The real annual cost of an AI medical scribe: the actual math on Twofold, Freed and Heidi

Posting this because "how much does an AI scribe cost" almost never has a clean answer — the monthly number on the pricing page usually isn't what you end up paying. Figured I'd do the annual math properly.

Disclosure up front: I work at Twofold, this is our subreddit, so obviously I'm not neutral. I've tried to make the numbers checkable rather than asking you to take my word for it — every figure is from the vendor's own pricing page, verified 28 July 2026, and I've included the cases where we're the more expensive option.

**Annual cost, unlimited notes:**

| Plan | Price basis | Annual | Note limit | Coding? |
|---|---|---|---|---|
| Twofold Personal (annual billing) | $49/mo | **$588** | Unlimited | Yes |
| Freed Starter | $39/mo | $468 | **40/month cap** | No |
| Freed Core | $79/mo | $948 | Unlimited | No |
| Freed Premier (annual billing) | $104/mo | $1,248 | Unlimited | Yes |
| Heidi Clinician (yearly billing) | $110/user/mo | $1,320 | Unlimited | No |
| Heidi Practice (annual billing) | $180/user/mo | $2,160 | Unlimited | Yes |

**The part worth actually knowing:**

The note cap is where the headline price stops being the price. Freed Starter looks like the cheapest option at $39/month, and if you're writing under 40 notes a month it genuinely is — $468/year vs our $588.

But 40 notes a month is roughly 2 a working day. Most full-time clinicians blow through that in the first two weeks.

**Then coding moves the goalposts again.** This is the bit I didn't expect until I went through the full comparison tables: *both* Freed and Heidi put CPT/ICD-10 coding on their top individual tier. Freed's is Premier ($1,248/yr). Heidi's is Practice ($2,160/yr) — it's not on Clinician at all.

So if you code, the real comparison isn't $588 vs $948. It's **$588 vs $1,248 vs $2,160**.

**Fine print that costs more than people expect:**

* *Heidi's prices are per user and exclude sales tax*, so the sticker isn't your invoice. And Clinician is $110/user/mo only if you pay yearly — monthly it's $150, i.e. $1,800/year. (That's why you'll see both $110 and $150 quoted around the web; both are right, different billing cycles.)
* *Freed's Starter $39 is a promo rate*, shown struck through from $59. At $59 it's $708/year — more than us. Worth knowing before you plan around $39.
* *And in fairness, we run a promo too:* our month-to-month plan is $19 for the first month, then $69. Over a year that's $778 — so if you're staying, our annual plan at $588 is still the better deal. The $19 is there to make month one cheap, not to beat the annual rate.

**Other things that mattered more than the monthly price:**

* *Per-action metering.* Ask whether regenerations, AI assistant use, or recording minutes are metered. If they are, you'll ration them, which defeats the point.
* *Whether the BAA costs extra or is tier-gated.* Ours is on every plan.
* *Whether the trial needs a card.* Ours doesn't (7 days). A trial that needs a card is really a subscription you have to remember to cancel.

**Where we're not the answer:**

Under ~40 notes a month at Freed's current promo rate, Freed Starter beats us on price, full stop.

And this one's more important: **Heidi has a permanent free tier and we don't.** We have a 7-day trial, that's it. Heidi's free plan gives you unlimited transcription, standard templates, and task management. Advanced templates, patient/session linking, personalizations, and Ask Heidi are all limited, and there's no coding — but if that covers your work, it's free forever versus $588 from us. Their paid trial is 14 days to our 7, too.

If you're not sure yet, go try Heidi's free tier before you pay anyone, us included.

**TL;DR:** under ~40 notes/month, Freed Starter is cheapest (at the promo rate). If basic documentation is enough, Heidi's free tier is $0 forever. For a full caseload with coding, it's Twofold $588 vs Freed Premier $1,248 vs Heidi Practice $2,160. Check the vendor pages yourself — pricing moves, and mine is the biased account by definition.