What it costs to answer the phone.

Start with the calls nobody answers. At our calculators’ defaults, they cost a medical practice taking 60 calls a day about $334,081 a year in lost appointments, a law firm taking 30 calls a day $726,737 in matters never opened, and a contractor taking 25 calls a day $381,972 in jobs booked elsewhere. Each calculator lists its sources and takes your own call volume: medical, law, field services.

Every option below costs a fraction of that. What separates them is how many of those calls each one turns into a booking.

The federal median wage for a receptionist was $18.27 an hour in May 2025, $38,010 a year. That is the wage. Payroll taxes, benefits, a desk, software and covering absences add a third or more, so a fully loaded receptionist in a US city runs about $25 to $30 an hour. We use $30 as the working figure.

For that you get the most capable option. A person who knows the practice can book, reschedule, take a payment, calm someone down and recognize a regular. The limit is hours. One receptionist covers one line for about 40 hours a week, minus lunch, holidays and sick days. Every call that arrives while they are on another call, or after six, goes to voicemail.

A second limit is turnover. The role is entry level and the median tenure is short, so the training cost repeats.

A dedicated receptionist working remotely from the Philippines or Latin America costs a fraction of a local hire. Staffing vendors quote general virtual assistants at $5 to $17 an hour direct and $15 to $25 through a managed service. For a dedicated receptionist with good English, the quotes we have seen top out near $10 an hour. No vendor publishes a receptionist-specific rate, so treat that as our benchmark.

What you get is close to the in-house option: a person who learns your systems and can book into them. What you give up is the walk-up desk, and you take on a time zone, a dependence on their connection, and the same 40-hour limit. Two shifts cover more hours, at twice the cost.

Answering services bill by the minute or by the call. Vendor price lists put live answering at roughly $0.75 to $2.00 a minute, packages of 100 to 500 minutes at $250 to $1,200 a month, and per-call plans at $1.75 to $8 a call. Setup fees of $50 to $300 are common, and overage minutes cost more than the base rate. The figures come from vendors and disagree with each other, so get three quotes.

The service covers all hours, and that is what you pay for. The limit is what the operator can do. Most take a message and relay it. Some will book into a shared calendar if you give them access and a script. Few can see your schedule, your patient record or your job board, so the operator turns a call that needs an answer from your systems into a message for the morning. The caller still waits for a callback, as with voicemail.

At 300 minutes a month, which is about 100 short calls, a service costs roughly what a receptionist costs for two days.

Off-the-shelf AI receptionist plans list at $25 to $65 a month for answering and taking messages, and $99 to $299 a month with booking into a calendar. Per-call overages run $0.65 to $11 and setup $0 to $500. These plans answer and book into a generic calendar. They do not read or write your EHR, your case management system or your dispatch board.

The capable tier answers at any hour, takes many calls at once, and books into the schedule while the caller is on the line. Unlike an answering service, it can act on a call as well as relay it. It cannot exercise judgment. A caller who is distressed, a clinical question, a dispute about a bill, all need a path to a person, and the quality of that handoff separates a good deployment from a bad one.

An agent that reads and writes your own system is a different product. Connecting it to the EHR, the case management system or the dispatch board is a build, quoted up front. That connection lets the agent book the right appointment type, run a conflict check or open the job while the caller is on the line. We build agents that read and write to whatever system a business has, with or without an API. See how it works for a practice.

AnswerConnect’s call logs put 47% of calls to US businesses outside Monday to Friday working hours, weekends included. That figure comes from an answering service’s customers, who already get after-hours calls, so it is high for a practice with fixed hours. Even at half that, a receptionist alone leaves a quarter of calls to voicemail. The missed call statistics page has the rest of the numbers.

Most practices and firms end up with two of these: a person for the hours and the judgment, and something that covers the rest. The missed-call calculator prices the rest for your own call volume.