Key takeaways:
An ambulance ride can be costly. In 2026, the average national base rate for transport with advanced life support is $1,379. A ride with basic services costs less.
With insurance, the average out-of-pocket cost for an ambulance ride is $450 nationally. But the average cost can exceed $1,000 in some states.
Ambulance companies typically set prices by the level of care delivered. You may be charged a flat rate, by mileage, or a combination of both — as well as other fees.
Ground ambulance services are not included in the No Surprises Act, which prohibits private insurers from billing extra for most emergency services — even if they are out of network or haven’t been preapproved for coverage.
If you’ve ever been transported in an ambulance, you may have experienced sticker shock when you received the bill. An ambulance is often the bridge between the scene of a serious accident or medical event and the hospital emergency room. 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 national base rate for an ambulance ride with advanced life support is $1,379 in 2026. Emergency transport with basic services costs less.
Without insurance, you’re likely to face the full cost of an ambulance ride, because you don’t have access to health plan contract pricing or cost-sharing. (This is known as self-pay or cash-pay healthcare.) With insurance, the average out-of-pocket cost for an ambulance ride is $450 nationally. But the average cost can exceed $1,000 in some states.
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According to a 2026 MedPAC report on ground ambulance services, factors that affect pricing include:
Volume of transports a company provides
Whether the services are provided in an urban, rural, or super-rural area
Whether an ambulance company is for-profit, not-for-profit, or government-owned
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.
If you have insurance, you could be responsible for the difference between the price the ambulance company charges and the amount your insurance covers if the company engages in balance billing. Whether you’re subject to balance billing for ambulance services depends on your state’s specific laws.
The No Surprises Act, which prohibits private insurers from billing extra for most emergency services — even if they are out of network or not preapproved for coverage — doesn’t apply to ground ambulance services. (Though, it does apply to air ambulance services.) That’s why your ground ambulance ride, even with insurance, may still leave you with a significant bill.
Types of ambulance services
When an ambulance is required, a 911 dispatcher sends an ambulance capable of basic life support (BLS) or advanced life support (ALS) — which can include specialty transport by a pediatric or stroke unit. The type of ambulance sent is based on the information the dispatcher receives about the person having the emergency. Each type of ambulance provides a different level of service:
BLS services: Ambulances that provide BLS carry equipment like automated external defibrillators (AED) and devices that provide basic airway management. They are staffed by EMTs who are trained in first aid, CPR, and basic medical monitoring.
ALS services: Ambulances used for ALS are outfitted for advanced clinical monitoring and interventions for cardiac or stroke events, as well as advanced airway management, IV administration, and medication administration. They are staffed by paramedics trained to provide more advanced medical assistance.
Ground ambulette: A ground ambulette is a ground ambulance for nonemergency transport. It’s specially equipped to transport people who can’t ride in a standard vehicle. There are three types of ambulette vehicles — ambulatory, wheelchair, and stretcher.
Here are some charts that explain the average cost of an ambulance ride by transport type and location. The second chart includes information about the level of consumer protection from balance billing for all states and Washington, D.C.
Average Cost by Type of Ambulance Service
Ambulance type | Average cost per ride | Cost range |
|---|---|---|
Basic life support (BLS) | $1,179 | $430-$2,822 |
Advanced life support (ALS) | $1,451 | $607-$3,406 |
Average Ambulance Ride Cost by Location and Care Level
Location | Average cost per BLS ride | Average cost per ALS ride | Consumer protection from balance billing |
|---|---|---|---|
Alabama | $595 | $706 | Limited |
Alaska | $868 | $1,084 | Limited |
Arizona | $1,751 | $1,755 | Limited |
Arkansas | $1,070 | $1,200 | Yes |
California | $2,822 | $3,406 | Yes |
Colorado | $1,470 | $1,640 | Yes |
Connecticut | $993 | $1,614 | Yes |
Delaware | $1,040 | $1,498 | Yes |
Florida | $750 | $875 | Yes |
Georgia | $1,104 | 1,488 | Limited |
Hawaii | $2,151 | $2,440 | Limited |
Idaho | $697 | $1,027 | Limited |
Illinois | $1,339 | $1,524 | Yes |
Indiana | $1,454 | $1,704 | Yes |
Iowa | $900 | $1,000 | Limited |
Kansas | $750 | $799 | Limited |
Kentucky | $634 | $830 | Limited |
Louisiana | $1,500 | $1,750 | Yes |
Maine | $875 | $1,025 | Yes |
Maryland | $601 | $786 | Yes |
Massachusetts | $1,769 | $2,487 | Limited |
Michigan | $655 | $911 | Limited |
Minnesota | $2,081 | $2,495 | Yes |
Mississippi | $985 | $1,364 | Yes |
Missouri | $891 | $950 | Limited |
Montana | $1,515 | $1,825 | Limited |
Nebraska | $1,063 | $1,285 | Limited |
Nevada | $1,092 | $1,236 | Limited |
New Hampshire | $1,130 | $1,724 | Yes |
New Jersey | $1,438 | $1,680 | Limited |
New Mexico | $512 | $607 | Limited |
New York | $1,385 | $1,679 | Yes |
North Carolina | $821 | $975 | Limited |
North Dakota | $2,010 | $2,199 | Limited |
Ohio | $703 | $857 | Yes |
Oklahoma | $1,300 | $1,300 | Yes |
Oregon | $1,810 | $1,810 | Yes |
Pennsylvania | $700 | $957 | Limited |
Rhode Island | $1,293 | $2,099 | Limited |
South Carolina | $769 | $1,500 | Limited |
South Dakota | $1,169 | $1,379 | Limited |
Tennessee | $1,022 | $1,415 | Limited |
Texas | $1,052 | $1,105 | Yes |
Utah | $1,278 | $2,404 | Yes |
Vermont | $1,094 | $1,515 | Limited |
Virginia | $675 | $835 | Limited |
Washington state | $1,250 | $1,368 | Yes |
Washington, D.C. | $2,000 | $2,000 | Limited |
West Virginia | $430 | $682 | Yes |
Wisconsin | $1,410 | $1,691 | Limited |
Wyoming | $1,469 | $1,521 | Limited |
What factors affect how much an ambulance ride costs?
