Conversational Agents Pricing: What Clinics Actually Pay in 2026

This article breaks down how conversational AI pricing works for medical practices, covering per-minute and per-call models, telephony and integration costs, and the factors that affect what you'll actually pay each month.

How conversational AI pricing works in healthcare

Conversational AI pricing for healthcare typically ranges from $0.002 to $0.12 per minute of interaction, depending on the platform and features included. Most platforms charge based on either call length or a flat rate per call, with additional fees for phone infrastructure, speech processing, and EHR integration.

Healthcare pricing differs from generic conversational AI because you're paying for HIPAA compliance, clinical workflow support, and integration with medical systems. A platform built for retail customer service won't include the security infrastructure or medical terminology understanding that your practice requires. When you evaluate pricing, you need to understand each component separately because some platforms bundle everything into one rate while others charge separately for each piece.

Per-minute and per-call pricing models

Per-minute pricing means you pay for every second your AI phone assistant is on a call with a patient. This model works well when your calls are short and predictable, like simple appointment confirmations or prescription refill requests. You'll see rates anywhere from $0.002 to $0.08 per minute depending on the AI capabilities included.

Per-call pricing means you pay a flat rate regardless of how long the conversation takes. This protects you when patients need extra time to explain symptoms, ask follow-up questions, or work through complex scheduling needs. Healthcare calls often take longer than typical customer service interactions because a patient scheduling a specialist appointment might need to verify insurance, check multiple provider calendars, and confirm pre-visit instructions.

Some platforms offer hybrid models that charge a base rate plus additional fees for calls exceeding a set length. This gives you flexibility but makes it harder to predict your monthly costs. The right model depends on your call patterns.

• Per-minute advantage: You pay less for quick calls like appointment reminders and simple confirmations.
• Per-call advantage: You're protected when calls run long due to clinical complexity or patient questions.
• Hybrid models: Charge a base rate plus overage fees, offering flexibility but more complex cost calculations.

Telephony and integration costs

Telephony is the phone infrastructure that connects your AI phone assistant to actual phone calls. This includes the technology that routes calls, manages hold times, and transfers patients to staff when needed. Most platforms charge $0.002 to $0.01 per minute for telephony on top of the base AI rate, so you need to factor this into your total cost.

Integration costs cover connecting your AI phone assistant to your EHR and scheduling systems. Without integration, your AI can only take messages and your staff still has to do the actual work. With integration, it can check real-time availability, book appointments directly, and access patient information to personalize conversations.

Some platforms include basic integration in their pricing while others charge setup fees ranging from a few hundred to several thousand dollars. You may also pay ongoing monthly fees for maintaining the connection. Platforms developed by practicing physicians often include deeper clinical integrations at standard pricing because they understand what workflows actually matter in a busy practice.

• Call routing: Directs calls to the right department or provider based on patient needs.
• EHR access: Lets your AI phone assistant check schedules and patient records during calls.
• SMS messaging: Enables appointment reminders and follow-up confirmations via text.
• Read-only integration: AI can check schedules but staff must complete bookings manually.
• Read-write integration: AI can book appointments and update records directly without staff involvement.

AI model and speech processing fees

Speech-to-text converts what patients say into text that the AI can understand. Text-to-speech converts the AI's responses back into natural-sounding voice. These processes happen in real time during every call, and some platforms charge separately for each component while others bundle them together.

Large language models power the AI's ability to understand context, interpret patient requests, and generate appropriate responses. Different models have different capabilities and costs. Clinical-grade models trained on medical terminology cost more but handle healthcare conversations more accurately, which means fewer calls get escalated to your staff.

Google Cloud's Dialogflow, one of the most common platforms for building conversational agents, shows how these costs break down. Their standard tier costs $0.007 per text request and $0.001 per second of audio. Their advanced tier with generative AI features costs $0.012 per text request and $0.002 per second of audio. These costs add up quickly at high call volumes.

