How Much Does an Ambulance Ride Cost?
Key takeaways:
An ambulance ride can be costly. In 2020, the average cost was $940 for transport with basic services and nearly $1,300 for a ride with advanced life support.
With insurance, the average out-of-pocket cost for an ambulance ride is $450, but it can exceed $1,000 in some states.
Ambulance services typically set prices by the level of care delivered, such as basic or advanced life support. You may be charged a flat rate, by mileage, or a combination of both — as well as other fees.
Ground ambulances were not included in the No Surprises Act, which prohibits private insurers from billing you extra for most emergency services — even if the services were out of network or did not have prior authorization.
Table of contents
If you’ve ever been transported in an ambulance, you may know the adrenaline rush of feeling your mortality. You also may have experienced sticker shock from the ambulance bill.
An ambulance is often the bridge between the scene of a serious accident or medical event and the hospital emergency room (ER). And that potentially lifesaving ride can be costly, whether you have insurance or not.
What’s the average cost of an ambulance ride?
Without insurance or discounts, the average cost of an ambulance ride in 2020 was $940 for transport with basic services and nearly $1,300 for a ride with advanced life support, according to a 2022 report on ground ambulance services from the data nonprofit organization FAIR Health. Without insurance, you’re likely to face the full charge because you don’t have the financial protection of negotiated rates or health plan cost-sharing.
If you receive a bill you can’t afford, you can contact the ambulance company and ask for a discount or request a payment plan.
How much is an ambulance ride with insurance?
With insurance, the charge for your ambulance ride could be limited to an “allowed amount” or “negotiated rate” if the service comes from an in-network provider.
It’s important to note that ground ambulances were not included in the No Surprises Act, which prohibits private insurers from billing you extra for most emergency services — even if the services were out of network or did not have prior authorization.
That’s why your ground ambulance costs — even with insurance — may still leave you with a significant bill. With insurance, the average out-of-pocket cost for an ambulance ride is $450, but it can exceed $1,000 in some states, according to a 2022 report on the high cost of ambulance surprise bills from the U.S. PIRG Education Fund. More than 7 in 10 ground ambulance rides had the potential of surprise out-of-network billing, a Health Affairs study found.
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What factors affect how much an ambulance ride costs?
How much an ambulance ride costs depends on factors such as:
If you had health insurance at the time of the emergency
If the ambulance company engages in “balance billing,” which is when you are charged the difference between their price and what your insurance covers. This applies only if you’re insured. Balanced billing is not prohibited under the No Surprises Act, but at least 14 states have laws that ban the practice for ground ambulance services.
If the ambulance service is in your health plan’s network
The provider, because the ambulance may be owned or operated by a private entity, such as a hospital or for-profit company, or a public entity, such as a government fire department
Whether you received basic life support (BLS), advanced life support (ALS), or specialized services, such as from a mobile stroke unit
How far the ambulance traveled (mileage)
Whether the provider charges by care level and also charges mileage
Site of origination, such as a home, incident scene, or medical facility
States with the highest mileage for ground ambulance trips
These are the five states with the highest average mileage for emergency ground ambulance trips in 2020:
Arkansas | 27.9 miles |
North Dakota | 27 miles |
Wyoming | 24.5 miles |
West Virginia | 21.6 miles |
Maine | 20.9 miles |
Source: FAIR Health
Ambulance service providers
In California, for example, private companies operate about 3 in 4 ambulances. But across the U.S., government entities provided about 2 out of 3 emergency ambulance rides in 2020.
According to Peterson-KFF Health System Tracker, more than 2 in 3 ambulance rides in the following states had an out-of-network charge that may have resulted in a surprise bill:
California
Colorado
Florida
Illinois
Texas
Washington
Wisconsin
Treat and release
It’s also important to note that you can be charged for ambulance medical services provided to you at home or at an accident scene even if you don’t take a ride in the vehicle.
Does insurance cover ambulance rides?
Many types of health insurance cover ground ambulances as well as other types of medical transportation.
Medicare
Original Medicare covers ambulance services under Part B as long as you need medically necessary services from a:
Hospital
Critical access hospital
Rural emergency hospital
Skilled nursing facility
Medicare covers emergency transport to the closest appropriate facility. Part B also may pay for nonemergency ambulance services with a written order from your doctor attesting that transport is medically necessary — such as for someone with restricted mobility who needs to get to a kidney dialysis center.
Medicare Part B pays for an air ambulance, airplane or helicopter if you need rapid transport for which ground travel wouldn’t be adequate. It’s important to note that if you only have Medicare Part A and need a ground or air ambulance, you or your family (if you die) could be stuck with the entire bill.
After meeting the Part B deductible, enrollees pay 20% of the Medicare-approved amount. Monitor your Medicare summary notices in case your claim is denied. And remember that you have the right to appeal a coverage decision.
Medicare Advantage plans provide at least as much coverage as original Medicare. You may have additional benefits, so check with your plan for more information about ambulance coverage.
Medicaid
Medicaid covers emergency ambulance rides by a state-licensed provider in an appropriate vehicle that has been inspected and permitted by the state or territory. This includes air ambulances when appropriate.
Tricare
If you have Tricare benefits for military service members, their relatives, and retirees, you have covered ambulance services that include:
Treat and release
Outpatient services
Inpatient transfers
Alternatives to ground ambulance, such as air and boat transport
Why are ambulance rides so expensive?
