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Minutes included, $0.25 a minute past that. No after-hours surcharge, no setup fee. Compare every plan.
2026 pricing teardown
Here's our opinionated take after pricing this market: per-minute billing isn't a pricing model, it's an incentive problem. The service earns more when your patients talk longer, and your bill spikes in exactly the weeks your phones are busiest. The numbers below are the market's, with sources.
The short answer
A live answering service costs $100 to $1,000+ a month (Nextiva), and bundled medical plans run $299 to $999+ a month, about $3,600 to $12,000+ a year (Gabbyville). Medical services bill $1.00 to $3.50 per minute at low call volumes or $0.96 to $1.84 per call, plus a $50 to $150 monthly after-hours surcharge and $50 to $200 in setup (Gabbyville); the general market quotes $0.75 to $1.50 per minute (Nextiva). Physician answering service cost follows the same meter, so a two-provider practice answering 300 calls a month at 3.5 minutes each (1,050 minutes) pays roughly $1,050 to $3,675 at the medical per-minute range. On Lydoh the same 1,050 minutes are $249 on Lydoh Frontdesk (1,200 minutes included) or $286.50 on Lydoh After Hours (300 included, $0.25 a minute past that). Published rates by provider are in the answering service pricing index.
What the market charges
| Model | Typical 2026 rate | The catch |
|---|---|---|
| Per minute | $1.00 to $3.50 / min for medical services at low volume (Gabbyville); $0.75 to $1.50 / min general market (Nextiva) | Long calls and hold time bill against you; a chatty month is an expensive month |
| Per call | $0.96 to $1.84 / call | Volume discounts kick in only at hospital-scale call counts |
| Bundled plans | $299 to $999+ / mo | Bundled minutes run out fast; overage returns you to the meter |
| Surcharges | $50 to $150 / mo after-hours; $50 to $150 / mo HIPAA; $0.15 to $0.40 / min bilingual; $50 to $200 setup | You pay extra for the exact hours an answering service exists for |
Worked example: a two-provider practice answering 300 calls a month at a 3.5-minute average uses 1,050 minutes. At Gabbyville's $1.00 to $3.50 medical per-minute range that's roughly $1,050 to $3,675 a month on the meter, plus the after-hours surcharge, plus setup. That's $12,600 to $44,100 a year for message-taking, before surcharges.
The rare alternative
A flat rate medical answering service charges one fixed monthly price for unlimited calls and minutes. Among human services it's close to extinct: KwoteAdvisor counts fewer than 35 providers nationwide still offering flat-rate plans, and notes most of those cap the monthly call volume, because unlimited live-operator contracts stop being profitable fast. Gabbyville's guide makes the related point that per-call or bundled monthly pricing is the most predictable option the human market offers, and bundles still run out.
Before signing a flat-rate plan, ask what KwoteAdvisor suggests: is there a call or minute cap, what happens when you pass it, and are holiday coverage and HIPAA compliance included or extra. Lydoh is not flat rate, so here are our answers plainly: Lydoh After Hours is $99/mo with 300 minutes included and Lydoh Frontdesk is $249/mo with 1,200 minutes included, with $0.25 a minute past the included minutes; after hours and holidays are billed at the same rate; and a BAA is available for eligible practices. Every plan is on our pricing page.
By specialty
Per-call prices move with how long a specialty's calls run. KwoteAdvisor's national averages put a physician answering service at $0.91 to $2.37 per call for primary care, with typical calls of 1.5 to 3 minutes, and a dental answering service at $0.91 to $2.14 per call, with typical dental calls of 1 to 2.5 minutes. At 300 calls a month that is roughly $273 to $711 for a physician practice and $273 to $642 for a dental office, before surcharges and setup. Chiropractic calls are the shortest in the table and plastic surgery the longest.
| Specialty | Cost per call | Typical call |
|---|---|---|
| Primary care physician | $0.91 to $2.37 | 1.5 to 3 min |
| Dental office | $0.91 to $2.14 | 1 to 2.5 min |
| Chiropractor | $0.84 to $1.76 | 45 sec to 1.5 min |
| Optometrist | $0.93 to $1.64 | 1 to 2 min |
| Plastic surgeon | $1.24 to $2.88 | 2 to 5 min |
| Hospital | $0.93 to $3.22 | 2 to 4 min |
Source: KwoteAdvisor, national averages, low to high. Lydoh charges every specialty the same published plans, from $49 a month.
