Guide Rankings Health Updated June 21, 2026

Ambulance Cost by State

Ambulance parked outside a hospital emergency entrance

Ambulance Cost by State

Ranking - Health

Ground ambulance prices vary dramatically by state even before mileage and extra services are added. In 2026, Hawaii's average basic life support base rate is nearly double the level seen in the cheapest Southern states.

Quick Answer

Ambulance Cost by State

  1. 1

    Hawaii has the highest average ambulance cost for basic life support at $2,473, with advanced life support averaging $2,426. Both figures are more than $600 above California, the next most expensive state at $1,854 for BLS.

  2. 2

    Hawaii is the only state where basic life support costs more than advanced life support, at $2,473 versus $2,426. In California, ALS exceeds BLS by $186, the widest positive gap in the data.

  3. 3

    Alabama has the lowest basic life support cost at $1,266 and the lowest advanced life support cost at $1,412. Oklahoma ($1,275 BLS), Arkansas ($1,277 BLS), and Mississippi ($1,294 BLS) are the only other states below $1,300 for basic service.

Map

Ambulance Cost by State 2026 Map

BLS
No data
Hawaii's $2,473 BLS cost sits more than $600 above all other states. Every state in the top 13 is on the Pacific coast or in the Northeast, while Alabama ($1,266) and Oklahoma ($1,275) anchor the lowest end.
Ambulance Cost by State 2026 Map
Rank State BLS
1 Hawaii 2,473
2 California 1,854
3 Alaska 1,792
4 Massachusetts 1,763
5 Maryland 1,687
6 Washington 1,679
7 New Jersey 1,622
8 Oregon 1,594
9 New York 1,592
10 Vermont 1,578
11 Rhode Island 1,575
12 Connecticut 1,548
13 New Hampshire 1,545
14 Colorado 1,504
15 Arizona 1,500
16 Idaho 1,497
17 Florida 1,485
18 Delaware 1,477
19 Maine 1,469
20 Montana 1,466
21 Nevada 1,464
22 Utah 1,458
23 Pennsylvania 1,442
24 Virginia 1,440
25 Wisconsin 1,391
26 Louisiana 1,385
27 Kentucky 1,380
28 North Carolina 1,378
29 South Carolina 1,377
30 Wyoming 1,375
31 Ohio 1,366
32 Indiana 1,364
33 Michigan 1,361
34 Minnesota 1,359
35 New Mexico 1,355
36 North Dakota 1,355
37 Texas 1,345
38 Illinois 1,344
39 Tennessee 1,336
40 Georgia 1,332
41 Nebraska 1,328
42 Missouri 1,318
43 South Dakota 1,313
44 West Virginia 1,307
45 Iowa 1,299
46 Kansas 1,296
47 Mississippi 1,294
48 Arkansas 1,277
49 Oklahoma 1,275
50 Alabama 1,266

Hawaii's $2,473 BLS cost sits more than $600 above all other states. Every state in the top 13 is on the Pacific coast or in the Northeast, while Alabama ($1,266) and Oklahoma ($1,275) anchor the lowest end.

Ambulance Cost by State Table

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Clean, print-ready version of Ambulance Cost by State.

Most and Least Expensive States for an Ambulance Ride

Highest

2473
Hawaii flag
Hawaii #1

Lowest

1266
Alabama flag
Alabama #50

Top 10 Highest — Avg. BLS Cost

#1 Hawaii flag Hawaii
2473
#2 California flag California
1854
#3 Alaska flag Alaska
1792
#4 Massachusetts flag Massachusetts
1763
#5 Maryland flag Maryland
1687
#6 Washington flag Washington
1679
#7 New Jersey flag New Jersey
1622
#8 Oregon flag Oregon
1594
#9 New York flag New York
1592
#10 Vermont flag Vermont
1578

Top 10 Lowest — Avg. BLS Cost

#50 Alabama flag Alabama
1266
#49 Oklahoma flag Oklahoma
1275
#48 Arkansas flag Arkansas
1277
#47 Mississippi flag Mississippi
1294
#46 Kansas flag Kansas
1296
#45 Iowa flag Iowa
1299
#44 West Virginia flag West Virginia
1307
#43 South Dakota flag South Dakota
1313
#42 Missouri flag Missouri
1318
#41 Nebraska flag Nebraska
1328

Most Expensive State for an Ambulance Ride

Ambulance parked outside a hospital emergency department entrance
Ambulance base rates vary by more than $1,200 between the highest-cost state (Hawaii) and the lowest (Alabama).

Hawaii's average BLS rate of $2,473 is $619 above California's $1,854, the largest gap between any two consecutive states in the ranking. No other state exceeds $2,100 for either service type, and Hawaii is the only state where basic service ($2,473) averages more per ride than advanced service ($2,426).

States with the Lowest Ambulance Costs

Interior of an ambulance showing a stretcher, cardiac monitor, and medical supply cabinets
Iowa and Mississippi have the smallest gaps between their BLS and ALS rates in the data, at $56 and $60 respectively.

Alabama averages $1,266 for basic life support and $1,412 for advanced life support, the lowest for both service types among all 50 states. Oklahoma ($1,275), Arkansas ($1,277), and Mississippi ($1,294) are the only other states where BLS averages below $1,300.

Iowa has the smallest gap between BLS and ALS in the table, with ALS running just $56 above BLS ($1,299 BLS, $1,355 ALS). Mississippi is next at $60, between its $1,294 BLS and $1,354 ALS.

Quick Answers

Which state has the most expensive ambulance in 2026?
Hawaii has the highest ambulance costs in the country, averaging $2,473 for basic life support and $2,426 for advanced life support. No other state exceeds $2,100 for either service type. California ranks second at $1,854 for BLS.
Which state has the cheapest ambulance ride?
Alabama averages $1,266 for BLS and $1,412 for ALS, both the lowest in the data. The spread between Alabama's BLS rate and Hawaii's is $1,207.
How much does an ambulance cost in California?
California averages $1,854 for basic life support and $2,040 for advanced life support, the only state besides Hawaii where ALS exceeds $2,000. At $1,854 for BLS, it ranks second in the country.
What does an ambulance cost in Texas?
Texas averages $1,345 for basic life support and $1,498 for advanced life support, ranking 37th among the 50 states for BLS cost. ALS runs $153 above BLS in Texas.
How much does an ambulance cost in New York?
New York averages $1,592 for BLS and $1,697 for ALS, ranking 9th highest nationally for basic service. The ALS rate is $105 above the BLS rate.
Which states have the smallest gap between BLS and ALS ambulance costs?
Iowa has the smallest positive gap, with ALS averaging just $56 above BLS ($1,299 BLS, $1,355 ALS). Mississippi is next at $60. Hawaii is the only state where BLS exceeds ALS, by $47.

Methodology

Figures represent 2026 average ground ambulance base rates by state, split between basic life support (BLS) and advanced life support (ALS) transport, from the CMS Ground Ambulance Data Collection System.

Sources

Information is cross-referenced with official state archives.
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