A0431

Ambulance service, conventional air services, transport, one way (rotary wing)

Medicare pricing data for 356 providers across 43 states

🤖AI Overview

This procedure has a 7.1x markup — hospitals charge $38,924 but Medicare allows only $5,463. Uninsured patients may face bills 7.1 times higher than what insurance negotiates. 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, conventional air services, transport, one way (rotary wing) (HCPCS code A0431) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $5,463, but hospitals typically charge $38,924 — a 7.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1,093

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $5,463, your out-of-pocket cost would be approximately $1,093. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$5,463
Average Hospital Charge
$38,924
Markup Ratio
7.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$38,923.56
Medicare Allowed$5,462.77
Medicare Payment$4,348.03

Hospitals charge 7.1x more than what Medicare allows for this procedure. Medicare actually pays $4,348 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$6,488$22,579275+18.8%
Alaska$6,479$35,2133296+18.6%
North Dakota$6,184$39,523231+13.2%
Colorado$5,962$32,066101,799+9.1%
Wyoming$5,918$41,0674281+8.3%
Nebraska$5,892$39,9002268+7.9%
New Mexico$5,878$38,11771,105+7.6%
Minnesota$5,831$25,19631,040+6.7%
Oregon$5,827$32,67243,843+6.7%
California$5,809$40,55532,619+6.3%
Washington$5,799$23,4211686+6.2%
Nevada$5,779$52,52031,918+5.8%
Oklahoma$5,773$40,745202,236+5.7%
Maine$5,704$14,7801280+4.4%
Kansas$5,640$36,6608721+3.2%
Kentucky$5,585$41,518211,871+2.2%
Utah$5,566$22,5411328+1.9%
Missouri$5,546$43,353173,575+1.5%
Texas$5,546$39,948444,638+1.5%
Iowa$5,544$45,0244343+1.5%
Mississippi$5,512$36,464161,730+0.9%
Illinois$5,508$39,937162,497+0.8%
Tennessee$5,505$43,349313,037+0.8%
Arkansas$5,446$38,159112,108-0.3%
Indiana$5,404$45,7347834-1.1%
Michigan$5,404$26,8916300-1.1%
Wisconsin$5,394$28,7153366-1.3%
North Carolina$5,351$33,85681,191-2.0%
Arizona$5,333$37,88981,372-2.4%
Georgia$5,330$40,770171,247-2.4%
Alabama$5,298$47,3241213,135-3.0%
New York$5,178$40,6153290-5.2%
Ohio$5,175$31,51171,706-5.3%
South Carolina$5,173$38,7398614-5.3%
West Virginia$5,114$25,6914912-6.4%
Virginia$5,107$37,22291,548-6.5%
Louisiana$5,085$29,27571,280-6.9%
Massachusetts$5,078$18,9621809-7.0%
Pennsylvania$4,908$22,33011,556-10.2%
Florida$4,904$36,875141,335-10.2%
Connecticut$4,523$48,521142-17.2%
New Jersey$4,494$37,4662199-17.7%
Maryland$4,490$18,9052711-17.8%

⚠️ 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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