You can't put a price on life-saving health care.
But the bill for it could plague you for life if you or a loved one is air-lifted to the hospital.
Teaming up with ABC stations nationwide, Contact 13 Chief Investigator Darcy Spears examines "Sky-rage."
They're people in bad shape. From traumatic crashes to strokes and heart attacks.
Without an air lift to get there quick, they may not survive.
Darcy Spears: They said "You're getting on that helicopter. We're flying you to Vegas."
Shauna Laswell: Yes. Unless I wanted to die.
In August, 2104, Shauna Laswell suffered a heart attack.
She was in Mesquite, far from a fully-equipped trauma center, wondering if she would make it.
Shauna: I have a 9 year old.
Darcy: You need to be there.
Shauna: I do.
Shauna's situation was too serious to be handled at Mesquite's Mesa View Regional Hospital, and the one about 30 miles away in St. George, Utah, was full.
So she had no choice but to be air-lifted to Las Vegas.
Her journey started on a Mesquite helipad and ended at Summerlin hospital more than $40,000 later.
Shauna had no idea what was coming after that ride from Mercy Air.
Shauna: You pay insurance every single paycheck and then you go and you get a bill for $46,800.
When she saw it, Shauna says, "I almost had another heart attack."
Shauna's health insurance only covered $8,000 of that sky-high bill.
She's been making payments for more than a year, but still owes nearly $39,000.
Air Methods, which owns Mercy Air, sent her account to collections.
"I realize they saved my life and there's no price on saving my life, but you know, when a person is struggling and they're trying to make ends meet, they're working, and then they're faced with this bill that's that horrific..."
So how can they get away with a bill like that?
"Pre-empted and protected by the federal government," says Maryland Insurance Commissioner Al Redmer, who explains that commercial helicopter companies are considered airlines, which were deregulated in 1978.
So no state agency has any authority over routes, service or price.
"I hate to say it, but because they're unregulated, they can send a bill for almost any amount that they want," said Redmer.
Air Methods nearly doubled its per-mile price over the last five years.
Their profits have gone up dramatically too.
According to Paul Webster, Air Methods vice president of payer strategy, "We just released our 10k for 2015. And our profit was $108 million."
Almost $5 million went to CEO Aaron Todd, who owns a home in Las Vegas.
Air Methods makes no apologies for any of it.
"We lose money on seven out of ten transports," said Webster.
He admits Air Methods jacks up costs on insured consumers to make up for what it's losing on the poor, the elderly and the uninsured.
It's a practice called "balance billing," which often leaves people like Shauna stuck deep in debt.
"I feel like I can never dig out," she said.
Air Methods blames Medicare and Medicaid for low reimbursement rates.
They also blame private health insurers.
"The insurance company that underpays the claim is the one that really sticks them with the bill," said Webster.
Air Methods says being ever ready to deploy an airborne emergency room is expensive, and they have to be able to recoup those costs.
But experts question how fair their methods are.
When patients can't pay, Air Methods sometimes sues them, sends them to collections or threatens to put liens on their homes.
"The accusation that we -- that we're aggressive in our collections -- we work with patients -- successfully, directly, all the time," Webster said. "And a patient is only liable for a balance that they have the ability to pay."
What does that mean for Shauna Laswell?
"I 'll be paying until I'm dead."
Congress is working to increase Medicare reimbursements for air ambulance services.
Health reform experts say it needs to go further with federal protection for all consumers stuck in an emergency situation.
Air Methods provided the following statement to Contact 13:
"At Air Methods, we believe that everyone deserves access to lifesaving care. We also understand that every patient's individual and financial circumstances are unique, and our team is dedicated to partnering with every one of them as they navigate through the post-flight and critical care process. Our patient financial counselors are here to help. We have a long-established charity care process in place to allow us to reduce patient financial responsibility within our legal parameters. If an air methods/mercy air patient has a question regarding a bill or correspondence sent by us, they can call us at (888) 636-4438.”
We also checked with the Nevada Division of Insurance to see if they were evaluating ways to help consumers. They provided the following statement:
"Please note that the division does not have jurisdiction over balance billing or the contract provisions between an insurance carrier and a medical air transport provider. However, the division stands ready to provide assistance to Nevada consumers who may have questions regarding the use of the medical air transport services and the coverage provided under their insurance policies."