However, I am not talking about "Fair." I am talking about gouging patients who often don't have a say in the transport or provider; and transparency for reasonable cost and billing structures. If every HAA transport charged 50K for 27 miles, then you may have an argument. But most don't charge that...Not the credible HAA transports.
If you have evidence of a hospital calling so as the staff can "Shift change," you better contact HHS to report fraud and abuse as required by federal law.
Your comment that the "Expenses are huge," [and they are significant], what are they for an independent transport to include the considerations included in my above post for your operation?