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Take a look at this: https://www.usatoday.com/story/money/personalfinance/2017/05...

basically it says the milleage is just 84$ (that includes all ambulance related costs: maintenance, gas, depreciation of the ambulance, etc) and that's already being very generous. Another 127$ goes to state of new york. we can get rid of that entirely.

they didn't mention the cost of labor, but we can assume about 75$/hr as you said. maybe another 75$/hr for rediness. "Part of what shocked Santoro is the fact that he received what he considered very little care: An EMT took his vitals and gave him oxygen, he said"

Where the heck does alll the rest of the 2100$ go? I would guess: It's all markup that goes to administrative waste and profits.

So, let's get rid of the extra 2100$ worth of administration and keep everyone's ambulance bills lower. that will lower your health insurance bill by a huge amount too.