There is no single price for medical billing. Outsourced billing companies charge in one of four ways: a percentage of what they collect, a flat monthly fee, a fee per claim, or a mix of these. What you actually pay depends on your specialty, claim volume, payer mix, how much old AR needs work and which services are included. The honest way to compare is to price the same scope of work from each vendor, and to compare it with the full cost of doing it in-house.
One note before the numbers. We looked for a current national survey of billing company rates from the Bureau of Labor Statistics (BLS), MGMA, HFMA or the AMA and did not find one we could cite. So this page does not quote typical percentages or per-claim prices. Ranges you see elsewhere without a named survey behind them are estimates. Every figure on this page comes from a cited government source.
The four pricing models
| Model | How it works | Pros | Cons | Best fit |
|---|---|---|---|---|
| Percentage of collections | The company is paid a share of the money it actually collects for you. | Its income rises only when yours does, so it has a reason to chase every claim. | Costs rise with your revenue even if the work does not; check what counts as a collection. | Most private practices, especially those that want the biller to carry collection risk. |
| Flat monthly fee | A fixed amount each month for an agreed scope and volume. | Predictable budget; easy to compare. | Less built-in reason to work hard claims; watch the volume cap and overage terms. | Stable practices with steady volume and few complex claims. |
| Per-claim fee | A set amount for each claim submitted. | Simple to audit against claim counts. | Paid for submitting, not collecting; follow-up and appeals may cost extra. | High-volume, low-complexity services with clean payer rules. |
| Hybrid | A base fee plus a percentage, or different terms for new claims and old AR. | Can match price to work more closely. | Harder to compare; read every line. | Practices with a backlog to clean up or a mix of simple and complex services. |
Whichever model you choose, ask exactly what the fee is calculated on. For a percentage, is it all payments posted, only insurance payments, or also patient payments you collected at the front desk? For a flat fee, what happens in a month when volume spikes?
What is usually included, and what may cost extra
Scope varies widely. Use this list to make every quote cover the same work:
| Service | Ask |
|---|---|
| Eligibility and benefits verification | Is it done before every visit, or only on new patients? |
| Prior authorizations | Included, or billed per request? |
| Denial management and appeals | Is every denial worked, and are appeals included? |
| AR follow-up | Which aging buckets are covered, and is there a cutoff age? |
| Credentialing | Included, discounted or separate, and for how many payers? |
| Reporting | How often, which metrics, and is there a named account manager? |
| Patient statements and calls | Included, or charged per statement? |
Fees to ask about before you sign
- Setup or onboarding fees for loading your fee schedule, payers and providers.
- EHR or software fees: do you have to use or pay for their system, or do they work in yours?
- Minimum monthly fees that apply even in a slow month.
- Contract length and termination fees, plus how much notice you must give and what happens to claims in progress when you leave.
- Charges for working old AR that existed before the contract started, which are often priced separately.
- Clearinghouse and statement fees passed through to you.
What drives the cost
- Specialty. Session-based or high-volume services cost less to bill per claim than complex procedures with modifiers, global periods and authorizations.
- Claim volume. More claims usually lower the cost per claim but raise the total.
- Payer mix. Medicaid managed care, Medicare Advantage and plans with heavy authorization rules take more work per dollar collected.
- AR backlog. A large pile of old, unworked claims is a project of its own.
- Scope. Billing only is cheaper than full revenue cycle management with authorizations, credentialing and reporting.
What an in-house biller really costs
Salary is only the start. The BLS reports a median annual wage of $51,140 for medical records specialists in May 2025, or $24.59 an hour. That is the BLS occupation that includes medical coders, who assign the diagnosis and procedure codes used for billing.
On top of wages come benefits. In the BLS Employer Costs for Employee Compensation data for June 2026, employer costs for private industry workers averaged $46.89 per hour worked, of which wages and salaries were $32.82 and benefits were $14.07, or 30.0 percent of total compensation cost.
Then add the costs that never appear in a salary line:
- Billing software, clearinghouse fees and payer portal time.
- Training every year as codes, payer policies and Medicare rules change.
- Turnover: recruiting, onboarding and the claims that sit while a new person learns your payers.
- Coverage gaps: vacations, sick days and the claims that wait for one person to come back.
- Manager or provider time spent supervising billing and answering payer questions.
A fair comparison sets the full in-house cost against the outsourced fee for the same scope, and then asks the more important question: which option collects more of what you are owed?
Questions to ask any billing company before signing
- Exactly what is your fee calculated on, and what is excluded?
- Which of the services listed above are included, and which cost extra?
- Are there setup, software, minimum or termination fees?
- How long is the contract, and what notice do we give to leave?
- Who owns our data, and how do we get it back if we leave?
- How do you handle claims and AR that existed before you started?
- Which reports will we receive, and how often?
- Do you work in our EHR and practice management system?
- Who is our day-to-day contact, and how fast do they reply?
- Can we try the service on our own claims before committing?
How Sterling Global Solution LLC approaches pricing
We quote after we understand your specialty, volume, payer mix and backlog, because a number given before that is a guess. Our quotes spell out the scope, and every service in it, from eligibility checks to appeals and reporting, is covered by the fee rather than billed as an add-on. The simplest way to judge whether we are worth it is to watch us work your own claims first. See also our in-house vs outsourced billing breakdown and the full list of billing and RCM services.
Frequently asked questions
How much does medical billing cost?
What are the pricing models for medical billing services?
What does an in-house medical biller cost?
What fees should I ask a billing company about?
Does Sterling Global Solution LLC publish its prices?
Sources
U.S. Bureau of Labor Statistics, Occupational Outlook Handbook: Medical Records Specialists: median annual wage $51,140 and median hourly wage $24.59, May 2025.
U.S. Bureau of Labor Statistics, Compensation costs for private industry workers averaged $46.89 per hour worked in June 2026, The Economics Daily, September 17, 2026: wages $32.82, benefits $14.07, benefits 30.0 percent of compensation.
Sterling Global Solution LLC does not publish its rates. No billing company prices appear on this page. How we verify this guidance.
Related reading
- In-house vs outsourced billing. A worked comparison of the two options.
- 2026 Medical Billing Benchmark Report. The benchmarks to hold any billing partner to.
- Denial management services. What working every denial should look like.
- Prior authorization services. One of the services to price into every quote.
- All billing and RCM services. The full scope of work we cover.
Every practice is different. Try us first with our 30-Day Free Trial.
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