Medical Billing Costs: Average Percentage, Fees and Rates

Prices checked October 6, 2026 (UTC). The company links on this page are unpaid source links. How we make money.

Medical billing services often charge a percentage of collections. The selected percentage offers we checked run from 2.9% to 8%, with different definitions of what the fee is charged on. Some companies charge a flat monthly fee or a price per claim instead.

We did not find an audited national average. Physician Side Gigs gives a general range of 4% to 10% and says most private practices in its physician communities report paying 5% to 7%. Those observations are useful context, not a national price survey.

The percentage is only part of the bill. At $50,000 a month in collections, 5% is $2,500 a month, or $30,000 a year. A monthly minimum, a software fee, or a different answer to "percent of what?" can change that a lot. One published offer is 3% of eligible insurance collections with a $1,000 monthly minimum. At $10,000 a month in those collections, the base billing fee is effectively 10%, before any separate charges.

Use the calculator to estimate your cost from the terms you know. It's free, and you don't need to give an email.

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See published prices

Sources and conditions for each price are in the table below.

Medical billing cost calculator

Type in the terms from a quote. You'll see the monthly cost, the yearly cost, and the effective rate after minimums and extra fees. An incomplete quote stays incomplete.

Three things to know before you start:

• Collections means money you actually received in a month, from insurers and patients. It does not mean what you billed.
• "Percentage of what?" matters. Some companies charge on everything you collect. Others charge only on insurance payments. A fee on an allowed amount can include a patient balance you have not received. Pick what your quote says.
• "Don't know yet" is an honest answer. The calculator won't treat a missing fee as $0. It shows what you know so far and lists what to ask.

Total monthly collections Money your practice actually received in a month from insurers and patients, before billing fees. Use the same number for every quote.

Compare with what billing costs you now

Add up your own billing costs: pay, payroll taxes and benefits, billing software, clearinghouse fees, training, and cover when someone is out. Count only the billing share.

What billing costs you each month now

Billing costs you would still pay yourself with Quote A Staff time or software you keep after outsourcing. Type 0 if there is none.

Calculate cost Compare a second quote Load a published example Load a two-quote example Clear inputs

This is arithmetic on the numbers you enter. It is not a quote and it does not predict what a company will collect. Results show annualized costs, not a payment calendar. Anything you mark "Don't know yet" is left out and listed, never counted as zero. Your numbers stay in your browser. The tool does not send or save them automatically; you can download your comparison as a local CSV.

Worked example: a 3% rate with a $1,000 minimum

Recoup publishes a rate of 3% of the insurance payments it collects, with a $1,000 monthly minimum. Say your practice collects $10,000 a month from insurers.

1. 3% of $10,000 is $300.
2. $300 is less than the $1,000 minimum. So the base billing fee is $1,000.
3. $1,000 divided by $10,000 is 10%. That's the effective base fee as a share of eligible insurance collections.
4. The minimum stops mattering at about $33,333 a month ($1,000 ÷ 0.03).

Press "Load a published example" in the calculator to see the same numbers. This is a base-fee illustration, not a complete practice-cost quote. It leaves out Recoup's separate fee for older unpaid balances (10% of what it recovers) and claim charges from a system your practice chooses to keep. Confirm those costs before treating the result as a total.

Have a quote in hand? Run it, then check it against the published prices below.

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Published medical billing prices and fees

These ten companies put a price in writing on their own websites. We list them A to Z. This is not a ranking, and it is not every company.

Read across each row before you compare the numbers. The price, what it's charged on, and the extra fees all change the total.

"Not publicly stated" means we couldn't find it on the company's public pages. It does not mean zero. Ask for it in writing.

Carepatron has terms to settle before you budget. Its current pricing page distinguishes the first provider from additional providers, while its help article still describes a uniform $99 monthly or $948 annual fee per billing clinician. Its terms also mention a supervisee category without a price we could locate. The help article starts the base fee at onboarding completion or 30 days after signature, whichever comes first; the terms start fees on acceptance. Confirm your schedule, start date and whether the percentage or per-claim model applies in your state. Monthly cancellation needs 30 days' written notice; annual seats are prepaid and generally nonrefundable if you cancel for convenience.

