A not-for-profit organisation in the Commonwealth of the Northern Marianas says huge bills for medical care offshore are not uncommon in the territory.
The National Foundation for Transplants is trying to raise more than 800,000 US dollars for a liver transplant for a patient who had to go to California for the operation.
Tom Camacho, from NFT in Guam, says it's not unusual.
"We don't have specialty doctors out here for heart or liver transplants, that sort of stuff. Right now we only have a government run hospital, and we know how government run hospitals are, they are basically limited in budgets based on priorities."
Tom Camacho says it is not unusual for patients to have bills of thousands of dollars just for airfares.