Branzino HealthAsk an EHR vendor what their software costs and you'll usually get a demo invitation, not a number. That's the first clue. The sticker price is rarely the real price, and for a cash-pay practice — where every dollar comes out of your own margin, not a payer's — knowing the true cost matters more than almost anything else.
So let's put actual figures on the table. Here's what EHRs cost in 2026, where the hidden money goes, and what a cash-pay practice should reasonably expect to pay.
How much does an EHR cost per month?
Most EHRs cost $150–$300 per provider per month at the standard tier, with basic plans from $50 and premium plans past $500. That's software only — setup, data migration and per-feature add-ons are billed separately and routinely add $1,000–$10,000 in the first year.
Most EHRs price per provider, per month, in tiers. Published and third-party figures for 2026 land roughly here:
| Tier | Per provider / month |
|---|---|
| Basic | $50–$150 |
| Standard | $150–$300 |
| Premium | $300–$500 |
Brand-name systems sit at the higher end. Published comparisons put DrChrono around $249 per provider per month and AdvancedMD in the $485–$729 range, while others like Tebra span roughly $99–$399 depending on what you add on. The pattern is clear: a full-featured EHR usually runs several hundred dollars per provider, every month.
The hidden fees that inflate the bill
The monthly tier is only the start. The costs that actually surprise people show up around it:
- Setup and implementation. Anywhere from $0–$500 for self-service to $2,000–$5,000 for full implementation, and far more for enterprise rollouts.
- Data migration. Bringing your own patients over commonly costs $500–$3,000, and complex migrations run well past $10,000.
- Training. From free self-paced options up to $2,000+ per staff member for one-on-one or on-site training.
- Per-feature add-ons. E-prescribing ($20–$50), a patient portal ($20–$40), billing ($50–$100), telehealth, and reporting are often billed separately, on top of the base.
- Support tiers. Real help sometimes sits behind a "priority" plan at $50–$500 a month.
EHR implementation cost breakdown
Implementation is the one-time money you spend before the system earns you anything, and it's the line vendors are slowest to quote. For a small practice it typically totals $1,000–$10,000. Here's where it goes:
| One-time cost | Typical range |
|---|---|
| Setup & configuration | $0–$5,000 |
| Data migration from your old system | $500–$3,000 |
| Staff training | $0–$2,000 per person |
| Template & form building | $0–$1,500 |
| Integrations (labs, payments, e-fax) | $0–$2,000 each |
| Lost productivity during cutover | 1–4 weeks of reduced volume |
That last row is the one nobody invoices you for and everybody pays. A two-week dip in patient volume while your staff learns a new system can cost more than every other line combined — which is why "how long until we're back to full schedule?" belongs in the sales conversation alongside the price.
Ask every vendor to break out setup, migration, training and integrations as separate line items in writing. A vendor who won't itemize implementation before you sign won't itemize it after.
Why "starting at $X" is a trap
That low headline price is almost always a stripped base plan. By the time you add the patient portal, e-prescribing, and billing — things you assumed were included — the "$99" plan is quietly $250 or more. Stack a setup fee and a migration charge on top, and your first year costs thousands more than the number that got you in the door.
This is the exact game our guide to choosing an EHR for a cash-pay practice warns about. The published price and the price you pay should be the same number.
What a cash-pay practice should actually pay for
Here's the good news for cash practices: you don't need most of what makes those bills so high. You're not running claims scrubbing, payer eligibility, or the heavy insurance machinery that premium tiers are built around. You need charting, scheduling, a patient portal, billing for packages and memberships, and e-prescribing if you have a prescriber.
That means you should be paying for a lean, complete tool — not subsidizing an insurance-first platform you'll never fully use. And it should be one predictable number, not a base price plus a stack of add-ons. That's the whole argument behind our EHR for cash-pay practices: charge for what a cash practice runs on, make the claims engine optional, and publish the number.
A fair price, in plain numbers
We built Branzino to be that number: $29 per provider per month for a cash-pay practice, with everything you actually need included — charting, scheduling, billing, and a patient portal — plus free data migration, no setup fee, and no contract. If you do bill insurance, that's an optional add-on, so a cash practice never subsidizes machinery it won't use. The price is published on the site, so what you see is what you pay.
Put it side by side. A typical standard-tier EHR at $200 per provider per month, plus a $1,500 migration and a modest setup fee, runs well over $3,000 in year one for a single provider. The same provider on a $29 all-in plan pays under $350 for the year, with migration included. That gap is not a discount — it's the cost of everything a cash-pay practice doesn't need.
How to compare EHR pricing honestly
Whatever you choose, judge every vendor on the same four questions:
- What is the total, all-in price per provider per month — with every feature I need included?
- Is there a setup fee, and is data migration free?
- Am I locked into a contract, or can I cancel anytime?
- Is the price published, or do I have to negotiate for it?
Switching EHRs without losing patient data
The fear of losing records is what keeps most practices paying too much for too long. It shouldn't. Your patient data belongs to your practice, not your vendor — but getting it out cleanly takes a specific order of operations.
- Request the export before you cancel. Once the contract ends, your leverage and often your access go with it. Ask for the export while you're still a paying customer.
- Name what you need. Demographics, encounter and progress notes, documents and scanned files, medications, allergies, problem lists, immunizations, appointment history and outstanding balances. A CSV of names and phone numbers is not a migration.
- Check the format. Structured data (CSV, CCDA, HL7) can be mapped into a new system. A folder of PDFs preserves the record legally but not usably — you'll be reading it, not searching it.
- Overlap the two systems. Keep read access to the old one for a few weeks after go-live. Cheap insurance against the field you forgot to map.
- Verify a sample before cutover. Pull twenty real charts across different visit types and compare them field by field. Errors cluster — if those twenty are clean, the rest usually are.
Watch for the exit charge, too. Some contracts bill for the export itself, or require notice before an auto-renew date. Read the termination clause before the pricing page. Our walkthrough on how to switch EHRs without downtime covers the full timeline, and migration is free and included on our side — we'd rather you moved than stayed stuck.
The bottom line
A cash-pay practice shouldn't pay insurance-clinic prices. Expect one honest, published number that includes what you actually use — and treat hidden setup fees, paid migrations, and per-feature add-ons as the warning signs they are. Do the year-one math before you sign, and the right choice usually gets obvious fast.
