An arthritic 83-year-old was charged $145 for an ambulance that took her just 5km.
Joyce Fraser's family organised a non-emergency service to pick her up from her Hepburn Rd home in Glendene, but says the cost - which equates to 40 per cent of her weekly pension - had to be borne out of desperation.
It was necessary because Ms Fraser, 83, finds it too difficult to get into her son David's car because of arthritis in her knees.
But Mr Fraser was never told about a free shuttle service, which operates in the area.
Mr Fraser said he was aware of the charge when he booked the ambulance on November 1. However, the pair had no other option to get her to Lincoln Dental Centre to fix a broken tooth.
He did not know about a shuttle service which operates in Waitakere and said operators did not alert him to the option. The service, which operates in the west and transports people to and from essential medical appointments, is free although a donation is appreciated. It is advertised on the website but Mr Fraser said he did not see it when making inquiries.
St John admitted it should have told the family about the donation-only health shuttle.
Mr Fraser said regardless of the shuttle the cost for the 10-minute 5km ride was ridiculous.
"It's just not reasonable.
"We felt we didn't have any other choice. There was no other way we could get mum down there in an urgent situation."
Another relation, who does not live with the pair and happened to be at the dentist, was able to bring her home in a vehicle that sits higher off the ground saving the pensioner a return trip which would have cost another $145. St John northern region general manager Gary Salmon said the pair should have been made aware of the shuttle when the ambulance was booked.
"I would encourage the family to contact St John to discuss their concerns."
Mr Salmon said non-emergency services were not covered by government funding and incur a full charge. How much patients are charged is based on kilometres travelled. The average cost was about $680.
When asked if the Frasers would have to pay a spokeswoman for St John said the invoice would be up for discussion.
The Herald revealed in September that St John is losing $15 million a year after the annual operating loss nearly doubled in five years from $8 million.
In non-emergency situations people can book ambulance transport, however the cost is not covered by government funding and incurs a full charge. How much you're charged is based on the kilometres travelled.
35km or less: $145
36-100km: $4.10 a km
101-400km: $4.50 a km
Over 400: $5.45 a km