AI Component	What It Does	Cost Impact
Speech-to-text	Converts patient speech to text.	Usually included or minimal cost.
Text-to-speech	Converts AI responses to voice.	Varies by voice quality selected.
Language model	Powers understanding and clinical responses.	Largest variable cost in most platforms.

What affects conversational agent pricing for clinics

Your total cost depends on factors specific to healthcare that don't apply to other industries. Understanding these factors helps you predict your actual spending and choose a platform that fits your practice. The three biggest cost drivers are EHR integration depth, specialty awareness, and compliance requirements.

EHR and scheduling system integration

The depth of integration between your AI phone assistant and your EHR determines how much staff time you actually save. Basic integration means the AI can see appointment availability but can't do anything with it. Deep integration means it can book appointments, update patient records, and flag urgent calls for clinical review without any staff involvement.

Deeper integration typically costs more but delivers more value. An AI phone assistant that can only check availability still requires staff to complete the booking, which defeats the purpose. One that can book directly, send confirmation texts, and update your EHR handles the entire workflow from start to finish.

Integration complexity varies by EHR platform. Major systems like Epic, AdvancedMD, and Office Practicum have established integration pathways that work quickly. Smaller or legacy systems may require custom development that adds weeks to your timeline and thousands to your costs., though implementation can still cost $20,000 to $65,000 for small practices. Smaller or legacy systems may require custom development that adds weeks to your timeline and thousands to your costs.

Integration Level	What Your AI Can Do	Staff Time Saved
Read-only	Check appointment availability only.	Minimal, staff still completes booking.
Read-write	Book appointments and update records.	Significant, handles full workflow.
Custom	Tailored to your specific EHR and workflows.	Maximum, but longer implementation.

Specialty-aware clinical workflows

A conversational AI built for general medicine handles different situations than one trained for cardiology, pediatrics, or orthopedics. Specialty awareness affects how accurately your AI phone assistant triages calls, answers patient questions, and decides when to escalate to clinical staff. This matters more than most practices realize when evaluating AI voice agent pricing.

An AI that doesn't understand your specialty will escalate more calls to your staff. Each escalation costs you staff time and reduces the value you get from the platform. A platform that understands your specialty terminology and protocols handles more calls end-to-end without human intervention, which is where the real savings come from.

Specialty training doesn't always add direct cost to your pricing. However, it dramatically affects your return on investment. An AI phone assistant that handles 85% of calls without escalation costs less per resolved call than one that escalates 40% of calls, even if the per-minute rate is lower. Always ask about specialty-specific training when comparing platforms.

HIPAA compliance and security requirements

HIPAA compliance is mandatory for any platform handling patient information. You're paying for encrypted data transmission, secure storage, audit logging, and infrastructure that meets healthcare security standards. These requirements add cost compared to platforms built for non-healthcare industries, but you can't skip them.significant cost compared to platforms built for non-healthcare industries, but you can't skip them.

Look for platforms with both HIPAA compliance and SOC 2 Type 2 certification. SOC 2 Type 2 indicates ongoing security audits over time, not just a point-in-time assessment. This matters because security threats evolve and your platform needs to keep up with them.

Business associate agreements are legal documents required when a vendor handles protected health information on your behalf. Some platforms include BAAs in their standard pricing. Others charge additional fees or require enterprise-tier subscriptions to access them, which can significantly increase your costs.

• Data encryption: Protects patient information during transmission and storage.
• Audit logging: Tracks all access to patient data for compliance reporting.
• BAA availability: Confirms the vendor accepts legal responsibility for protecting patient data.
• Regular security audits: Demonstrates ongoing compliance, not just initial certification.

How to compare conversational agent pricing for healthcare

Comparing platforms requires looking beyond the headline per-minute rate. Two platforms with similar rates can have dramatically different total costs depending on integration fees, escalation rates, and what's included in the base price. You need to calculate your total cost of ownership to make an accurate comparison.

