The most-hidden number in the category
When this post first ran on August 18, it could cite two published prices: Cuvo at roughly $25 per completed consult and Qualiphy at $27.99 per exam. On September 22 we checked every vendor pricing page again and found nine, from Remedora at $200 a month to Telegra at $5,999 a month plus $10,000 onboarding, with Cuvo now showing a $997 base fee under that $25. The 2026 entrants (Karpa Health, Remedora, MDLaunchr, EmbedCare) lead with a number. The holdouts, OpenLoop, Wheel, SteadyMD, MD Integrations, MyOrbitHealth and, for now, us, still say "talk to sales," which shifts the modeling work onto you.
This post does that work once: the published prices first, then five models and what each optimizes for, a worked platform cost at three volumes, the hidden costs outside the headline number, and a worksheet that converts any quote into cost per patient per month, the only unit that lets you compare a flat-fee vendor against a per-consult vendor against a revenue share. It pairs with the honest platform comparison from August: that post tells you who to shortlist, this one tells you what the shortlist will cost.
Updated September 22, 2026: added the published-price table (nine vendors, checked that day), a worked platform cost at 100, 500 and 2,000 patients, and four hidden costs missing in August: LegitScript, ID verification, Visa's $8 VAMP fee and processing reserves.
Published prices, checked September 22, 2026
| Vendor | Model | Published price | Setup or onboarding | Revenue share | Notes |
|---|---|---|---|---|---|
| Remedora | Flat monthly | From $200/mo | Not stated | Not stated | New in 2026; "one flat bill", "live in hours" |
| Karpa Health | Flat monthly | Launch $297 / Grow $797 / Scale $1,997 per month | Not specified | None | GA July 3, 2026; consults, medications and labs pass through at cost; LegitScript included with a two-business-day review guarantee |
| MDLaunchr | Flat monthly | $297/mo | Not stated | None | 0% medication markup; about a seven-day launch (whitelabelclinic.com) |
| EmbedCare | Flat monthly | Launch from $495/mo | Not stated | Not stated | As listed on its site in September 2026 |
| Fuse Health | SaaS plus usage | Growth $699/mo, Partner $3,000/mo | One-time onboarding, amount not published | None stated; 2% merchant fee on top | Built for supplement brands and med spas |
| Cuvo | SaaS plus per-consult | Launch $997/mo, Grow $2,000/mo, plus $25 per consult | $9,800 (Launch) or $15,000 (Grow) | None | 0% medication markup; month to month; the 2026 rebrand of Medstra |
| Rimo | Flat monthly | From $2,500/mo | Not stated | Not stated | Reported on Karpa's comparison page; not verified on Rimo's own site |
| Telegra | SaaS plus usage | Plus $2,999/mo, Pro $5,999/mo | $5,000 (Plus) or $10,000 (Pro), or three installments | None stated | ID verification $1.00 (Plus) or $0.75 (Pro) per patient; 21-day onboarding; Pro adds a native app and bring-your-own-pharmacy |
| Qualiphy | Per-consult | $27.99 per good-faith exam, $28.99 per consult | None | None | No subscription; a clinical layer, not a full storefront |
| Healthie | SaaS tiers | Core $19, Essentials $49, Plus $129, Group $149+ plus $50 per clinician, per month | None published | None | EHR-first; DoseSpot e-prescribing $40 per clinician per month |
| OpenLoop | Quote | Not published | Not published | Not published | Third-party pages report roughly $1,500 to $5,500 a month, unverified |
| MyOrbitHealth | Quote | Not published | Not published | Not published | Publishes a build-vs-white-label range ($250,000 to $900,000+ vs $10,000 to $75,000) but no fee |
| Turbopills | Quoted per program | Private beta, quoted per program | Itemized in the quote | Stated in the quote | One system: storefront, conditional intake, state-aware routing, billing on your own gateway accounts, pharmacy routing, branded portal, GraphQL API |
Two reading notes. A flat fee excludes what the tier passes through: Karpa and MDLaunchr bill consults and medications at cost, so the real number is the fee plus your provider's per-visit rate times visits. And the setup column is where the spread lives: Cuvo's $9,800 and Telegra's $10,000 buy a website build and hands-on onboarding that the $200 to $495 tiers leave to you.
