The price to remove a gall bladder or replace a hip has spiked more than 20 percent during the past five years, according to an analysis of data collected for NBC News. Surgery has bloomed into a $500 billion industry in the United States, where 80 to 100 million procedures are performed annually — a per-capita rate that's some 50 percent higher than in the European Union, said Dr. John Birkmeyer, a researcher and adjunct professor at the Dartmouth Institute and in the university's Community & Family Medicine program. The reason? Expensive yet safer technologies and hospital consolidations that create medical monopolies, according to doctors and researchers.