BUFFALO, N.Y. -- The ride lasted about five minutes.
But Karoll Melendez says her heart stopped when she saw the bill for a short ride by ambulance, which cost around $1,700.
"It was just like a shock to see the bill -- how much it was -- just for a five-minute drive," she says.
It was a very short ride by ambulance from the Melendez home on Pratt Street in Buffalo to Buffalo General Hospital, a distance of about 1.6 miles.
Melendez called 911 in the middle of the night on May 2 when her husband suddenly had a seizure. At 2 a.m. when the incident happened, Melendez said the last thing she was thinking about was money.
"I thought he was dying," she said.
She also said she is glad they have insurance; however, her husband Nelson still questioned why such a short ride was so expensive.
"If it's something that you need, I don't know why it's so expensive, when it's a life-threatening situation," he said.
2 On Your Side posted a story in May about an ambulance ride that cost a man $2,700. After receiving more than 700 comments from local viewers with stories like the Melendez's -- many who said they spent more than $1,000 on short ambulance rides -- 2 On Your Side decided to find some answers.
The cost breakdown
The CEO of Twin City Ambulance based on Commerce Dr. in Buffalo says there's a lot that goes into the cost of each ambulance ride. It goes beyond the paramedics who ride in the ambulance and offer care to patients.
“Nobody has the benefit of scheduling emergencies," says Twin City Ambulance CEO Bryan Brauner. "When they happen… they have to be dealt with… and the reality of providing ambulance service is that we have to have sufficient staff and reasonable deployment to have ambulances available to respond around the clock and to respond to the majority of emergencies in just a few minutes.”
Each time Twin City Ambulance responds, its executives say it costs about $568 just to "break even."
About 30 percent of people refuse transport, which means Twin City Ambulance loses the full $568 on each of those refused calls.
Another 23 percent of calls are for patients who have Medicaid or Medicare. The federal government caps what it will pay for these calls at $160 for Medicaid and $350 for Medicare.
"The government defines ambulance service as a transport benefit," Brauner said. The catch is that it is so much more than transportation.
The remaining 47 percent of ambulance calls have to make up for those losses.
The CEO of Twin City Ambulance says Uncle Sam reserves the best price for himself.
"The government always enjoys the best discount," he said. "They get the best rates from all their suppliers."
Ambulances are also incredibly expensive to insure, Brauner says.
"Generally, our liability policy for our company is up over a million dollars," he said. "That's just vehicle liability."
Worker's compensation is another million bucks, he added.
"You called 911, you have two highly trained crew members," Brauner said. "You had an expensive ambulance and you had very specialized, high-end equipment at your door within a matter of minutes."
Allison Feng is one of those highly-trained crew members, as a Twin City Ambulance paramedic.
"I love it," she says. "It's something different every day, different every call."
She explained calls can range from a stubbed toe to a stroke and even helping a mother who is giving birth.
"I love helping people, whether it's reversing an overdose, or having a chest pain patient or helping a little grandma off the floor, and all they need is a little shoulder and some attention," she said. "It's something different every day, and when you enjoy helping people, it's a real fun job."
There are a lot of skills required as well, such as being able to drive carefully and safely.
"You need to have a knowledge of anatomy and physiology; how the body works," she said. "But you also need an understanding of how people work."
Feng says she needs to know how to interpret EKG's on a monitor to analyze the electrical activity of a heart. She also needs to know how to take vital signs, how a healthy lung is supposed to sound, and she must have knowledge of drugs and dosages, and contraindications.
"Basically, everything from delivering a baby to pronouncing someone dead and a little bit of everything in between," she said.
She also said while she understands that an ambulance is expensive, she has received a bill for one herself and believes it is worth the cost to have a lifesaving service.
"You're not just paying for a taxi ride," she said. "You're paying for an experienced, educated clinician in the back of an ambulance to sometimes make life and death, and life-saving decisions."
Help paying for it
Brauner said they have worked with people in the past to help them pay for an ambulance ride if they have a high-deductable insurance plan.
"If you can't pay the entire deductible right away, we're willing to provide a time-payment plan," he said. "We're willing to work with people to make whatever arrangements that are necessary to make it less of a burden."
Insurance companies help offset some of the high costs of taking an ambulance. Every plan offered by BlueCross BlueShield of Western New York includes coverage for ambulance services, says Kyle Rogers, Manager of Corporate Relations at BlueCross BlueShield of Western New York.
"This largely protects our members from the prices set by medical transportation companies who contract with municipalities and face no competition," Rogers said via an emailed statement.
But those without great insurance can feel out of luck.
Lori Miller, 41 of Cheektowaga, says she is still trying to pay off a $1,102 bill for an ambulance ride last year.
Miller said she didn't have insurance through an employer at the time, as she was working as a substitute teacher. While in the ambulance, Miller says she didn't receive any medical care, because it wasn't needed in her situation.
The fact that she was primarily a passenger in the ambulance makes her more skeptical about the cost, she says. Miller, a mother of two children under 18, says she now worries the bill will negatively impact her credit.
A volunteer firefighter who would prefer to remain anonymous says he did receive medical care when he had to be transported by ambulance after responding to a call for smoke in a building. However, his bill was also much higher than he ever would have expected.
The volunteer firefighter says he responded last summer to the call and was feeling lightheaded with a high pulse and blood pressure. He took the ambulance to a local hospital.
As he was being transported, a ride of around 5 to 7 miles, he said a paramedic monitored his pulse and he received fluids through an I.V.
While he is grateful for this care, he also says he was shocked when he opened his bill for the ride and discovered it cost $1,300.
"It was kind of hurtful to get that bill," the 25-year-old said. He added that his mother's insurance was able to pay for a portion of it.
Rogers with BlueCross BlueShield of Western New York said insurance deductibles can make a difference in terms of how much people pay out of pocket for ambulance rides.
He added BlueCross BlueShield will "continue to explore ways to manage and control ambulance services" for employers and members.
Karoll Melendez says while she is grateful to have insurance, she still wonders if it is worth it to call an ambulance in the future.
“In an emergency, do I call the ambulance again, or do I just go and take the ride to the hospital?" she told 2 On Your Side. "But you don’t think about that stuff.”
While there is a growing trend of people using Uber and Lyft, which launched in Western New York Thursday, to get to the hospital instead of an ambulance, emergency officials say an ambulance is best when time is of the essence because it has lights and sirens.
Uber and Lyft both say they are not a substitute for medical professionals and 911 should be called in an emergency situation.