The five pricing models
| Model | How it charges | Published examples | Wins when | Watch for |
|---|---|---|---|---|
| Flat monthly | Fixed platform fee; consults and medications passed through | Remedora from $200; Karpa $297 to $1,997; MDLaunchr $297; EmbedCare from $495 | You want a known floor at uncertain volume | What the tier leaves out: website, LegitScript, automation, the consult line |
| Per-consult | Fixed fee per completed visit | Qualiphy $27.99 per exam; Cuvo $25 per consult on top of its base fee | Volume is small or uncertain | The definition of "completed"; the rate at 10x volume |
| Per-member-per-month | Fee per active patient per month | Rarely published | Subscription programs with strong retention | The definition of "active"; minimum member counts |
| Revenue share | Percentage of program revenue | Not published; Cuvo, Karpa and MDLaunchr advertise none | You are cash-poor and pre-revenue | The effective cost at scale; audit and exit rights |
| SaaS plus usage | Base platform fee plus per-use charges | Telegra $2,999 or $5,999 plus $0.75 to $1.00 per ID check; Fuse $699 or $3,000 plus 2% | Volume is predictable and growing | Usage line items multiplying; per-seat pricing |
Flat monthly is the 2026 model, and its trap is the mirror image of per-consult: the fee is trivial at 500 patients, and the pass-through consult line quietly becomes the real platform cost. Per-consult is the cleanest alignment at launch: you pay when care happens. Its trap is success, the rate that was generous at 100 consults a month is a tax at 3,000, so negotiate the volume curve before you need it. PMPM matches subscription economics but punishes you for patients who linger in "active" without paying. Revenue share is seductive with no cash and brutal with traction; it is the model most likely to be triple the alternatives by month 18. SaaS plus usage is the most predictable and the most padded, because each usage line, messages, storage, seats, API calls, is a place for margin to hide.
What the models cost at 100, 500, and 2,000 patients
Assumptions, so you can swap in your own: patients pay $149 a month and generate one billed consult every other month (an initial visit, then quarterly reviews); the flat-fee row is Karpa Grow at $797 without the consult line it passes through; per-consult is Qualiphy's $28.99; the hybrid row is Cuvo Launch at $997 plus $25 a consult, setup excluded; revenue share is 10% because nobody publishes one. Monthly platform cost, cost per patient-month in parentheses.
| Model (anchor) | 100 patients, 50 consults | 500 patients, 250 consults | 2,000 patients, 1,000 consults |
|---|---|---|---|
| Flat monthly (Karpa Grow, $797) | $797 ($7.97) | $797 ($1.59) | $797 ($0.40) |
| Per-consult (Qualiphy, $28.99) | $1,450 ($14.50) | $7,248 ($14.50) | $28,990 ($14.50) |
| Flat plus per-consult (Cuvo Launch) | $2,247 ($22.47) | $7,247 ($14.49) | $25,997 ($13.00) |
| Revenue share (10% of $149) | $1,490 ($14.90) | $7,450 ($14.90) | $29,800 ($14.90) |
Three things fall out. The flat fee wins the platform line at every volume, which is why the flat-fee vendors can afford to publish; add the consult line at even $20 a visit and the Karpa row becomes $1,797, $5,797 and $20,797, and the four rows converge to roughly $10 to $18 per patient-month. Revenue share is the most expensive row from 100 patients onward and the only one that rises when you raise prices. At 2,000 patients the gap between cheapest and dearest is about $29,000 a month, a number worth negotiating before you have 2,000 patients.
The nine hidden costs
Implementation fees. One-time setup ranging from zero to five figures, often surfaced after the pricing conversation. Ask for it in the first quote, itemized.
Integration fees. The EHR, lab, or analytics connection that was a logo on the website turns out to be a professional services project. Ask which integrations are live in production today and what any new one costs.
Provider network minimums. Platforms that supply clinicians often carry monthly clinical minimums regardless of your volume, reasonable for them, painful for a seasonal or early-stage program. Ask what you owe in a zero-patient month.
Pharmacy markups. The platform fee looks small because the margin lives in the medication price. Ask for the pharmacy price list next to any wholesale reference you can get, and whether you are free to route to your own pharmacy partner, a topic we covered in choosing a compounding pharmacy.
Data egress. The exit fee: charges or long timelines to export your own patients, charts, and subscription records when you leave. The full question list lives in data ownership questions to ask before choosing a platform. A platform that hesitates here is quoting you the price of being trapped.
Four more that we left out in August; they sit outside the platform contract and land on your books anyway.
LegitScript. Google, Microsoft, Meta and TikTok require it before a telehealth brand can advertise prescription programs: $975 per website, nonrefundable, plus $2,150 a year per website, plus an optional $2,500 expedite that starts review within two business days. Founders on r/telehealth reported four to eleven weeks doing it themselves (September 13 and 21, 2026). Cuvo bundles the expedite into Grow and Karpa includes it at every tier; ask where it sits in any other quote.
ID verification per patient. Telegra prices it at $1.00 on Plus and $0.75 on Pro: small per check, $1,500 to $2,000 a month at 2,000 new patients, and usually buried under "usage".
Dispute fees under VAMP. Since April 1, 2026, Visa's Acquirer Monitoring Program charges $8 per fraudulent or disputed transaction for merchants above a 1.5% ratio (TC40 fraud plus TC15 disputes over settled card-not-present transactions), with a three-month grace period for a first violation, per the Merchant Risk Council. A program running 2% disputes on 2,000 monthly charges pays $320 a month in penalties before the chargebacks themselves. Charging only after clinical approval, plain renewal notices and easy cancellation keep you under the line; the mechanics are in reducing refunds and chargebacks.
