Pricing is the most common question healthcare practices ask when evaluating billing companies — and the hardest to get a straight answer to. In our analysis of 273 billing companies across 5 specialties, only about 30% publicly disclose their pricing model on their website.
This guide explains the five pricing models used by medical billing companies, the typical cost ranges for each, and how to determine which model is the best fit for your practice size, specialty, and financial goals.
The 5 Pricing Models
Percentage of Collections
Most Common36 companies in our directory use this model
The billing company charges a percentage of the revenue they successfully collect on your behalf. This is the most common model in medical billing because it aligns the company's incentives with yours — they earn more when you collect more.
Typical Cost Range
4% – 9%
of collected revenue (not billed charges)
Pros
- Aligned incentives
- Lower risk for new practices
- No payment if nothing collected
- Scales with practice growth
Cons
- Expensive for high-revenue practices
- May incentivize volume over accuracy
- Percentage may not include all services
- Minimum monthly fees common
Best for: Solo practitioners, new practices, and practices with variable monthly revenue.
Flat Monthly Fee
21 companies in our directory use this model
The billing company charges a fixed monthly fee regardless of how much revenue they collect. This provides predictable budgeting and can be more cost-effective for established practices with consistent volume.
Typical Cost Range
$500 – $5,000+
per month, based on practice size and claim volume
Pros
- Predictable monthly cost
- Cost-effective for high-revenue practices
- All services typically included
- Easy to budget and forecast
Cons
- Less incentive alignment
- Still owed during slow months
- May not scale well for growing practices
- Scope creep risk if services expand
Best for: Established practices with consistent volume, multi-provider groups, and practices that want budget predictability.
Hybrid
16 companies in our directory use this model
Combines elements of percentage-of-collections and flat-fee models. Typically involves a lower base fee plus a smaller percentage of collections, or a flat fee for core services with percentage-based pricing for add-ons.
Typical Structure
Base fee + 2-5% of collections
or flat fee for core services + percentage for add-ons
Best for: Mid-size practices seeking a balance between cost predictability and performance incentives.
Custom Quote
7 companies in our directory
Pricing is tailored to each practice based on volume, complexity, and services needed. Common for enterprise clients and complex multi-specialty groups.
Best for: Large practices, hospital systems, and complex billing scenarios.
Hourly
1 company in our directory
Charges by the hour for billing work performed. Rare in the industry and typically used for consulting, auditing, or project-based work rather than ongoing billing.
Best for: Short-term projects, billing audits, or supplemental support.
Pricing by Specialty
Billing complexity varies by specialty, which affects pricing. Here is how pricing models distribute across the specialties in our directory.
| Specialty | % of Collections | Flat Fee | Hybrid | Notes |
|---|---|---|---|---|
| Mental Health | 12 | 7 | 3 | % model dominant; telehealth adds complexity |
| ABA | 7 | 4 | 3 | Auth complexity may command higher rates |
| Dental | 6 | 9 | 9 | Flat/hybrid more common; per-claim pricing exists |
| Physical Therapy | 17 | 3 | 3 | % model strongly dominant in PT |
| Home Health | 4 | 3 | 2 | Medicare-heavy; compliance costs factor in |
Note: Many companies do not publicly disclose their pricing model. These numbers reflect companies where pricing information was available.
What's Included vs. What Costs Extra
Not all billing company quotes are apples-to-apples. Here is what is typically included in a standard billing agreement versus what may incur additional charges.
Usually Included
- Charge entry and coding
- Claim submission
- Payment posting
- Basic denial follow-up
- Monthly reporting
- Eligibility verification
- Patient statement generation
Often Costs Extra
- Credentialing ($300-1,500/provider)
- Prior authorization management
- Complex appeal work
- Patient collections
- Clearinghouse fees ($50-200/mo)
- Setup/onboarding ($500-5,000)
- Custom reporting
Pricing Model Comparison Table
| Factor | % of Collections | Flat Fee | Hybrid |
|---|---|---|---|
| Cost Range | 4-9% | $500-5,000+/mo | Base + 2-5% |
| Incentive Alignment | High | Low | Medium |
| Budget Predictability | Low | High | Medium |
| Best Practice Size | Solo/Small | Medium/Large | Any |
| Risk for New Practices | Low | Higher | Medium |
| Scalability | Auto-scales | Needs renegotiation | Partially scales |
How to Compare Pricing Across Companies
When comparing quotes from different billing companies, use this framework to ensure you are making an apples-to-apples comparison.
Request a complete fee schedule
Ask for all fees — not just the headline rate. Include setup fees, monthly minimums, per-claim charges, and add-on service costs.
Calculate your total annual cost
Estimate your annual collections, then calculate what each company would cost under their pricing model. A 5% rate on $1M in collections is $50,000/year.
Compare included services
Make sure you are comparing the same scope of services. If one company includes credentialing and another charges extra, factor that into the total cost.
Ask about minimums and maximums
Many percentage-based companies have minimum monthly fees ($1,000-3,000). Some cap their percentage at a maximum monthly amount. These details significantly affect your actual cost.
Factor in transition costs
Switching billing companies involves setup fees, parallel billing periods, and potential revenue disruption. Include these one-time costs in your comparison.