A0428

Ambulance service, basic life support, non-emergency transport, (bls)

Medicare pricing data for 4,333 providers across 51 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 3.0 million services annually. Even small pricing inefficiencies here affect millions of patients. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Ambulance service, basic life support, non-emergency transport, (bls) (HCPCS code A0428) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $253.05, but hospitals typically charge $1,046 — a 4.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$50.61

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $253.05, your out-of-pocket cost would be approximately $50.61. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$253.05
Average Hospital Charge
$1,046
Markup Ratio
4.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,046.16
Medicare Allowed$253.05
Medicare Payment$200.38

Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $200.38 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$317$1,282264,460+25.2%
Wyoming$302$95815733+19.4%
California$301$2,123143193,908+19.1%
North Dakota$298$1,043411,235+17.7%
South Dakota$297$607611,670+17.3%
Montana$296$1,233562,999+16.8%
New York$294$990209187,987+16.1%
Hawaii$292$1,8661753+15.6%
Washington$284$1,3628224,200+12.4%
Maryland$283$6352183,158+11.9%
Oregon$282$1,026595,612+11.4%
Minnesota$282$1,0738910,940+11.2%
Colorado$280$1,2207519,530+10.6%
Massachusetts$276$1,97463151,340+9.1%
New Hampshire$276$1,634319,167+9.0%
Connecticut$274$9651454,092+8.3%
Nevada$272$1,545235,177+7.4%
Arizona$271$1,2624410,485+7.0%
Delaware$268$84062,384+6.0%
New Mexico$264$395397,891+4.1%
Vermont$263$709396,024+4.1%
Rhode Island$262$69669,489+3.7%
Maine$262$710727,300+3.4%
Nebraska$261$9636247,281+3.2%
Pennsylvania$260$716336109,514+2.8%
Idaho$260$564372,662+2.6%
Wisconsin$258$1,39310127,138+2.0%
Illinois$257$1,563147144,537+1.7%
Utah$257$1,466314,526+1.7%
Florida$256$62182122,189+1.3%
New Jersey$254$688105229,841+0.5%
Michigan$254$98611575,656+0.4%
Iowa$254$7601245,978+0.3%
Missouri$253$86411824,357-0.2%
Kansas$252$624997,563-0.6%
Oklahoma$251$1,0069122,759-0.9%
Virginia$249$7507667,406-1.4%
Indiana$243$1,0259353,031-4.0%
Ohio$243$743134123,043-4.1%
Arkansas$243$8414525,078-4.1%
Texas$242$1,263349270,319-4.5%
Kentucky$239$78413042,475-5.6%
North Carolina$236$44612997,340-6.7%
Louisiana$235$1,1921945,499-7.2%
Puerto Rico$229$250932,501-9.6%
Alabama$228$5749462,083-9.8%
West Virginia$227$6309246,197-10.2%
Tennessee$226$1,120103100,930-10.5%
Mississippi$225$9702331,321-11.0%
Georgia$217$973200238,114-14.4%
South Carolina$214$59784164,246-15.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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