Payment processing reserves. Stripe's restricted-businesses page (updated May 13, 2026) lists "Telemedicine and telehealth services", "Online pharmacies, including SaaS platforms" and "Card-not-present prescription-only products" as restricted: approval required, and revocable. Approved telehealth merchants commonly carry a rolling reserve of 5% to 10% of revenue for the first months. It is your cash rather than a fee, and a working-capital gap most TCO models skip; passing payment processor review covers the underwriting.
The TCO worksheet
Model a 12-month total cost of ownership in five steps. The numbers below are illustrative arithmetic, not benchmarks: a program doing 300 new patients a month at $149 per month, averaging four months of retention, roughly 1,200 active members at steady state.
- Forecast volume. New patients, active members by month, and total clinical touches including refill reviews, not just initial consults.
- Apply the model. Per-consult at $25 with initial plus quarterly reviews lands around $150,000 for the year. An illustrative SaaS deal at $2,500 per month plus $8 per consult lands near $78,000. A 10% revenue share on the same program costs about $17,900 in a month at steady state, over $180,000 annualized, the "cheap" model became the expensive one.
- Add one-time costs. Implementation, integrations, migration of any existing patients.
- Add per-order deltas. If medications route through the platform, price the markup against your alternative and multiply by annual order volume; this line quietly exceeds the platform fee in many programs.
- Add the exit. Egress fees and the rebuild cost if you leave in month 24. A cheap platform with an expensive exit is not cheap.
Divide each total by patient-months served and you get cost per patient per month, one number per vendor, finally comparable. Then judge it against margin, not against the other vendors: the framework in evaluating platform ROI without vanity metrics is the second half of this worksheet. Full launch context, everything beyond the platform line, is in the line-item launch budget.
When each model wins, and our approach
Flat monthly wins for a first brand on a budget, provided you price the pass-through consult line honestly before you compare it to anything. Per-consult wins for launches and uncertain volume: pay for care that happens, keep fixed costs near zero, renegotiate at scale. PMPM wins for retention-strong subscription programs where active members and revenue move together. Revenue share wins only when cash is the binding constraint and you have a contractual path out of it. SaaS plus usage wins once volume is predictable, it is usually the lowest cost per patient at scale, provided the usage lines are capped and the integration list is priced up front.
Our approach, stated plainly: Turbopills is in private beta and we quote per program, which puts us in the quote-only rows of our own table, next to the vendors we just criticized for it. Two things you can verify in a demo make that quote comparable rather than evasive. Billing runs on your own gateway accounts and charges start only after clinical approval, so the processor relationship, the reserve and the dispute ratio are yours. And your data is reachable through the GraphQL API while you are a customer, so the export question is answered before you ask it; ask us for the exit terms in writing anyway, because that is the right question for every vendor. Storefront, conditional intake, state-aware routing, billing, pharmacy routing and the branded portal run as one system, launched in weeks. We do not publish prices yet. Having built this table, we think we should, and we would change our mind only if per-program quotes turned out cheaper for customers than a published floor.
FAQ
How much does a white-label telehealth platform cost? Published prices checked September 22, 2026 run from $200 a month (Remedora) and $297 (Karpa Launch, MDLaunchr) through $495 (EmbedCare), $699 (Fuse Growth), $997 plus $25 a consult and $9,800 setup (Cuvo Launch), $1,997 (Karpa Scale), $2,999 plus $5,000 onboarding (Telegra Plus) and $5,999 plus $10,000 (Telegra Pro). Qualiphy charges $27.99 per exam with no subscription. OpenLoop, Wheel, SteadyMD, MD Integrations, MyOrbitHealth and Turbopills quote per program. Convert any quote to cost per patient per month at your projected volume before comparing vendors.
What is the best pricing model for a new telehealth brand? A flat monthly fee or per-consult pricing usually wins at launch: a $200 to $797 flat fee keeps fixed cost near zero, and per-consult means you pay only when care happens. In the worked example above the models converge to roughly $10 to $18 per patient-month by 500 patients once consult costs are included, so negotiate the crossover before you reach it. Revenue share should be a bridge, not a permanent structure; at 10% it is the most expensive model from 100 patients onward.
What hidden costs should I check in a telehealth platform contract? Nine recur: one-time implementation fees, per-integration professional services charges, provider network monthly minimums, pharmacy markups embedded in medication prices, data egress fees at exit, LegitScript ($975 application plus $2,150 a year per website, $2,500 to expedite), ID verification at $0.75 to $1.00 per patient, Visa's $8 per disputed transaction under VAMP once you cross 1.5%, and a 5% to 10% rolling processing reserve. Ask for each in writing with the first quote; the reaction is itself diligence data.
Why do telehealth platforms hide their pricing? Fewer do than this post claimed in August: on September 22, 2026 we found nine vendor pricing pages with a number. The holdouts (OpenLoop, Wheel, SteadyMD, MD Integrations, MyOrbitHealth and Turbopills) quote per program, partly because deals vary with volume, states and scope, partly because opacity favors the vendor. Treat quote-only as normal but model it aggressively: a vendor unwilling to itemize implementation, usage and exit costs is telling you where the surprises live.