How can ambulances cost $6000? That's ridiculous.
The promise that "government" provides ambulances is as bogus as the government providing ATC services at Oshkosh.
Most municipalities charge you / your insurance a significant dollar amount. They're not a true government service anymore.
In some municipalities you get charged more if you're not a resident. Personally I think anyplace that does that, the surrounding municipalities should reciprocate only for the residents of the place doing it, just to make it slightly more fair.
Dad's ambulance ride the day he passed away was about a mile and a half with Advanced Life Support in the South Metro Fire Rescue District which basically covers almost all of the South Denver Suburban area. Bill was about $3K. South Metro has some of the best budget around, very new gear, and is doing quite well. They just know they can do even better if they charge out the wazoo.
I suspect there's folk who are poor enough they're paying off ambulance rides on high-interest credit from their collections agency over many months.
Ambulance rides haven't been paid for as part of "government" here for a long time. The only protection we do have here is a 911 call gets whoever the dispatcher has available. In a non-emergency you can call any of three or four private ambulance companies if you don't want to use the city/county/district ones.
Not many people do that. But they can. There's competition but you have to be aware. 911 sometimes uses the private companies as overflow also. Most of the private companies stay busy and in business transporting nursing home patients, and other patients around under contracts.
It's a strange little business. Not cheap either. I love the response times but the property taxes going to South Metro are pretty high for something you have to add $2K per mile or two (in the suburbs) to make up their shortfall. They're not really lining their pockets either. They do equip well compared to some districts, but not overly so.
They're latest gadget is a digital voice for dispatch. That is interesting. No more medical dispatch by human voices. The computer does the talking after the dispatcher hits send. The system also transfers the address/location to the laptop in the ambulance and displays a map for the driver. Pretty fancy.