Total cost of ownership beyond per-minute rates

Your total cost includes the per-minute or per-call rate plus integration fees, setup costs, and the staff time required to handle escalated calls. A platform with a lower per-minute rate but higher escalation rates may cost more overall than one with a higher rate but better call resolution. The math matters here.

Calculate your expected monthly cost by estimating your call volume, average call length, and escalation rate. Then add integration and maintenance fees. This gives you a realistic comparison between platforms rather than just comparing headline rates.

Consider staff time savings as part of your calculation. If your AI phone assistant handles 500 calls per month that would otherwise require 3 minutes of staff time each, you're saving 25 hours of staff work monthly. That savings offsets your platform costs and often makes a more expensive platform the better financial choice.

• Base monthly rate: Per-minute charges multiplied by your expected call volume.
• Integration fees: One-time setup costs plus ongoing monthly fees for EHR connection.
• Staff time savings: Hours saved per month multiplied by your staff hourly rate.
• Net monthly cost: Total platform cost minus staff time savings equals your true cost.

Escalation and handoff quality

Escalation happens when your AI phone assistant transfers a call to a human staff member. Every escalation costs you staff time and reduces the efficiency gains you're paying for. Lower escalation rates mean more calls handled without human involvement, which is the whole point of implementing an AI phone assistant.

When escalation does happen, the quality of the handoff matters enormously. Your staff should receive a complete summary of the conversation so they don't have to start from scratch with the patient. Good handoffs save time and improve patient experience. Poor handoffs frustrate patients and waste staff time, making your AI investment less valuable.

• Routine calls: Scheduling, refills, and reminders should rarely need escalation.
• Clinical calls: Symptom questions and urgent concerns should transfer with full context.
• Handoff summaries: Staff should see exactly what was discussed before picking up the call.

Integration depth with your specific EHR

Platforms often claim EHR integration, but the depth varies significantly. Some offer pre-built connections to major EHR systems that work immediately. Others require custom development that adds weeks or months to your implementation timeline and thousands of dollars to your costs.

Ask specifically about integration with your EHR platform. A platform with deep Epic integration may have only basic support for AdvancedMD or Office Practicum. The integration depth determines what your AI phone assistant can actually do during calls, which directly affects how much staff time you save.

Read-only integration limits your AI to checking information. Read-write integration enables booking, updating records, and managing follow-ups. The difference affects how many calls your AI can resolve without staff involvement, which is the key metric for calculating your return on investment.

Integration Depth	What Your AI Can Do	Implementation Time
Basic	Check appointment availability only.	Days to weeks.
Standard	Book and modify appointments directly.	Weeks to a month.
Deep	Update records, manage referrals, handle intake.	One to two months.
Custom	Tailored to your unique workflows and systems.	Two months or longer.

Frequently asked questions

What is typically included in conversational AI pricing for healthcare practices?

Most pricing includes the AI interaction, speech processing, basic phone infrastructure, and standard EHR integration. Additional costs may apply for custom integrations, specialty-specific training, advanced security features, or premium support tiers.

How does conversational agent pricing compare to hiring additional front desk staff?

A full-time front desk staff member costs $35,000 to $50,000 annually costs $35,000 to $50,000 annually plus benefits and training. An AI phone assistant handles calls continuously without breaks, covering after-hours and peak times when staffing is most expensive.

Can healthcare practices start small and scale their conversational AI usage?

Most platforms offer flexible pricing that scales with your call volume. You can start with one phone line or department and expand as you see results. Verify that per-minute rates don't increase as you scale and that integration costs don't multiply with each new location.

What questions should I ask vendors about Dialogflow pricing and other platform costs?

Ask about all components separately: base AI rate, telephony fees, speech processing costs, integration setup and maintenance, and any minimum commitments. Request a detailed breakdown showing exactly what's included in the quoted price versus what costs extra.