Just like passenger vehicles, ambulances come in a range of qualities and prices. The latter continues to climb.

EMS agencies in 1985 mostly used Ford vans, according to Harmony EMS Chief Jay Grinnell. They were built for transport rather than treatment, as crews rarely included paramedics back then.

Then, as regulatory agencies began requiring more equipment and trained personnel in ambulances, the ambulances were made bigger.

“It’s been a clash between having equipment that is big enough to do a good job and affordable at the same time,” Grinnell said.

The ambulances generally last longer today than they did back then, but they still must be replaced regularly. Agencies can’t risk breaking down in an emergency, Grinnell said.

He said the old engines in the vans would experience problems faster than today’s engines and they’d be replaced when they reached around 100,000 miles. Today’s ambulances regularly reach 200,000 miles.

Nate Bacher, operations supervisor for Butler Ambulance Service, said his ambulance services replaces ambulances every 200,000 miles or five years.

Each time they go back to buy a new ambulance, the price has climbed.

Bacher said the service purchased a new Medix ambulance that had never been remounted two years ago for $125,000 and that same ambulance today is $155,000 — almost an 81% increase.

Jesse Haas, Butler Ambulance Service’s director of operations, explained remounting an ambulance can be even more expensive than purchasing a new ambulance. He said every brand can be remounted, but remounts vary in complication depending on the brand of ambulance and the services needed.

Grinnell added some EMS agencies will also purchase a full-size ambulance that typically cannot be remounted. These cost around $200,000, he said.

Other agencies buy Ford Transit vans for $120,000 to $125,000, but they don’t have much room for patient care and some patients don’t fit.

Karns City Regional Ambulance Service, one of the smaller ambulance services in the area, uses two advanced life support ambulances to cover between 210 and 225 miles.

“I have a philosophy of buying slow and rotating out,” said Chief Mark Lauer.

The ambulance service purchases an ambulance every five years then sells the ambulance when its been in service for 10 years, Lauer said. The most recent ambulance it purchased had a base price around $155,000. Its vehicles have a Medix ambulance model on a Ford chassis.

Lauer added larger ambulance services have been able to use transport vans for non-emergency transports. The vans cost less and are more fuel efficient than an ambulance, but he said they start to see more mechanical problems after 100,000 miles.

Instead of buying completely new ambulances, Harmony EMS works with Iowa-based manufacturer Life Line Emergency Vehicles, which remounts the aluminum ambulance boxes to a new chassis. The aluminum, rust-proof box can then have its emergency lights replaced, its wiring redone and other upgrades that can increase the price.

They’re typically connected to a Ford E-series, which has a front like a van, or an F-series, which has a front like a pickup truck.

The remounts have different rules than buying a new ambulance. For example, a loader system, which automatically lifts the stretcher into the ambulance, doesn’t have to be added to a remounted box because if its grandfathered in, which can save more money.

Grinnell said he also tried a Freightliner front once, thinking the vehicle was built to rack up thousands of miles, but he said it was plagued with mechanical and electric problems.

The remount last year cost the company about $178,000, and the next is projected to cost around $200,000, Grinnell said. The remount three years ago cost the company $135,000 — a $40,000 increase in about two years.

“The point being, they’ve gone up drastically,” Grinnell said.

Despite the increase, Grinnell continues buying Life Line ambulances because of their durability. He said in one instance about three years ago, Harmony EMS crews were responding to an incident on Interstate 79 during a snowstorm where it was rear-ended by a tractor trailer, which pushed it into the median. The tractor trailer had to be towed from the scene, but the ambulance was able to be driven away with its crew uninjured.

“Everybody has adapted to what works for them, their service area and their budget,” Grinnell said about purchasing ambulances.

Harmony EMS serves its municipalities with five ambulances with the Ford E-450 van chassis, and seven wheelchair vans. The ambulances are two-wheel drive.

Grinnell said he tried a four-wheel-drive ambulance at one point and the ride wasn’t as smooth. He said the vehicle also had to be lifted to accommodate the four-wheel drive, which put more wear on the suspension.

Butler Ambulance Service uses 10 ambulances, 14 wheelchair vans and one paramedic response squad SUV. Of the 10 ambulances, six have an ambulance box with a Ford E-450 chassis, and four are the Ford Transit vans.

Hass added the smaller ambulances can sometimes worsen quality of life for paramedics as they work in a smaller space with all the same equipment, but they cost less without factoring in insurance.

Karns City Regional Ambulance Service uses two Medix ambulances on a Ford chassis.

“It’s been an eye-opening experience over the last several years,” Lauer said about purchasing ambulances.