AI Receptionist Pricing in 2026: What 500 Minutes a Month Really Costs

We priced eight AI receptionists at 100, 500 and 1,500 minutes a month. How they bill, what bundles leave out, and what to ask about HIPAA.

By SpeechSage Team, 2026-10-23

At list prices in October 2026, AI receptionists cost between $60 and $311 a month for 500 minutes of calls. Human answering services cost about $1,725 for the same minutes. The price you pay depends less on the headline plan than on how the vendor bills: per minute, per call or per caller.

What an AI receptionist costs in 2026

At list prices in October 2026, AI receptionists cost between $60 and $311 a month for 500 minutes of calls. That is roughly what a small practice or service business takes in a month: about eight 3-minute calls a working day.

Human answering services cost far more. Ruby charges about $1,725 for 500 minutes, and PATLive charges $1.79 to $2.99 a minute.

The headline plan price tells you little on its own. What decides your bill is how the vendor counts usage, and what the cheapest plan leaves out.

Three ways vendors bill

• Per minute. You pay for the minutes you use, either from a bundle (Rosie, Dialzara, Frontdesk) or pay as you go (SpeechSage, developer platforms such as Retell and Vapi). Cheapest when calls are short or volume moves around.
• Per call. Each answered call counts the same, however long it runs (Smith.ai). Simple to predict, but costly at higher volume: about $2.40 per extra AI call, and $8.50 to $11.50 per call with a human.
• Per caller. You pay for unique callers each month, with unlimited minutes (Goodcall). Good value if the same people ring several times; less so if every call is a new person.

Healthcare vendors that sell to health systems, such as Assort Health and Hyro, don't publish prices. Expect a sales process and a quote.

Monthly cost at three call volumes

We priced each service at 100, 500 and 1,500 minutes a month, using public list prices and assuming 3-minute calls. These cover usage only, not setup or phone number fees.

Two others don't fit the same scale. Weave, common in dental and optometry offices, costs about $250 a month per location plus $500 to $750 to set up. Ruby, a human service, costs $250 for 50 minutes and $1,725 for 500.

Prices change often. Check each vendor's pricing page before you decide; the sources we used are listed at the end of this post.

What the cheapest plan leaves out

• Booking. Some entry plans only take messages. Rosie's $49 plan, for example, books appointments only from the $149 plan up.
• Overage. Bundles charge for every minute or call past the limit, often at a higher rate than the plan works out to.
• Setup and per-location fees. Practice phone systems often charge onboarding fees and bill each location separately.
• Transfers and texting. Live transfer to your staff and two-way texting are often on higher tiers, or sold separately.
• Records. Most answering services pass you a message. Few keep a customer or patient record that the next call can use.

HIPAA questions to ask before you sign

If you are a healthcare practice, price is the second question. The first is whether the service can legally handle your patients' calls.

1. Will you sign a BAA, before any patient calls? A Business Associate Agreement is required when a vendor handles protected health information for you.
2. Which AI models and providers does the BAA cover? A vendor's BAA means little if the speech or language model behind it has no BAA of its own.
3. Where are recordings and transcripts kept, and for how long?
4. Is there an audit log of who viewed or changed patient information?
5. Who are the subprocessors? Ask for the list, not a summary.

Treat "HIPAA compliant" on a pricing page as a starting point, not an answer.

Outbound and follow-up calls need consent

Reminder and recall calls are one of the best ways to cut no-shows. But in 2024 the FCC ruled that AI-generated voices count as "artificial" under the Telephone Consumer Protection Act. Automated calls with an AI voice need the right consent from the person you're calling.

Before you turn on follow-up calls, ask any vendor how it records consent for each contact and how people opt out.

Where SpeechSage fits

SpeechSage is pay as you go: 12¢ a minute for businesses and 15¢ a minute for healthcare practices, with monthly plans for practices that prefer a set bill. Healthcare accounts can sign a BAA at sign-up, and calls run only on AI providers covered by a BAA. Each call shows its exact cost. Messages and appointment requests land as tasks in your inbox, matched to the patient's record by phone number.

SpeechSage doesn't yet offer two-way texting, live transfer to staff or follow-up calls. If you need those today, weigh that against the price.

To see how it handles your calls, book a demo or read about our security controls.

Common questions

How much does an AI receptionist cost per month?

For a small business or practice taking about 500 minutes of calls a month, list prices in October 2026 ran from about $60 to $311. Human answering services cost far more, about $1,725 for 500 minutes at Ruby.

Is per-minute or per-call pricing cheaper?

Per-minute pricing is usually cheaper when calls are short and volume changes month to month. Per-call pricing gets expensive at higher volume, and per-caller pricing favours businesses whose callers ring more than once.

Does an AI receptionist need a BAA?

Yes, if it handles calls for a HIPAA covered entity. Ask for a signed Business Associate Agreement before any patient calls, and ask which AI models and providers it covers.

What does SpeechSage cost?

SpeechSage is pay as you go: 12 cents a minute for businesses and 15 cents a minute for healthcare practices, with a BAA available at sign-up. New accounts get starter credit to try a shared demo number.