These are prices the companies advertise. They are not quotes for your practice. They also don't tell you how well a company collects.

Look at the "Charged on" column. The fee bases differ. Recoup charges on insurance payments it collects; TheraThink charges on the allowed amount of paid claims. Check the exact definition in each proposal. Two quotes with the same percentage can cost different amounts.

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Price is one part of the choice. To see how fees, software rules, and exit terms line up side by side, use our comparison.

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What is the average medical billing percentage?

The sources we reviewed do not establish an audited national average. Be careful with any site that gives you one exact number without showing how it was measured.

Here is what the evidence does show:

• 4% to 10% of collections is the general range described by Physician Side Gigs. It says most private practices in its communities report 5% to 7%. The article does not publish a sample size or survey method.
• Your rate still depends on the work included. Check coding, denial follow-up, patient billing, staff responsibilities and minimums instead of judging scope from a percentage alone.
• 2.9% to 8% is the range of selected percentage offers in our table above. The services and fee bases differ, so this is not a market average.

For a collections-based quote, the fee should use the money actually collected, not the charges sent to insurers. Physician Side Gigs lists fees based on billed charges as a red flag. An allowed-amount contract is different again: ask whether unpaid patient responsibility is included.

Here is what a plain percentage costs each month, before any minimum or extra fee:

Multiply by 12 for a year. Then add minimums and extra fees to get your real number.

How medical billing pricing works

Billing companies charge in four main ways. None is always cheapest. It depends on your size and the work you need.

A percentage of collections ties the company's pay to money received. That can give it a reason to chase unpaid claims. It doesn't prove it will.

A flat fee is easier to budget within its tier. A per-claim fee depends on claim volume. Ask how the company handles denied claims and whether another submission creates another charge.

Software is not the same as a billing service. Software gives your own staff tools. A billing service does the work for you. Don't compare a software price to a service price as if they were the same thing.

Why a lower percentage can cost more

Three things can flip the order of two quotes: a minimum, the amount the percentage is charged on, and extra fees.

A minimum raises your real rate when collections are low

This table uses Recoup's published terms: 3% of insurance collections, with a $1,000 monthly minimum.

These are our calculations from the published terms, not customer invoices. They exclude separate older-balance recovery and charges from a claims system the practice chooses to retain.

Two made-up quotes for the same practice

These quotes are invented to show the math. They are not from real companies.

A practice collects $80,000 a month. $60,000 comes from insurers and $20,000 from patients. Both quotes cover the same work.

The "4%" quote costs $800 more each month and $11,500 more in the first year.

This shows cost only. It doesn't show which company would collect more. A cheaper company that collects less can cost you more than the fee you saved.

Press "Load a two-quote example" in the calculator to see these numbers, then swap in your own.

Other medical billing fees to ask about

Ask about each of these by name. If a fee isn't in your proposal, it's unknown. It isn't zero.

Each example comes from the company's own pricing, help or terms pages, linked here or in the table above.

Medical billing rates by specialty

The sources we reviewed do not establish an audited market average for each specialty. The figures below are named offers, not specialty averages.

For company-by-company details, see the ABA billing services comparison.

Here is what companies actually publish:

A price for outpatient therapy tells you nothing about hospital or residential billing. Check that the company serves your setting.

Why specialty changes the price

Billing costs vary with the work involved and the revenue associated with it.

A 2018 study in JAMA used interviews and a costing model at one academic health system. It estimated $20.49 in billing costs for a primary care visit, equal to 14.5% of its $141.27 in revenue. For inpatient surgery, professional billing cost $141.54, or 3.1% of $4,569.57 in professional revenue. Total billing costs for surgery, including hospital billing, were $215.10.

These historical estimates describe that system's internal costs. They are not current outsourced prices or evidence of what any specialty should pay.

