Clinical AI converges on per-clinician gated contracts
Clinical AI pricing is not uniform — it stratifies by who funds the purchase, and that variable predicts both the billing unit and the transparency level. (1) Health-system operating budget → per-clinician (PEPM) annual contract, sales-gated: Abridge, Ambience, Suki, Rad AI, Viz.ai and Nabla Enterprise, driven by EHR integration economics (Epic and Cerner charge by enrolled clinician), FDA/HIPAA compliance attaching to the provider seat, and multi-stakeholder IT procurement. (2) Individual clinician's own card → per-seat, public, self-serve: Freed, Heidi Health, Nabla's free tier, Eko+ at $12.99/mo. (3) Payer/CMS reimbursement → per-procedure with a PUBLISHED price, because the government publishes it: Eko SENSORA at CPT 0962T (~$128.90), Viz.ai LVO NTAP (~$1,040/use), Paige ~£1/slide via NICE, Tempus xT CDx ADLT $4,500/test. So 6 of 11 clinical AI companies are sales-only and 8 of 11 are non-public — high, but not the 100% originally claimed. Two newer forces are pulling the PEPM unit apart from above: as the AI does more of the documentation work seat count stops tracking value, so Abridge (2026-07-22) now names an unlimited system-wide agreement that decouples price from headcount, and Hippocratic bills per agent-hour (~$9/hr vs ~$39/hr RN wage) rather than per seat. Expect the health-system branch to migrate from PEPM toward site licenses and per-encounter/per-outcome units, while the reimbursement branch stays the most transparently priced clinical AI in the corpus.
Evidence over time
14 supporting · 5 counter — hover or tap a point for detail, click to jump to the row.
Evidence
| Company | Date | What happened |
|---|---|---|
| Abridge | Jun 2026 | Sales-only per-clinician annual contract; no /pricing page (routes to Contact Us). Third-party estimate ~$2,500/clinician/year (~$208/month). Deployed at 150+ health systems, ~$100M ARR. |
| Abridge | Jul 2026 | The PEPM unit cracks at the top of the segment. Abridge's site now advertises a customer story titled 'Why CHRISTUS Health Expanded to an Unlimited Enterprise Agreement with Trusted AI Partner Abridge' — the first time any health-system-scale scribe in the corpus names a contract that is not counted per clinician. Same capture: modules consolidated from four (Clinician, Nursing, Revenue Cycle, CDS) to three product lines with CDS folded in as a platform capability; deployed-base claim moves 150+ → 300+ health systems; positioning widens to 'health systems, payers, and life sciences.' Still zero dollar figures on any surface. |
| Eko Health | Jun 2026 | The 11th clinical AI company in the corpus and the most transparently priced: fully public hybrid pricing — one-time devices at $259 (CORE Attachment) / $379 (Littmann CORE) / $449 (CORE 500), Eko+ software at $12.99/mo or $119.99/yr (Vet+ $180/yr), and the health-system SENSORA platform billed PER EXAM under CPT 0962T at a CMS OPPS national payment of ~$128.90 (finalized 2025-12-01). No PEPM anywhere in the model; price_transparency public, self-serve + PLG + sales-led. |
| Tempus | Jul 2026 | Boundary case for the reimbursement branch: acquired Personalis for ~$1.5B, folding MRD testing into its precision-oncology platform, with no change to commercial terms expected because 'diagnostics pricing is reimbursement-driven rather than list-priced.' Tempus is price_transparency sales-only yet its headline unit price is public — CMS set the xT CDx initial Medicare ADLT rate at $4,500/test (2024-07-01) — and its billing stack is an in-house payer-billing engine keyed to CPT/AMA codes and CMS/MAC reimbursement. It also acquired Paige AI (2025-08-22, $81.25M), so one of this trend's ten original PEPM/per-slide vendors is now inside a reimbursement-priced parent. |
| Tempus | Aug 2026 | The reimbursement branch reconfirmed, and the boundary case held. Tempus's agreement to acquire Personalis — the cancer-monitoring and minimal-residual-disease platform — reached confirmed public reporting at approximately $1.5B in cash and stock (agreed 2026-07-21, reported alongside Personalis's Q2 2026 results: revenue up 30% year on year, net loss widened). The pricing-relevant fact is what did NOT happen: no listed price moved, and the stated reason is the mechanic this trend identified — Tempus carries no public self-serve price sheet because genomics is payer- and Medicare-reimbursed per test (xT CDx at the $4,500 ADLT rate) and the data/AI-app lines are custom-quoted. So the largest transaction in clinical AI this window changed the scope of a reimbursement-priced business without producing an observable price event, which is exactly what the who-pays framing predicts for that branch. |
| Ambience Healthcare | Jun 2026 | /pricing URL 404s; quoted per-clinician annual license modular across ambient scribe + coding/CDI suites. Third-party estimate $2,800–$5,000/provider/year. |
| Suki AI | Jun 2026 | Sales-only; no public list price. Reported per-clinician/month subscription with volume discounts, annual contract, plus separately-licensed Suki Platform SDK. |
| Nabla | Jun 2026 | No public price page for paid tiers; third-party-reported ~$119/mo/provider Pro (unlimited notes, EHR), with quoted Enterprise. Individual free tier (30 notes/mo) is the only self-serve entry. |
| Freed | Jun 2026 | Published per-clinician ladder captured: Starter $39/mo (capped at 40 notes/month), Core $79/mo (unlimited notes), Premier $119/mo or $104/mo annual, plus a sales-quoted Groups plan. 7-day no-card trial, no permanent free tier. Note the direction of travel: Freed used to sell one flat $99/clinician/month plan, so today's unlimited-notes tier is CHEAPER than its old single price — the opposite of the segment's gated half. |
| Heidi Health | Jun 2026 | Per-seat subscription; freemium model with free tier, sold to individual clinicians and health systems alike. |
| Paige AI | Jun 2026 | Sales-only clinical AI for digital pathology; per-slide subscription (~£1/slide volume-tiered) plus ~£15,000 LIS integration fee. No public list price. |
| Rad AI | Jun 2026 | Sales-led, quoted annual contracts per radiology practice or health system; modular across Reporting, Impressions, Continuity. No public list price. |
| Viz.ai | Jun 2026 | Sales-led per-facility annual subscription, modular by disease suite; no public list price. Viz LVO carries a Medicare NTAP (~$1,040 per use) that partially offsets the subscription. |
| Hippocratic AI | Jun 2026 | Per-agent-hour pricing (~$9/hour vs ~$39/hr RN wage); enterprise sales-led. The only clinical AI vendor in corpus that breaks PEPM with a pure-usage model. |
Counterexamples
- Freed · Jun 2026 — Clinical scribe with public per-seat pricing and a self-serve trial — the outlier in a gated segment, likely because it targets individual clinicians rather than health-system IT procurement.