How much an ambulance ride costs depends on factors such as:
Insurance coverage: If you have health insurance at the time of the emergency, your plan will likely cover all or part of the ambulance ride.
In-network coverage: Your plan will likely cover more of the cost if the ambulance company is within your health plan’s network.
Balance billing: With insurance, you could be responsible for the difference between the billed rate and what your plan covers if the ambulance company engages in balance billing. Balance billing is not prohibited under the No Surprises Act for ground ambulance services, but at least 24 states have laws that provide consumer protections or ban the practice.
Ambulance company: The transport provider 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.
Services provided: One of the key factors that affects the cost is the type of care you receive. This could be BLS, ALS, or specialized services, such as from a mobile stroke unit.
Distance: Some ambulance companies charge separately for mileage.
Location: The charges may be affected by the site of origination, which could be a home, incident scene, or medical facility.
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These five states had the highest average mileage for emergency ground ambulance trips in 2020.
States With the Highest Mileage for Ground Ambulance Trips
State | Average distance per trip |
|---|---|
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
Across the U.S., government entities provided about 2 out of every 3 emergency ambulance rides in 2020, according to Peterson-KFF Health System Tracker. Still, more than 2 in 3 ambulance rides in the following states came with 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 medical services provided to you at home or at an accident scene by ambulance staff even if you don’t take a ride in the vehicle. This is also known as a “no transport” rate.
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.
With insurance, the average out-of-pocket cost for an ambulance ride is $450 nationally. But the average cost 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.
How are ambulance rides covered by insurance?
Many types of health insurance cover ground ambulances as well as other methods of medical transportation.
Medicare
Medicare covers about half of the nation’s ground ambulance claims. Original Medicare will cover ambulance services under Part B if you need medically necessary care at a:
Hospital
Critical access hospital
Rural emergency hospital
Skilled nursing facility
Medicare will cover emergency transport to the closest appropriate facility. Part B may also pay for nonemergency ambulance transport with a written order from your healthcare professional attesting that it is medically necessary. This could be for a number of reasons, such as if you have restricted mobility and need to get to a kidney dialysis center.
Medicare Part B will pay for an air (airplane or helicopter) ambulance if you need rapid transport for which ground travel isn’t 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 your Part B deductible, you will be responsible for 20% of the Medicare-approved amount for ambulance services. If you receive ambulance services, 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 plans. You may have additional ambulance service or medical transport benefits, so check with your plan for more information.
Medicaid
Medicaid covers emergency ambulance rides provided by state-licensed companies. To qualify for coverage, a ride must be in an appropriate vehicle that has been inspected and given a permit by the state or territory. This includes an air ambulance when appropriate.
Tricare
If you have Tricare benefits, which are offered to military service members, their relatives, and retirees, you have coverage for ambulance services such as:
Treat-and-release care
Outpatient services
Inpatient transfers
Air and boat transport
Can a supplemental insurance plans help with the cost of an ambulance ride?
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-related costs.
Medigap
Medigap plans, which are supplemental policies for enrollees with original Medicare, cover all or part of Medicare Part B coinsurance charges or copays. This is one way to reduce your out-of-pocket costs associated with ambulance transport.
Ambulance membership programs
Some hospitals, fire departments, and transport providers offer discounts through ambulance membership programs. Joining a program involves completing an enrollment form and paying an annual fee for ambulance services for an individual or household members in a service area. (The fee is about $90 a year for one Arizona program.) Be aware that you might not be in the service area when you need help, and your membership may not apply.
Why do ambulance rides cost so much?
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 the hospital. This includes:
Life-sustaining medical equipment
Communication systems
Fuel and vehicle insurance
Supplies for sanitation and biohazard cleaning
When should you call an ambulance, and when is it safe to drive to the ER?
Given the high, unpredictable costs of ambulance rides, 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 using a rideshare service such as Uber or Lyft to cut costs.
This may make sense in nonemergency situations or if you’re going to 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 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 you decline ambulance services after a car crash?
Yes, you have the right to refuse ambulance transport and other services as long as you are a competent adult. But you may receive a bill if you have an evaluation or consult with the emergency medical 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/or ambulance arriving on the scene. Paramedics may want to evaluate you for signs of a serious injury, such as a head injury or internal bleeding, that aren’t immediately apparent. They may take your blood pressure, check your heart rate, and offer 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:
Abdominal pain
Blurry vision
Burns
Chest pain
Confusion
Dizziness
Headaches
Severe pain and/or swelling that could indicate broken bones
Trouble talking
Uncontrolled bleeding from a cut
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 and balance billing, because ground ambulance services aren’t included in the No Surprises Act — even though air ambulance services are.
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, you will need Part B to get coverage for emergency ambulance services (and possibly nonemergency ambulance transport with a written order from your healthcare professional). Medicare Advantage plans offer benefits that meet or exceed those included in original Medicare plans, and may offer additional medical transport coverage.
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