FAIR Health report shows 76.4% increase for in-network air ambulance costs


Ethan Kispert


A recent report from FAIR Health finds a 76.4% increase in in-network costs for fixed-wing air ambulance services.


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Air ambulance services transport patients to or between medical facilities when a higher level of care is needed. This alternative form of ambulance service involves either a rotary-blade helicopter or a fixed-blade airplane. These types of services are particularly important in remote states such as Hawaii and Alaska. 

According to the report from FAIR Health, patients generally have no control over whether to use an air ambulance service and what particular service they should use. Consequently, surprise bills from out-of-network health care providers are common. Data from the report indicates that both usage and costs for air ambulances have increased in recent years.


Costs with the service

Air ambulance service costs include an initial or base fee and a mileage fee. 

According to the FAIR Health report, the average costs for uninsured patients or anyone seeking out-of-network care associated with a fixed-wing air ambulance rose by 27.6% — from $19,210 in 2017 to $24,507 in 2020. 

The average out-of-network charges associated with the rotary-wing air ambulance rose by 22.2% — from $24,924 in 2017 to $30,446 in 2020. 

In-network costs for the service saw more significant increases. According to the report, the average costs for a fixed-wing air ambulance increased by 76.4%from $8,855 to $15,624. For rotary-wing air ambulances, the in-network costs rose 60.8% from $11,608 to $18,668. 


Usage of the service

Usage of the service has been on the rise since 2016. The FAIR Health report finds that air ambulance services make up an increasing percentage of total health insurance claims for both air and ground services. In 2016, air ambulance claim lines made up 0.7% of all ambulance claims. That number has risen to just over 0.9% in 2020. 

Data from the report shows that from 2016 to 2020, claim lines for rotary-wing aircraft had a greater share of the air ambulance market nationally. Fixed-wing aircraft, however, saw continued increases over the same five-year span. 


Fixed-wing vs rotary-wing air ambulances

U.S. data from the FAIR Health report showed Alaska as having the highest average mileage for fix-wing air ambulances in 2020. According to the report, the state has the highest average distance per trip at 455 miles, with Florida, Georgia, North Carolina, and Indiana following closely behind.

Massachusetts had the shortest average distance at 117 miles. 

Hawaii leads the list with the highest average mileage for rotary-wing air ambulances in 2020 at 126 miles. North Dakota, Wyoming, Nebraska, and New Mexico follow closely behind. 

Washington D.C. had the lowest mileage with 25 miles. 


Types of diagnoses

According to data from 2016 to 2020, the most common diagnoses with air ambulance patients was mainly from digestive system issues, which comprised of a little over 7% of all air ambulance claim lines. 

When looking at 2020 data during COVID-19, however, the most common diagnosis from air ambulance patients was from chronic respiratory diseases, which comprised of just over 10% of all claim lines. 

A number of states have attempted to regulate air ambulance charges but haven’t been fruitful, according to the organization, since these efforts have been found to be in violation of the Airline Deregulation Act of 1978.