Don’t know about where you are, but here the Fire Department does or does not do the transport based on what they find. They will encourage people to go to the ER on their own or with friends and family but those really needing transport with services get it. Charged $800 for it too.
DK
Some ambulances here send out bills. They receive remuneration from the insurance company if the patient has insurance ,but if not it mostly goes unpaid.
A ride in the helicopter if needed is $6,000 bucks.
Where I live the FD responds and a paramedic ambulance shows up. The ambulance company only gets paid if the FD tells them to treat and transport. You will be treated and transported for about $1,500 a pop.