How Much Does an EHR Really Cost a Small Practice in 2027? Published Prices, Side by Side

Ask most EHR vendors what their software costs and you get the same answer: “it depends,” followed by a demo request. That makes budgeting hard and comparing harder. Some vendors do publish list prices, though, and the ones that don’t still leave clues in their pricing policies.

So we collected what is actually published. Below is a side-by-side table of the list prices EHR vendors show on their own websites as of November 13, 2026, with the date and a link for each. Then come the costs that never make the headline number, and a short worksheet for working out what an EHR will really cost a 1 to 5 provider office in 2027.

We’re an EHR vendor too, and our prices are in the table under the same rules as everyone else’s.

How we built this table

• Vendor pages first. A price is listed only if the vendor publishes it on its own website. We read each page on November 13, 2026.
• No published price means “quote only.” Where a vendor publishes nothing, we say so instead of repeating guesses from review sites.
• List prices only. Discounts, promotions and negotiated rates are not included. Prices change: confirm every figure with the vendor before you decide.

Published EHR prices, side by side (November 2026)

Vendor	Published list price	Contract terms published	Notable extras on the price list
Practice Fusion	$199 per provider per month	Annual commitment required, billed monthly	Includes e-prescribing with EPCS, claim submission, 3 signing staff licenses and unlimited non-signing staff. Billing service and AI scribe: no published price.
Office Ally EHR 24/7	$44.95 per provider per month; Practice Mate (practice management) $0	No long-term contract, no setup or licensing fees	EPCS token $100 per provider per year; eligibility checks $10 a month for the first 100, then $0.10 each; reminders from $29.95 a month; claim attachments $0.55 each.
Tebra	Practice Essentials (EHR, billing, telehealth): $599 per physician per month ($399 non-physician, $225 therapist). Low-volume practices from $349. EHR Starter from $199 (requires a billing plan).	Auto-renews unless you give notice at least 60 days before term end; fees non-refundable and non-cancellable; increases capped at 4.9% a year	AI Note Assist $99 per provider per month; EPCS $75 application fee; PDMP $500 per facility plus $50 per user per year; published data-export fees on exit (see below).
eClinicalWorks	EHR only $499; EHR plus practice management $599 per provider per month; billing service 2.9% of collections	No start-up costs; contract term not published	Per-statement and per-message fees apply; initial training included for 1 to 9 providers. Its Sunoh AI scribe is priced separately.
Amazing Charts	Hosted EHR $229 a month; locally installed $249; EHR plus practice management $499	Not published	Lab and radiology interfaces, billing services and patient engagement: “inquire.” The pricing page doesn’t state the unit; the vendor’s blog describes $229 as per provider per month.
CharmHealth	Free for under 50 encounters a month (limited features); pay-per-encounter plan from a $25 monthly minimum; provider plans $200 to $350 per provider per month	Monthly, billed in arrears; annual prepay with a discount	EPCS $250 per provider per year; AI scribe $125 per provider per month or $2 per encounter.
OpenEMR	$0 (open-source software)	None	You pay for hosting, setup, backups, upgrades and support yourself, or through a support vendor.
athenahealth	No published price; quote only	Not published	Usually sold as a percentage of collections; the percentage is not published.
DrChrono	No published plan price; quote only	Not published	Published unit fees include extended lab integration at $30 per provider per month and paper claims at $1.00 each; data migration “may require an additional fee.”
ChartLogic	No published price; quote only	Not published	Pricing on request.
MedTec	Free Engagement: $0, free forever. Clinical Pro: $55 per provider per month. Enterprise: custom pricing.	Billed monthly, no setup fee, no long-term contract, cancel anytime	Clinical Pro includes charting, e-prescribing with EPCS, billing and the Basic tier of the seven core modules. AI modules and higher tiers are add-ons, listed separately below.

Sources and dates for every row are listed at the end of this article. All prices are list prices as published on November 13, 2026; confirm with the vendor.

Three pricing models, and what each one rewards

• Per provider per month. The most common model (Practice Fusion, Office Ally, Tebra, eClinicalWorks, Amazing Charts, MedTec). Easy to budget; the cost grows with headcount, not with how busy you are. Check who counts as a “provider” and whether nurse practitioners and therapists are priced differently.
• Percentage of collections. Common when billing services are bundled in (athenahealth, eClinicalWorks’ billing service). You pay more as you collect more, which lines the vendor’s incentives up with yours but makes a growing practice’s costs grow too. A few percent of collections is often more than any flat subscription once a provider is busy.
• Pay per use. Per encounter, per claim, per message (CharmHealth’s encounter plan, Tebra’s low-volume plans, many add-on fees). Cheap when you are small or part-time, but harder to predict. Read where the low-volume price stops: Tebra, for example, moves low-volume practices to standard pricing after more than 100 claims per provider per month for three months.

