HCPCS A0428

Ambulance service, basic life support, non-emergency transport, (bls)

Current codeMedical Transport - Ground13 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for HCPCS A0428 by hospital
HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27—$115$288
Cascade Medical CenterLeavenworth$295 – $1,7087 plans$1,634$2,043
Deaconess Medical CenterSpokaneFile dated 2026-08-27———
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$301 – $3617 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$115$288
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$115$288
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$115$288
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$115$288
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27———
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$115$288
Virginia Mason Medical CenterSeattle$195 – $2939 plans——
WhidbeyHealth Medical CenterCoupeville—$655$655
Yakima Valley MemorialYakimaFile dated 2026-08-27———

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.