Cost breakdown
What it really costs, all-in
DirectScribe's software fee is fixed. The rest is your own vendor spend, which you can see and control. These static tables use figures verified in July 2026 for a solo outpatient practice of roughly 440 notes per month.
These are estimates, not quotes. Vendor prices change; audio length, note length, and patient volume all move the number. Treat the ~440-notes column as the anchor and the lighter/heavier columns as scaled estimates. Re-check the current rates with each vendor before you rely on them.
Transcription (speech → text)
You send the physician's audio to one cloud vendor. This is usually the larger of your two API costs.
| Vendor | ~200 notes | ~440 notes | ~800 notes | Notes |
|---|---|---|---|---|
| Deepgram (nova-3-medical) | ~$4 | ~$8 | ~$15 | Lowest-cost medical model. Recommended default. |
| ElevenLabs (Scribe) | ~$4–6 | ~$7–12 | ~$13–22 | Comparable quality; slightly higher and more variable. |
| AWS Transcribe Medical | ~$64 | ~$141 | ~$256 | Coming soon For maximum-compliance practices; ca-central-1. |
Note-shaping (text → your template)
The transcript is shaped into your template by an intelligence vendor. This step is cheap on a mid-tier model — or free of API cost if you run it locally.
| Vendor / model | ~200 notes | ~440 notes | ~800 notes | Notes |
|---|---|---|---|---|
| Claude (mid-tier) | ~$1–4 | ~$2–8 | ~$4–15 | BAA status for small customers is being verified — see the guide. |
| OpenAI GPT (mid-tier) | ~$1–4 | ~$2–8 | ~$4–15 | BAA available to individuals by email. |
| LM Studio (local model) | $0 | $0 | $0 | No API cost — runs on your Mac. You provide the hardware and power. |
All-in stacks versus the incumbents
Add the fixed $39/month software fee (or $33.25 on the annual plan) to your vendor spend. Even the middle of the range lands well under the all-inclusive competitors.
| Stack | Software | API | All-in |
|---|---|---|---|
| DirectScribe + Deepgram + local (LM Studio) | $39 | ~$8 | ~$47 |
| DirectScribe + Deepgram + Claude/GPT | $39 | ~$10–16 | ~$49–55 |
| DirectScribe + ElevenLabs + Claude/GPT | $39 | ~$9–20 | ~$48–59 |
| Heidi Health | — | incl. | $150 USD |
| Scribeberry | — | incl. | $99 USD |
| Tali AI | — | incl. | $135–150 |
| Dragon Medical One | — | incl. | $109 + setup (Windows) |
Review cadence
Vendor pricing and endpoints were verified on 2026-07-02. Prices drift. These tables are reviewed on the same monthly cadence as the app; if a vendor changes rates, the figures here are updated at the next pass.