How much does an AI receptionist cost?

Most vendors in this category land between roughly $300 and $2,000 a month for a single practice, and many quote only on a call. Echo publishes two rates: Starter at $499 a month ($449 billed annually) covering 50,000 automation tokens, and Growth at $1,999 ($1,799 annually) covering 225,000 tokens. Work past the included amount is billed at one cent a token on either plan.

Usually, but the comparison worth making is coverage rather than headline price. A front-desk hire at $35 an hour fully loaded costs about $5,600 a month for 160 hours, and covers one line at a time during those hours. Echo's Starter plan is $499 a month and answers every line at once, around the clock. The honest caveat: an AI receptionist does not replace the person at the window who greets patients and collects payment.

A token is the unit Echo meters work in, and one token is one cent. A completed AI call costs 100 tokens, an SMS or email costs 10, a completed form costs 5, an insurance or benefit check costs 50, and each Autopilot-enrolled patient costs 100. Online scheduling costs nothing. Every channel draws from the same monthly budget, so you are not buying separate seats for phone and text.

It depends on the vendor, and it is the first thing to establish. Per-minute billing means a patient who talks for six minutes costs six times one who talks for one, which penalises exactly the thorough conversations you want. Echo bills flat per completed call — 100 tokens, a dollar — with no per-minute meter. Failed calls, meaning no-answer, busy, or a voicemail drop under ten seconds, are not billed at all.

Three to ask about specifically: a one-time setup or integration fee, per-minute overage once a bundle is exhausted, and carrier passthrough charges for A2P 10DLC registration and MMS. Echo charges a one-time setup fee for EHR integration, bills overage at one cent a token on every plan rather than at a penalty rate, and passes carrier fees through at cost. PrognoCIS also carries that vendor's own per-practice fees.

Echo's is 14 days and 1,000 automation tokens, about 10 AI calls or 100 texts, with no credit card. Trials are sandbox-only: verified phone numbers, no patient outreach, and no EHR integration. That boundary is deliberate. The trial is there so you can hear how it sounds; a paid plan and a signed BAA are what put it in front of real patients.

When the arithmetic says so, not when the bundle runs out. Overage is billed at the same penny a token on both Echo plans, so staying on Starter and paying overtime is cheaper until that overtime covers the difference in salary — 185,000 tokens a month on annual billing, 200,000 on monthly. Running a plan into overage is a normal month, not a signal to upgrade.

Not with Echo. Pricing is per agent against the workload it covers, not per seat, per user, or per site, so a two-location practice on one plan pays once. Past 400,000 tokens a month the rate, the master service agreement, and the integration scope are quoted together, which is where most multi-site groups and DSOs land.

Traditional answering services usually bill per minute or per call and only cover the hours you are closed, so a busy month costs more precisely when you can least absorb it. The larger difference is what you get: an answering service takes a message your staff re-key the next morning, whereas an AI receptionist books the appointment into your schedule during the call.