mike, the cost is going to be different, depending on who you are. the price can be radically different for two people, using the same aircraft on the same day and receiving the same services. it depends on their insurance.
people with no insurance will be billed the most. by law, those on medicare and medicaid will be billed the least.
the center for medicare and medicaid services (cms) has established the bill rate they will pay to air ambulance providers. that rate varies depending on the zip code in which the patient boards the aircraft. there is one rate for fixed wing aircraft and another for helicopters. in addition, there is a payment for how many miles the patient is transported on the aircraft. the cms makes absolutely no adjustment for the type helicopter that is used. it doesn't matter if the helicopter is a bell 206, a bell 222, or a s 76. it doesn't matter if the patient is simply strapped onto a stretcher with no additional services or received two large-bore iv's, is intubated, on a cardiac monitor, o2, and receives cpr. the cost is the same. there is no consideration for the services that are provided. it doesn't matter if the medical crew consists of two nurses, an emt and a nurse, a md and an emt, just one nurse, an rn and an rt, or any other combination you want to consider. the only consideration by cms is where the patient boards the aircraft, was it an airplane or helicopter, and how many miles the patient is transported. each commercial insurance company will have its own bill payment allowance and the criteria for payment, such as particular drg and evidence of necessity. private pay, with no insurance, will have the highest bill rate and that depends on each individual air ambulance operator. individual states have no control over air ambulance operators and cannot set or influence fees. this is in accordance with the airline deregulation act and affirmed by a federal court in the middle district of nc this past november. states cannot require a certificate of need (con) or regulate air ambulance operators if it tends to influence the "aviation" aspect of the operation. this influence is very broadly interpreted and pretty much excludes the states from what is considered exclusively reserved to the faa. the cms however has established reimbursement rates. again, by law, cms gets the lowest rate and cms dictates what that rate is. commercial insurance companies negotiate various rates, as long as it is more than the rate for cms. individuals can't negotiate and they will pay whatever the carrier asks. many of these people simply never pay.