- Heidi Health · Jun 2026 — Free tier plus self-serve plans — another clinical scribe that keeps pricing public, also targeting individual clinicians directly. Repackaged to USD annual pricing on 2024-11-09 (Free / Pro $799 / Together $1,199 / Enterprise) and held those rates through the 2026-06-06 review.
- Eko Health · Jun 2026 — Breaks the pattern on unit AND transparency at the same time: public hardware prices ($259/$379/$449), a $12.99/mo consumer software subscription, and a health-system platform billed per exam at a published CMS rate (CPT 0962T, ~$128.90 OPPS) rather than per clinician per month. Sells self-serve, PLG and sales-led simultaneously — the only clinical AI company in the corpus doing all three.
- Abridge · Jul 2026 — Counterexample to its own trend entry: the segment's largest vendor now names an 'unlimited enterprise agreement' that removes headcount from the invoice. The stated pressure is structural — as the AI does more of the documentation work, seat counts stop tracking value — and the new payer and life-sciences buyers it is courting have no clinician seats to count at all.
- Hippocratic AI · Jun 2026 — Prices per agent-hour (~$9/hour of active agent–patient time against a ~$39/hr RN wage) with no seats and no tokens, plus an Agent App Store paying clinician-builders 5% of base and 70% of premium up to $5,000/agent. A pure-usage, labour-substitution unit inside a segment of committed annual seat licenses.
Trivia
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6 of the 11 clinical AI companies in the corpus are sales-only and 8 of 11 publish no usable price (sales-only or gated) — a 73% opacity rate, among the highest of any vertical but not the 100% this trend first claimed. The structural driver differs from billing-infra's identical gating: billing-infra gates because its own pricing is usage-metered and complex; clinical AI gates because the EHR integration fee, module mix, and health-system size interact in ways that resist a published rate card.
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Abridge's per-clinician price (third-party estimate ~$2,500/year, ≈$208/month) is 5.3× Freed's $39/mo Starter tier and 2.6× its $79/mo unlimited-notes Core tier (ladder captured 2026-06-05), yet both are ambient AI scribes targeting clinicians writing notes. The gap is entirely explained by deployment context: Freed sells direct-to-clinician (self-serve, credit card), while Abridge sells to the health system (IT-governed, Epic-integrated, custom contract) — same job, radically different pricing motion.
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Hippocratic AI is the one clinical AI vendor in the corpus that breaks the PEPM mold: it bills per agent-hour (roughly $9/hour) rather than per clinician seat, positioning it as on-demand AI staffing that health systems pay for only when the agent is active — a pure-usage model in a segment dominated by committed annual licenses.
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The most transparently priced clinical AI in the corpus is priced by the US government, not by the vendor. Eko Health's SENSORA platform is billed per exam under CPT 0962T at a CMS OPPS national payment of roughly $128.90 (finalized 2025-12-01, still live in the 2026-06-30 capture) — and Viz.ai (~$1,040/use NTAP), Paige (~£1/slide via NICE) and Tempus ($4,500/test xT CDx ADLT rate) follow the same pattern. In clinical AI, a reimbursement code is a public rate card; four of the five published clinical prices in the corpus come from payers.
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Abridge broke its own unit on 2026-07-22. The vendor whose entire model was per-clinician now advertises a customer story titled "Why CHRISTUS Health Expanded to an Unlimited Enterprise Agreement" — the first non-headcount contract shape any health-system-scale scribe in the corpus has named on its own surfaces. In the same capture its deployed-base claim jumped from 150+ to 300+ health systems and its module count fell from four to three, while still publishing no dollar figure anywhere.
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The spread inside the gated half is wider than the gap between the gated and public halves. Ambience's third-party estimate runs $2,800–$5,000/provider/year — a 1.8× band for a single vendor — while Freed's entire published ladder (2026-06-05) spans $39 to $119/mo, a 3.1× range you can actually read off a page. Buyers can compare Freed's tiers precisely and cannot compare Ambience's own quote to itself.