Health Insurance
Ambulance Rides Have Cost $1,189 on Average Since 2010 — Totaling More Than $46 Billion
The cost of an ambulance ride increased slightly from $1,185 to $1,211 over the last decade — an average of $1,189 a year. While ambulance expenses totaled $46 billion during this period, the yearly cost fell 3% from $4.6 billion in 2010 to $4.5 billion in 2019 — the last year of available data.
ValuePenguin analyzed Medicare claims data to find the cost of getting an ambulance and evaluate how spending has changed at state and local levels. While costs dropped at the national level, the change in spending at state and county levels varied. Statewide expenditures in California averaged $380 million annually — the highest annual spending of any state — but the amount spent per user fell by 6%.
While California had the highest yearly spending, ambulance-related spending grew the most in Wyoming, though total costs were relatively low compared to other states. Spending in Wyoming rose 148% from $4 million in 2010 to $10 million in 2019, and per-user expenditures grew by 83%.
Key findings
- Spending on ambulance services totaled $46 billion during the last decade, according to the latest available data from the Centers for Medicare and Medicaid Services (CMS). While overall expenditures dropped by 3%, per-user spending went up by 2% from 2010 to 2019.
- The cost of ambulance services in California during this period was the highest compared to other states. On average, statewide expenditures totaled $380 million annually, even while total spending decreased by 7% and per-user spending dropped by 6% from 2010 to 2019.
- Ambulance-related spending grew the most (148% in total) in this period in Wyoming, from $4 million to $10 million. Per-user expenses grew by 83% in Wyoming — also the largest increase.
- Per-user spending on ambulance services grew by 445% in Hot Springs County, Wyo. — the largest increase. Total expenditures were highest in Los Angeles County, Calif., though spending dropped by 44% there.
Per-year spending on ambulances dropped from 2010 to 2019 — but only by 3%, or $116 million
Spending on ambulance-related services totaled more than $46 billion from 2010 to 2019. On average, these services cost $4.6 billion annually. In fact, total expenditures remained relatively flat year over year. From 2010 to 2011, costs rose by 3% — the largest 12-month difference, positive or negative.
From 2013 to 2014, the money spent on ambulance services remained fairly flat — with a decrease of $4 million, or close to 0%.
Year | Actual cost | Change |
|---|---|---|
| 2010 | $4.6 billion | — |
| 2011 | $4.7 billion | 3% |
| 2012 | $4.8 billion | 1% |
| 2013 | $4.7 billion | -1% |
| 2014 | $4.7 billion | 0% |
| 2015 | $4.7 billion | -1% |
| 2016 | $4.6 billion | -1% |
| 2017 | $4.6 billion | 1% |
| 2018 | $4.5 billion | -2% |
| 2019 | $4.5 billion | -1% |
This table displays rounded actual costs, rather than standardized costs, from the Centers for Medicare and Medicaid Services.
Per-user spending figures reveal more closely the cost of ambulances. Per-user costs averaged $1,189 from 2010 to 2019. In 2010, per-user ambulance-related spending was $1,185 across the U.S. The cost in 2019 grew to $1,211 — a difference of $26, or 2%. Like total expenditures, year-over-year change affecting per-user rates was relatively flat. The largest change (increase or decrease) was just 2% — from 2014 to 2015 and from 2018 to 2019.
Year | Actual per-user cost | Change |
|---|---|---|
| 2010 | $1,185 | — |
| 2011 | $1,191 | 1% |
| 2012 | $1,203 | 1% |
| 2013 | $1,197 | -1% |
| 2014 | $1,200 | 0% |
| 2015 | $1,180 | -2% |
| 2016 | $1,165 | -1% |
| 2017 | $1,175 | 1% |
| 2018 | $1,187 | 1% |
| 2019 | $1,211 | 2% |
This table displays rounded actual per-user costs, rather than standardized costs, from the Centers for Medicare and Medicaid Services.
Who pays for ambulance services?
Assuming an individual doesn't have to pay out of pocket for an ambulance, their car or health insurance plans could offer some payment — but the amount covered varies by plan.
Payment for ambulance services could come from different sources, depending on location and insurance. Health insurance can offer some coverage for ambulance services, but whether a policyholder is covered depends on their plan. Coverage also depends on whether consumers have paid their deductible.
Medically necessary ambulance trips are sometimes at least partially covered by auto insurance policies. The at-fault driver's bodily liability coverage could pay for some of the cost of an ambulance. An injured driver's personal injury protection or medical payments coverage may also provide protection — if they carry it.
The best way for someone to know how their insurance treats a potential ambulance trip is to contact their auto and health insurance providers. Depending on the plan and local insurance rules, the amount and order in which each type of coverage offers reimbursement for ambulance-related services varies.
Ambulance-related spending was highest in California, though costs fell by more than the national average — 7% compared to 3% — during this period
While yearly ambulance-related expenses dropped by just 3% across the U.S., changes at the state level varied much more. At the state level, the average yearly amount spent on ambulance services rose by 10%.
In Wyoming, costs rose by 148% — by far the largest increase of any state. In 2010, expenses in Wyoming sat at $4 million, increasing to $10 million by 2019. Despite the steep trend upward, ambulance-related spending in Wyoming in 2019 was among the lowest in the country based on standardized values used by the Centers for Medicare and Medicaid Services to compare across geographic regions. In 2019, expenditures in Wyoming were greater than those in just three places: Hawaii, the District of Columbia and North Dakota.
