PORTLAND – As more Americans choose to have medical procedures performed at lower cost outside the U.S., Hannaford Bros. has begun offering to employees the option of getting hip and knee replacements at a hospital in Singapore.

Even when airfare and hotel charges for the employee and a traveling companion are factored in, the Scarborough-based supermarket chain could save thousands of dollars per procedure, said Peter Hayes, who manages health benefits for 27,000 workers, including about 7,000 in Maine.

A hip replacement that can cost $40,000 to $60,000 ranges from $10,000 to $15,000 in Singapore.

Hannaford started to allow joint replacements at Singapore’s National University Hospital in January, Hayes said, and a handful of employees are considering the offer. He said almost all workers he surveyed were open to traveling for health care as long as the quality equaled that of U.S. hospitals.

Hayes said Hannaford’s entry into medical tourism has given rise to offers from hospitals and medical practices across the U.S., who say they can match overseas prices.

He expressed hope that medical tourism will revitalize the national dialogue on health costs and eventually drive down the price of care domestically.

Other major companies in Maine, including L.L. Bean, Unum, Bath Iron Works and Cianbro, say the idea of medical tourism is not under consideration.

It’s difficult enough persuading employees to go to an out-of-state hospital, even if the procedure can be performed better there, said Rita Bubar, human resources and wellness manager at Pittsfield-based Cianbro.

“We haven’t overcome the ‘how do we get them to Boston’ issue, let alone how would we get them to Asia,” Bubar said.

Many uninsured patients, and those with high deductibles or plans that do not cover certain procedures, have gone outside the U.S. for medical or dental procedures.

Lisa Stewart of Jackman signed up with a medical tourism company called Planet Hospital for a four-day trip to Tijuana, Mexico, that included two root canals. She paid $1,200 for the entire package, far less than the $4,000 to $5,000 she was told she would have to pay out of pocket to have the work done at home.

“Patients Without Borders,” a new book on medical tourism by Josef Woodman, says 150,000 Americans left the U.S. last year for procedures, most of them surgeries.

Among them was Gayle Curtis of Camden, who used a medical tourism company called MedRetreat to arrange a stay at a hospital in Malaysia for a $6,000 face-lift performed by an American-trained plastic surgeon. Travel and accommodations cost an additional $4,000. Curtis said a Bangor plastic surgeon quoted her a price of $4,000 for just an eyelid lift.

MedRetreat acknowledges that prospective patients worry about quality of care in overseas hospitals but says it takes steps to partner with private hospitals that have proven records of quality.

“We’re sharing maybe the same hospitals used by a king, or diplomats, government officials and very wealthy people,” said Patrick Marsek, MedRetreat’s Chicago-based managing director. “Knock on wood, we only had two complications in over 1,200 patients.”