The part vendors don't say
Think about what the meter rewards. If the operator rushes your patient, your reputation pays. If the operator is thorough, your invoice pays. Every incentive in per-minute billing points away from the thing you bought the service for. And the spikes aren't hypothetical: flu season, a vaccine clinic, a recall letter, a snowstorm rescheduling day. Your busiest weeks, the ones where the phone matters most, are the weeks the meter runs hottest. That's not a pricing model a practice can budget around; it's a variable tax on being needed.
Full disclosure of our bias: Lydoh sells the alternative, monthly plans with a block of minutes included and a published overage. Lydoh After Hours is $99/mo with 300 minutes included and Lydoh Frontdesk is $249/mo with 1,200 minutes included, with $0.25 a minute past the included minutes, and no night or weekend surcharge. Judge the argument on the math either way.
The build-vs-buy math
$63k to $83k+ / yr
Fully loaded cost for 40 hrs/week, on a $36k to $44k salary. One call at a time, no nights or weekends, and the desk is empty when they're sick. Essential for in-office work; expensive as phone coverage.
$3.6k to $12k+ / yr
Bundled plans of $299 to $999+ a month, times 12. 24/7 coverage on a meter, reading from your script. Message-taking with a relay delay; billing scales with your busiest weeks.
$1,188 to $2,988 / yr
Lydoh After Hours to Lydoh Frontdesk, times 12. Answers every call instantly and identically, books requests, and runs after-hours on-call triage; Frontdesk also answers from your own content. Minutes included, then $0.25 a minute.
The honest framing: these aren't substitutes. Keep the front desk for the patients standing at it. The question is what answers the phone when they're busy, out sick, or gone for the day, and whether that layer should bill you by the minute. More on the trade-offs in AI vs. a traditional answering service.
Weighing a specific provider? We compare Lydoh head to head, with sourced pricing and where each one wins, against Ruby, Smith.ai, MedXCom, and Weave.
FAQ
Live answering services run $100 to $1,000+ per month (Nextiva), and bundled medical plans $299 to $999+ (Gabbyville). On the meter, medical services charge $1.00 to $3.50 per minute at low call volumes, or $0.96 to $1.84 per call (Gabbyville). A practice taking 300 answered calls a month at a 3.5-minute average (1,050 minutes) lands around $1,050 to $3,675 monthly at those per-minute rates, before surcharges.
Physician answering services bill the same meters as the rest of the medical market. On per-call pricing, KwoteAdvisor puts primary care physician calls at $0.91 to $2.37 per call, with a typical call running 1.5 to 3 minutes, so 300 calls a month comes to roughly $273 to $711. On per-minute pricing, medical services charge $1.00 to $3.50 a minute at low volumes (Gabbyville), so a two-provider practice using 1,050 minutes a month pays roughly $1,050 to $3,675. Either way, add an after-hours surcharge of $50 to $150 a month and $50 to $200 in setup (Gabbyville). Lydoh charges physicians the same published plans as every practice: Lydoh After Hours is $99/mo with 300 minutes included and Lydoh Frontdesk is $249/mo with 1,200 minutes included, with $0.25 a minute past the included minutes.
Four recur constantly (Gabbyville's 2026 figures): an after-hours surcharge of $50 to $150 per month, for exactly the hours you bought the service for; HIPAA compliance at another $50 to $150 per month; bilingual operators at $0.15 to $0.40 per minute extra; and setup fees of $50 to $200. Always price the month you'll actually have, not the teaser bundle.
Per-call is more predictable if your calls run long; per-minute wins only if your calls are unusually short. But both share the same problem: your bill rises exactly when your patients need you most. A flu season or a recall week becomes a billing event. A plan with a large block of included minutes keeps a busy month close to a quiet one, as long as the block fits your volume and the overage rate is published.
Dramatically, but they solve different problems. A full-time medical receptionist earns $36,000 to $44,000 a year and costs $63,000 to $83,000+ fully loaded with benefits, payroll taxes, and overhead (OmniMD), and covers 40 hours a week with no nights, weekends, sick days, or simultaneous calls. Bundled answering plans of $299 to $999+ a month work out to about $3,600 to $12,000+ a year. The strongest setups keep the human front desk for in-office work and let a service absorb overflow and after-hours.