Conversely, New Jersey experienced the steepest decline of any state for ambulance-related services. In 2010, expenditures totaled $176 million. In 2019, spending fell to $119 million — a drop of 32%. Still, costs equaled an average of $170 million per year in the state, making New Jersey the state with the 11th-highest annual spending total.
Average yearly spending related to ambulance services was highest in California, where expenditures totaled $380 million annually from 2010 to 2019, despite falling by 7% during the same period.
Rank | State | Total change (%) | Average annual spending |
|---|---|---|---|
| 1 | Wyoming | 148% | $7 million |
| 2 | Georgia | 66% | $190 million |
| 3 | Oregon | 51% | $39 million |
| 4 | Montana | 48% | $11 million |
| 5 | Maryland | 45% | $79 million |
| 6 | Minnesota | 43% | $27 million |
| 6 | Idaho | 43% | $14 million |
| 8 | Nevada | 42% | $29 million |
| 9 | Alaska | 38% | $12 million |
| 10 | Mississippi | 32% | $55 million |
| 11 | New Mexico | 31% | $27 million |
| 12 | Iowa | 30% | $33 million |
The states are ordered by the percentage change in annual spending for ambulances, from 2010 to 2019, and dollar amounts are rounded.
At the state level, the per-user cost of ambulance services also grew by the most in Wyoming. Annual costs grew by 83%, from $832 in 2010 to $1,523 in 2019. At the same time, the state was only 24th for average per-user expenses. To this end, Georgia (average expenses of $1,637 per user) carried the most expensive services.
In addition to having the highest average yearly per-user expenses, Georgia saw the largest increase in spending. Total expenditures were 66% higher in 2019 than in 2010, and per-user costs went up by 70%.
Expenses for ambulances in Los Angeles County were the highest in the country, but the overall drop in costs (44%) was among the largest for highly populated counties
At the county level, per-user and total costs commonly changed more drastically than at the state and national levels due to relatively lower user levels, based on an analysis of counties in which data was available. There were 84 counties where the per-user cost of ambulance services rose by at least 100%. There were no states where costs changed by as much.
Moreover, costs were most likely to rise dramatically instead of becoming more affordable. On a per-user basis, the cost of ambulance services rose most steeply in Hot Springs County, Wyo. In that county, the cost rose by 445%, from $737 per user in 2010 to $4,014 in 2019.
Conversely, in Zapata County, Texas, the per-user cost of ambulance services fell by 76% from $11,620 to $2,796 — the largest decrease of any county.
Rank | County | State | Change from 2010 to 2019 |
|---|---|---|---|
| 1 | Hot Springs | Wyo. | 445% |
| 2 | Minidoka | Idaho | 401% |
| 3 | Fremont | Wyo. | 355% |
| 4 | Roseau | Minn. | 338% |
| 5 | Big Horn | Wyo. | 328% |
| 6 | Washakie | Wyo. | 292% |
| 7 | Clinch | Ga. | 285% |
| 8 | Clarke | Iowa | 260% |
| 9 | Fallon | Mont. | 250% |
| 9 | Cassia | Idaho | 250% |
| 11 | Richland | Mont. | 249% |
| 12 | Wallowa | Ore. | 237% |
Table lists top 25 counties by percentage change to standardized per-user costs.
Los Angeles County, Calif., had the highest overall cost of any county in the U.S. Here, ambulance-related spending averaged $112 million annually. Importantly, however, annual spending fell by 44% in the county from 2010 to 2019. Moreover, per-user spending decreased by 34% in the area. In other high-spending counties, the trend was mixed.
The following table shows how per-user spending related to ambulance services changed in the counties where total yearly spending was highest. In just eight of these 25 counties, per-user costs fell, while costs rose in 16 and remained even in one. The county where costs went up the most among the highest spending counties was Pinellas County, Fla., west of Tampa.
Per-user spending remained the same in just one of the 25 highest-spending counties: San Diego County, Calif.
Rank | County | State | Average annual expenses | Change (per-user) |
|---|---|---|---|---|
| 1 | Los Angeles | Calif. | $112 million | -34% |
| 2 | Cook | Ill. | $83 million | 7% |
| 3 | Harris | Texas | $57 million | -34% |
| 4 | Philadelphia | Pa. | $41 million | -62% |
| 5 | Kings | N.Y. | $38 million | 20% |
| 6 | Wayne | Mich. | $34 million | -2% |
| 7 | San Diego | Calif. | $32 million | 0% |
| 8 | Middlesex | Mass. | $31 million | 6% |
| 9 | Essex | N.J. | $24 million | -20% |
| 10 | Orange | Calif. | $24 million | 2% |
| 11 | Dallas | Texas | $24 million | -2% |
| 12 | Miami-Dade | Fla. | $23 million | 2% |
The counties are ordered by average rounded annual expenses related to ambulances.
Methodology
ValuePenguin analyzed how ambulance-related spending changed from 2010 to 2019 — using the most up-to-date available data. Researchers sourced aggregate and standardized data from the Geographic Variation Public Use File, published by the Centers for Medicare and Medicaid Services (CMS). This data represents Medicare beneficiaries' spending patterns.
Researchers used standardized data to compare expenditures across states. The standardized rates enable cross-geographic comparison by focusing on the standard payment amount rather than the standard allowed amount. This adjustment accounts for factors that led to different expenditures for the same services. Aggregate amounts are used to analyze annual values at the national level where comparisons aren't necessary.