Is in-house billing cheaper?

It depends on your numbers. No single revenue level decides it.

Compare two totals:

• What billing costs you now. Pay, payroll taxes and benefits, billing software, clearinghouse fees, training, and cover when someone is out. Count only the billing share.
• What it would cost with a billing company. Their fees, plus the billing costs you would still pay yourself.

That second part gets missed. Count any billing work your staff will still handle, such as front-desk insurance checks or patient questions if the company does not cover them.

A made-up example. A practice spends $6,500 a month on billing today. A billing company would charge $3,200 a month.

• If the practice still spends $1,000 a month on its own billing work, the new total is $4,200. That saves $2,300 a month.
• If it still spends $3,500, the new total is $6,700. That costs $200 more.

Same quote. Opposite answers.

For a rough idea of pay: the U.S. Bureau of Labor Statistics reports a median wage of $51,140 a year for medical records specialists as of May 2025, and $47,120 in physicians' offices. That job group includes coders and records staff, not only billers. It's pay only, before benefits and software. Use your own costs in the calculator.

Cost is half the picture. The other half is how much each option collects, and no calculator can predict that. Ask any company for reports from practices like yours.

Compare my current billing costs

When a percentage fee may not be allowed

Percentage fees are common. Still, three rules are worth knowing before you sign.

• Medicare. If a billing agent receives Medicare payments on your behalf, its compensation cannot be tied to the amounts billed or collected, or depend on collection. See 42 CFR 424.73(b)(3) and 424.80(b)(5). Ask who receives the payments and how the agent is paid.
• Medicaid. Federal rules place similar conditions on a billing agent that receives Medicaid payments in your name. Its pay must relate to processing costs, cannot be tied to the amount billed or collected, and cannot depend on collection. See 42 CFR 447.10(f).
• New York. Education Law § 6530(19) restricts certain arrangements tied to professional fees, with exceptions. The Board of Regents' professional-conduct rules also address fee sharing. In a 2015 New York court case, an insurer challenged a practice's percentage-based billing arrangement. The court rejected fee splitting alone as a defense to that no-fault claim; it did not declare all percentage billing contracts lawful.

The federal rules above concern agents receiving payments. State fee-splitting rules can impose separate limits. A company's published percentage does not establish whether its contract is appropriate for your practice.

This is general information, not legal advice. If you bill Medicare or Medicaid, or you practice in New York, ask a healthcare attorney before you sign a percentage contract.

How to get medical billing quotes you can compare

Quotes are only comparable when every company answers the same questions about the same numbers.

1. Pick one recent period. Three months is fine. Write down your average monthly collections from insurers and from patients, and how many claims you send.
2. Send every company the same request. Use the text below.
3. Put each answer in the calculator. Compare monthly cost and first-year cost, not the headline rate.
4. Check the work matches. A cheaper quote that leaves denials or patient calls with your staff isn't the same service.

Send totals only at this stage. Don't send patient names or records. If your practice is a HIPAA-covered entity, a billing company handling protected health information on your behalf generally needs a written business associate agreement in place before that work starts.

Subject: Request for a written medical billing proposal - [practice name]

Hello,

We are comparing billing companies and would like a written proposal.

ABOUT OUR PRACTICE
- Specialty and setting: [for example, outpatient therapy, primary care, ABA]
- State: [state]
- Clinicians: [number]   Locations: [number]
- Current EHR or billing software: [system]
- Work we want you to do: [full billing / specific tasks]
- Work our staff will keep: [tasks]
- Start date we have in mind: [date]

OUR NUMBERS (monthly averages for the same recent period)
- Collected from insurers: $[amount]
- Collected from patients: $[amount]
- New claims sent: [number]
- Older unpaid insurance balances: $[total], [how old]

