What the headline rate leaves out
A quoted per-minute rate is the start of a calculation, not the price. Several additions are standard across the industry and legitimate; the problem is when they surface after you have committed.
- Minimum fee per order — a $25 minimum makes a six-minute file cost the same as a fourteen-minute one.
- Difficult-audio surcharge — background noise, crosstalk, strong accents, or narrowband telephone audio.
- Timestamps — commonly priced separately, and required if you want caption files or to cite passages.
- Speaker identification — sometimes included, sometimes not, and essential for any multi-party recording.
- Turnaround tier — the headline rate is often the slowest tier, with rush and same-day priced well above it.
- Verbatim convention — some services charge more for true verbatim than for cleaned output.
When the price gets fixed
This distinguishes vendors more reliably than the rate does. Two models exist, and only one of them lets you budget.
In the first, difficult audio is identified before work begins and you are quoted the higher rate with the option to decline. In the second, the surcharge appears on the invoice after delivery, when you have no leverage and the work is done. Both are described in the same language on a pricing page.
Ask directly: if my audio is assessed as difficult, when am I told, and can I decline at that point? A vendor that cannot answer clearly is describing the second model.
Where per-page and per-minute diverge
Audio and video transcription are priced per minute of recording, which is straightforward: a sixty-minute file is sixty billable minutes regardless of how much was said.
Document transcription is priced per page, because the work scales with pages rather than time. The thing to check is how a page is defined and what happens with unusually dense ones — a vendor that flags and quotes a dense page before starting behaves differently from one that re-counts it afterwards.
Video carries an extra consideration: timestamps are what make output usable for captions, so for a captioning workflow the timestamp cost is not optional and belongs in the comparison from the start.
Turnaround tiers are a pricing decision, not a service level
Buyers habitually order faster turnaround than they need, because the tier names imply urgency and the price difference looks small per minute. On a long file it is not small.
Work out when you actually need the document. A four-day standard tier at a base rate against a same-day tier at double it is a meaningful difference across a caseload, and for records being filed rather than acted on immediately, the slow tier is usually correct. Reserve the fast tier for the files where a decision waits on the transcript — a coverage determination, a hearing, a discharge.
One thing to check specifically: whether a rush order that misses its window is refunded or re-rated. A same-day tier with no remedy for late delivery is a price, not a commitment.
Template matching is where the hidden cost usually sits
The cost that rarely appears in a comparison is your own staff time after delivery, and it is frequently larger than the difference between two vendors’ rates.
A transcript returned in a vendor’s house format, when your practice uses a particular SOAP layout or your firm has a standing transcript style, moves the formatting work to whoever receives it. At volume that is a recurring internal cost being paid to save a smaller external one. A vendor that maps to your existing template absorbs it once.
Ask for a sample in your own format before committing, not a sample in theirs. The relevant question is not whether the transcript is good but whether it arrives ready to use.
Questions that separate vendors quickly
Most of what actually matters is not on a pricing page at all, and none of these five questions takes a vendor long to answer. The speed and directness of the reply is itself informative — a vendor who has to check whether they will sign a BAA has told you something before they answer:
- Is every file reviewed by a person, or only files I flag?
- Will you sign a BAA or a confidentiality agreement, and how quickly?
- Is my material used to train models?
- Can you match our existing document templates, or do we reformat your output?
- When is the final price fixed — before work starts, or on the invoice?