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U.S. has most expensive ambulance billing, international analysis finds

An international comparison found U.S. ambulance call-out fees top seven developed nations and vary sharply by state, with Illinois among the most expensive for ALS responses

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DALLAS — An international comparison is spotlighting how costly ambulance transport can be in the United States, with analysts finding U.S. call-out fees far outpace those in other developed countries.

An analysis from Compare the Market in 2024 found the U.S. has the highest ambulance call-out costs among seven developed countries reviewed.

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The report estimates the average ambulance ride in the United States costs $1,383.44, more than double Australia’s $622 average. The gap widens further with mileage fees: Americans pay about $19.49 per mile, while most other countries charge little to nothing based on distance traveled.

Average Ambulance Costs (USD)

Country Avg. Ambulance Call-Out Fee (USD) Avg. Cost per km (USD)
USA $1,415.85 $31.90
Australia $636.72 $4.22
Canada $254.34 $2.62
UK $134.29 $0.00
New Zealand $62.76 $0.00
Japan $53.60 $0.00
Germany $11.58 $0.00

Ambulance charges also vary widely by state, with the gap between the most and least expensive jurisdictions running into the thousands of dollars. Illinois ranks among the costliest for emergency transport, where an advanced life support response averages more than $3,000 per callout.

By comparison, Michigan and Maryland are among the lower-cost states, with basic life support typically costing about $365 to $500 and advanced life support averaging roughly $650 to $670.

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Bill Carey is the associate editor for FireRescue1.com and EMS1.com. A former Maryland volunteer firefighter, sergeant, and lieutenant, Bill has written for several fire service publications and platforms. His work on firefighter behavioral health garnered a 2014 Neal Award nomination. His ongoing research and writings about line-of-duty death data is frequently cited in articles, presentations, and trainings. Have a news tip? He can be reached at news@lexipol.com.