PLEASE PUT THESE IN WRITING
1. Your rate, and exactly what it is charged on. Do patient payments, copays collected at our front desk, and payments on older claims count? Is the base actual cash received or an allowed amount that can include unpaid patient responsibility?
2. Any monthly minimum: the amount, when it starts, and exactly which fees count toward it or are added outside it.
3. Every other recurring fee, with its unit and payment schedule: software, per-provider, per-claim, clearinghouse, statements, eligibility checks. Identify any annual prepayment and the rate for each clinician category.
4. Every one-time fee: setup, training, data migration, credentialing per payer and provider. State when fees begin, including before onboarding or credentialing is complete.
5. What is included and what is not: denials, appeals, patient statements, patient phone calls, prior authorizations, credentialing.
6. How you count claims if you charge per claim: first claims, corrected claims, secondary claims, resubmissions.
7. Your terms for our older unpaid balances.
8. What happens to your fee if an insurer takes a payment back.
9. Contract length, renewal, notice to cancel, rate increases, exit fees, and how we get our data when we leave.
10. Where insurance payments are deposited: our bank account or yours, and who controls the account.
11. A sample monthly invoice at the numbers above, and a first-year total.
12. Anything you cannot price yet.

These are totals only. Before we share any patient information, please send your business associate agreement and tell us how to send data securely.

Thank you,
[name]
[title]
[phone or email]

Download the quote request (TXT)

Copy the quote request

Not sure who to send it to? Start with the companies in our comparison and the questions for your practice type.

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Medical billing cost FAQ

How much do medical billers charge per claim?

Members of the Physician Side Gigs community report $3 to $10 per claim. Gina Consulting publishes $7.50 per claim with a $750 monthly retainer. Carepatron publishes $7 per claim in place of 3.9% where its per-claim service model applies, with provider and software fees still added. Its terms charge for the first submission, not another corrected submission of the same claim. These service fees are different from software claim-transaction charges.

Can I estimate the cost before my practice has collections?

Yes. Enter the collections you expect. Then try $0. A minimum or flat fee can still be due in a month with no money coming in. Ask when fees start.

Do I pay on claims that never get paid?

It depends on the contract. A percentage-of-collections component is $0 when eligible collections are $0, but minimums, fixed base fees and other charges can still apply. A per-claim fee can be due whether or not the claim pays. A fee on the allowed amount of a paid insurance claim can include the patient's share before the patient has paid.

What if an insurer takes a payment back?

Ask how the fee on that payment is credited back, and when. Don't assume it happens on its own.

Is 10% too high?

It's the top of the general range described by Physician Side Gigs. That alone does not tell you whether a quote is good value. Compare the work included, the fee base and the total dollars. Check whether a minimum is what pushes your effective rate to 10%.

Can I negotiate the rate?

You can ask. Check whether a lower rate comes with a higher minimum, a longer contract, or less work included. Run both versions through the calculator.

Is this page about a medical bill I got as a patient?

No. This page is for practices hiring a billing company. If you have a question about a bill you received, CMS explains your rights and where to get help.

How we checked these prices

We reopened each company's own pricing, help or terms pages on October 6, 2026 (UTC) and recorded what it publishes. We did not call the companies, get quotes, or test their service.

• This is a small sample of companies that publish prices. It is not a survey, and we don't work out an average from it.
• Each price belongs to one specific service. We kept each company's own wording for what the fee is charged on.
• When a detail was missing, we say so. When a company's own pages disagreed, we say that too.
• Examples marked "made-up" use invented numbers to show the math.
• Published prices show what a company advertises. They don't show how well it performs.

Sources: the company pages linked in the table and additional-fees section, Physician Side Gigs (updated February 2026), the U.S. Bureau of Labor Statistics (page dated August 27, 2026), Tseng and colleagues in JAMA (February 20, 2018), and the official federal and New York sources linked in the percentage-fee section. The eCFR pages displayed Title 42 as current through October 2, 2026; all these sources were checked for this audit on October 6, 2026 (UTC).

Read how we research and compare billing companies. See a price that has changed? Tell us.

Ready for the next step? Compare companies by fees, software, and contract terms.

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