)) and requires Member States to ensure that patients from other Member States are charged the same scale of fees as domestic patients in a comparable medical situation, or a price based on objective, non-discriminatory criteria where no comparable domestic price exists (Article 4(4)).
The Package Travel Directive is a separate question. Directive (EU) 2015/2302 defines a package as a combination of at least two different types of travel service (carriage of passengers, accommodation, car rental or another tourist service) for the same trip, sold under one contract or at an inclusive price (Article 3(2)). Whether a treatment bundle that adds hotel nights and transfers is a package depends on how it is put together, who sells it and how your country applied the Directive, so it is a question for your legal adviser. If a bundle is a package, price increases after the contract are limited: only if the contract reserves them, only for fuel or power costs, third-party taxes or fees, and exchange rates, with notice no later than 20 days before the start, and an increase above 8% of the total price gives the traveller the right to accept the change or terminate (Articles 10 and 11).
For patients from the United Kingdom, the Foreign, Commonwealth & Development Office states that planned medical treatment is considered a commercial arrangement and that it cannot usually help if you have travelled abroad for medical treatment, for example with issues about the care received or the costs involved. For you that is a reason to put complications, cancellation and refunds in the written offer rather than in conversation, and to have the offer reviewed by a lawyer in the patient’s market and yours.
Agency or tour operator? Join Health onMESSE free, browse the participating hospitals and clinics and ask for their package terms.
The figures below are what the calculator shows when you open it untouched: round placeholders for the arithmetic, not market prices, in euro as a label only. Two prices, a 25% target margin, whole-volume tiers and 8 agency patients a month.
Related tools and guides for this fair: the agency-side view in the case economics calculator, the clauses to negotiate in the clinic contract checklist, the Turkish rules in the authorization certificate guide and every term in the health tourism glossary. The fair itself is at Health onMESSE.
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