Ambulance companies cite the responsibility of around-the-clock staffing, limited insurance reimbursements, and high-cost equipment as reasons rides are expensive. Ambulances are equipped with everything necessary to save your life in an emergency and stabilize you on the way to a hospital. This includes:
Highly trained personnel available 24 hours a day, 7 days a week
Overhead, such as the vehicle itself and insurance
Gasoline
Communications systems
When should you call an ambulance, and when is it safe to drive to the ER?
WIth ambulance costs high and unpredictable even with insurance, it can be tempting to drive yourself or a loved one to the ER. Or you may consider calling a taxi or rideshare service such as Uber or Lyft to cut costs. This may make sense in nonemergencies or if your destination is an urgent care center.
But if you’re having chest pain, shortness of breath, dizziness, or any other symptom that may compromise your senses, judgment, or motor skills, it’s best to at least stay away from the driver’s seat for the safety of yourself and others.
Call 911 if your symptoms are severe. Ambulance crews are trained to save lives.
Can a supplemental insurance plan help with the cost of an ambulance ride?
It depends. Supplemental insurance plans, such as critical illness policies that are marketed to people with private health plans, don’t cover ambulance services. But accident insurance benefits may help you pay for ambulance costs.
Medigap
Medigap plans, which are supplemental policies for enrollees with original Medicare, cover all or part of your Medicare Part B coinsurance or copayment. This is one way to reduce your out-of-pocket costs associated with ambulance transport.
Ambulance membership programs
Some hospitals, fire departments, and ambulance services offer discounts through ambulance membership programs. You complete an enrollment form and pay an annual fee that’s typically around $75 for ambulance services for an individual or household members in a service area. Be aware that you might not be in the service area when you need help, and your membership may not apply.
Can you decline ambulance services after a car crash?
Yes. You have the right to refuse ambulance transport or services as long as you are a competent adult. But you may receive a bill if you have an evaluation or consult with the crew. You can appeal the bill if you feel the cost was unjustified.
Keep in mind that even a minor car crash can result in a fire truck and ambulance arriving on the scene. Paramedics may want to evaluate you for signs of serious injury that aren’t immediately apparent, such as a head injury or internal bleeding. They may take your blood pressure and heart rate and give you advice about whether it’s safe to drive on your own.
You may want to consent to be checked — both for your safety and to protect yourself legally. Here are some symptoms to watch for after a car crash:
Headache
Blurry vision
Confusion
Suspected broken bones
Uncontrolled bleeding from a cut
Chest pain or abdominal pain
Burns
Dizziness
Trouble talking
The bottom line
Ambulance rides can be costly with or without health insurance. Because of many factors, including the level of care needed and the distance traveled, ambulance costs can vary greatly. And you may be on the hook for out-of-network charges, because ground ambulances aren’t included in the No Surprises Act.
If you get a big bill that you can’t pay, contact the ambulance company or agency and ask about financial assistance or payment plan options. If you have original Medicare, only Part B covers emergency ambulance services and may cover nonemergency ambulance transportation with a written order from your doctor.
References
American College of Emergency Physicians. (n.d.). When — and when not — to call an ambulance.
Amin, K., et al. (2021). Ground ambulance rides and potential for surprise billing. Peterson-KFF Health System Tracker.
Bonnici Law Group. (n.d.). If I don’t take an ambulance after an accident, does it mean I don’t have a case?
California Ambulance Association. (n.d.). California’s ambulance industry.
Centers for Medicare & Medicaid Services. (2023). Medicare coverage of ambulance services.
Chhabra, K. R., et al. (2020). Most patients undergoing ground and air ambulance transportation receive sizable out-of-network bills. Health Affairs.
CMS.gov. (2024). Ending surprise medical bills.
CMS.gov. (2016). Let Medicaid give you a ride.
Dignity Health. (n.d.). Ambulance membership program.
FAIR Health. (2022). Ground ambulance services in the United States: A study of private healthcare claims.
Finney, M. (2018). Bay Area couple in car crash refuses medical help, gets big bill anyway. ABC7 News.
Frakt, A. (2018). Uber, Lyft and the urgency of saving money on ambulances. The New York Times.
Gong, J. H., et al. (2024). Site of ambulance origination and billing for out-of-network services. JAMA Network Open.
HealthCare.gov. (n.d.). Balance billing. Centers for Medicare & Medicaid Services.
Herman, B., et al. (2023). Ambulance rides for just $100? Government advisers want major billing fixes. STAT.
Irving Fire. (n.d.). Ambulance service fees. City of Irving.
Leys, T. (2024). Without Medicare Part B’s shield, patient’s family owes $81,000 for a single air-ambulance flight. KFF Health News.
Medicare.gov. (n.d.). Ambulance services. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Compare Medigap plan benefits.
Navi, B. B., et al. (2022). Mobile stroke units: Evidence, gaps, and next steps. Stroke.
O’Donovan, C. (2018). People are using Ubers as ambulances – and drivers hate it. BuzzFeed News.
U.S. Department of Health and Human Services. (2014). Does Medicaid cover ambulance services?
U.S. Department of Health and Human Services. (2023). No Surprises Act: Overview of key consumer protections.
U.S. PIRG Education Fund. (2022). Emergency: The high cost of ambulance surprise bills.
Wake County, North Carolina. (n.d.). User fee structure.
Wolfson, B. J. (2023). New California law offers fresh protection from steep ambulance bills. Los Angeles Times.