AI answering costs far less per minute because software doesn't need a night shift. Lydoh After Hours is $99/mo with 300 minutes included and Lydoh Frontdesk is $249/mo with 1,200 minutes included, with $0.25 a minute past the included minutes, including after-hours triage and on-call escalation for medical practices, with no night or weekend surcharge. We publish those numbers because we think hiding pricing behind a sales call is part of the problem.
Live answering services run $100 to $1,000+ a month (Nextiva); bundled medical plans run $299 to $999+ a month, about $3,600 to $12,000+ a year (Gabbyville). Per-minute billing runs $0.75 to $1.50 a minute across the general market (Nextiva) and $1.00 to $3.50 a minute for medical services at low call volumes (Gabbyville), or $0.96 to $1.84 per call on per-call plans. Bundled minutes run out fast and the overage puts you back on the meter. Lydoh's plans start at $49 a month: Lydoh After Hours is $99/mo with 300 minutes included and Lydoh Frontdesk is $249/mo with 1,200 minutes included, with $0.25 a minute past the included minutes.
$100 to $1,000+ a month for a live answering service (Nextiva), and higher as volume climbs: a two-provider practice answering 300 calls a month at a 3.5-minute average uses 1,050 minutes, which is $1,050 to $3,675 a month at Gabbyville's $1.00 to $3.50 medical per-minute range. On top of that sit an after-hours surcharge of $50 to $150 a month and add-ons such as HIPAA compliance at another $50 to $150 a month. Price the month you will actually have, not the starter tier. The same 1,050 minutes fit inside the 1,200 included on Lydoh Frontdesk, so that month costs $249.
On per-call pricing, $0.96 to $1.84 per answered call for medical services in 2026 (Gabbyville), covering the whole call however long it runs; general-market guides quote anywhere from $1 to $11 per call (Nextiva). Per-call is steadier than per-minute when your calls run long, but volume discounts only arrive at hospital-scale call counts, and an after-hours surcharge of $50 to $150 a month still sits on top. Both meters share the same flaw: the bill rises in exactly the weeks your patients need you most. Lydoh prices by the month instead: Lydoh After Hours is $99/mo with 300 minutes included and Lydoh Frontdesk is $249/mo with 1,200 minutes included, with $0.25 a minute past the included minutes.
After hours is usually a surcharge on top of your normal rate, $50 to $150 a month in 2026, plus the per-minute or per-call charges for the calls themselves at $1.00 to $3.50 a minute or $0.96 to $1.84 a call (Gabbyville). You pay extra for the exact hours an answering service exists for. Lydoh includes after-hours triage and on-call escalation in Lydoh After Hours, $99/mo, with no surcharge. Published rates by provider are compiled in our answering service pricing index.
One fixed monthly price for unlimited calls and minutes, instead of a per-minute or per-call meter. KwoteAdvisor calls flat-rate plans nearly extinct in medical answering: fewer than 35 providers nationwide still offer them, and most of those cap monthly call volume, so ask whether there is a cap and what happens when you pass it. Lydoh is not a flat-rate plan: each voice plan includes a set number of minutes (300 on Lydoh After Hours, 1,200 on Lydoh Frontdesk), and past that the published rate is $0.25 a minute.
KwoteAdvisor puts dental-office calls at $0.91 to $2.14 per call on per-call pricing, with a typical dental call running 1 to 2.5 minutes. An office answering 300 calls a month would pay roughly $273 to $642 on that range, before any after-hours surcharge or setup fee. Lydoh charges dental offices the same published plans as any practice: Lydoh After Hours is $99/mo with 300 minutes included and Lydoh Frontdesk is $249/mo with 1,200 minutes included, with $0.25 a minute past the included minutes.
Market rates checked October 11, 2026 against published pricing guides: Nextiva, Gabbyville, OmniMD, KwoteAdvisor (flat-rate plans and per-call rates by specialty, checked October 18, 2026). Individual providers vary; verify current rates directly.
Keep reading
Minutes included, $0.25 a minute past that. No after-hours surcharge, no setup fee. Compare every plan.