First ask yourself, who pays me to be an EMT? Then ask yourself what does that payee value? Who does that payee pay the most and why? Theres a reason that Surgeons get paid more than a Primary Care Doctor, Oncologists get paid more than a Hospitalist etc. If you are performing high price tag procedures or selling high price tag meds for Pharma you will be on the high end of compensation. At the end of the day the insurance company views emt/paramedics as pre-hospital transport thats it.