The costs that are not in the headline price

The monthly subscription is usually not the biggest number in the first year. Plan for these too:

1. Setup and implementation. Some vendors charge nothing (Office Ally, eClinicalWorks and MedTec say so on their pricing pages); others quote it separately. Ask for it in writing.
2. Data migration. Moving patients, histories, schedules and balances from your old system. Some vendors include it, some quote it “based on volume and complexity.” The MGMA has long warned that migration “can be very costly and time consuming.”
3. Training and lost productivity. The first weeks on any new system are slower. Budget for fewer appointments during the switch, not just for training sessions.
4. Per-transaction fees. E-prescribing tokens for controlled substances, eligibility checks, text reminders, faxes, paper statements, claim attachments. Individually small, they add up across a year.
5. Add-ons you’ll actually use. AI scribes, patient engagement, lab interfaces and PDMP connections are often priced separately. Price the setup you need, not the base plan.
6. Contract terms. Annual commitments, auto-renewal notice periods and early-termination balances decide what leaving costs. A 60-day notice window you miss can mean another full year.
7. Leaving: data export fees. Some vendors publish what they charge to hand your data back. Tebra’s help center, for example, lists $1,000 for a billing export, $250 for a clinical export and $2,000 per 20,000 notes and documents.

What vendors may charge to give you your data

Federal information-blocking rules limit what an EHR vendor can charge to export your data. Under the fees exception (45 CFR 171.302), fees must be based on objective criteria and reasonably related to the vendor’s costs. Two kinds of fee are not covered by that exception at all:

• A fee for using the certified export function (the one required by ONC certification criterion 170.315(b)(10)) when you are switching systems, or giving patients their data.
• A fee to export or convert data that was not agreed to in writing when you bought the system.

A fee outside the exception isn’t automatically illegal, but it loses that protection. The practical step is simple: before you sign, get the exit process and any export fees written into the contract, and ask whether the vendor’s export is the certified (b)(10) export.

A worksheet for a 3-provider office

Use this to compare any two quotes on the same basis. Fill in each line from the vendor’s written quote:

• ☐ Monthly subscription × providers × 12 = ______
• ☐ Setup or implementation fee = ______
• ☐ Data migration from your current system = ______
• ☐ EPCS, eligibility, reminders, fax and statement fees for a year = ______
• ☐ Add-ons you will use (AI scribe, patient engagement, interfaces) × providers × 12 = ______
• ☐ Training time and slower weeks during the switch = ______
• ☐ Cost to leave: notice period, early-termination balance, export fees = ______
• First-year total = ______; second-year total = ______

Compare the second-year total as well as the first. A vendor with a low entry price and a long commitment can cost more over two years than one with a higher monthly price and no contract.

MedTec’s prices, in full

• Free Engagement: $0, free forever, no card. Online booking, appointment reminders, patient portal and a practice profile page. No charting and no AI.
• Clinical Pro: $55 per provider per month, billed monthly, no setup fee, no long-term contract, cancel anytime. Charting, e-prescribing (including EPCS), billing, and the Basic tier of the seven core modules. We migrate patients, histories, schedules and balances. A three-month free trial is available, with no card; a signed BAA is needed before real patients.
• Enterprise: custom pricing for multi-location groups and custom integrations.

AI modules (AI Medical Assistant, Speech-to-Text and the AI Scribe bundle) and the Deluxe and Premium tiers are paid add-ons, priced per provider per month. They are not part of the Clinical Pro price. Current add-on prices:

All add-on prices are per provider per month, billed monthly, cancel anytime. Add them to Clinical Pro, or use them on their own alongside your current EHR.

For the full breakdown, see our plans and pricing page.

Frequently asked questions

What are published EHR prices per provider per month?

Among vendors that publish prices, list prices in November 2026 run from about $45 per provider per month (Office Ally EHR 24/7) to $599 per physician per month (Tebra Practice Essentials, which includes billing). Free and open-source options exist, with limits or self-hosting costs.

Why don’t all EHR vendors publish prices?

Many quote each practice individually, often as a percentage of collections or with bundled services. athenahealth, DrChrono and ChartLogic publish no plan prices.

Which EHR costs are not in the monthly price?

Usually the switch itself: data migration, training and slower weeks while staff learn the system. Contract terms decide the cost of leaving.

Can an EHR vendor charge me to export my data?

Sometimes, within limits. Federal information-blocking rules restrict fees for the certified export used when switching systems, and fees not agreed in writing. Put the exit terms in your contract.

Sources (all read November 13, 2026)

• Practice Fusion pricing
• Office Ally pricing and EHR 24/7
• Tebra pricing, Tebra pricing policy (effective July 1, 2026), Tebra help center: Data Services: Export
• eClinicalWorks pricing
• Amazing Charts pricing and Amazing Charts blog: Best EHR for small practices in 2026
• CharmHealth pricing FAQ and Charm AI Scribe
• DrChrono pricing; ChartLogic pricing
• OpenEMR
• Information blocking fees exception: 45 CFR 171.302

Prices are list prices published by each vendor on November 13, 2026 and can change at any time. Confirm current pricing and contract terms with the vendor in writing before you decide. This article is general information, not financial or legal advice.

Want a quote you can hold us to? Book a Free Demo: a free 30-minute demo on your own workflows, no sales script.