Key facts
| Fact | Detail |
|---|---|
| One-time charges | Setup or implementation fee, hardware, number porting, SMS campaign registration |
| Regulatory lines | Federal USF charge (FCC contribution factor, set quarterly), state and local 911/E911 fees, state and local telecom taxes and gross-receipts taxes |
| Usage charges | SMS over the plan allowance, fax pages or a dedicated fax line, toll-free and international minutes, AI add-ons |
| Exit charges | Early-termination fees on annual or multi-year terms, auto-renewal, port-out charges |
| ZentryVoice | $20 per user per month, month-to-month; texting and eFax $15 per practice per month each; desk phones $119 one-time, optional |
| How to compare | A 3-year total: monthly charges × 36, plus every one-time charge, plus the cost of leaving early |
Why does the invoice not match the seat price?
The seat price is a marketing number, and the invoice is an accounting number. The gap between them comes from four kinds of charges that headline pricing leaves out.
One-time charges appear once, at signup or when hardware ships. Regulatory charges are set by the FCC and by state and local governments and change over time. Usage charges depend on how much the office texts, faxes and calls. Exit charges appear only when the office tries to leave. A vendor can publish a low seat price and still bill more than a competitor once the other three categories are counted.
The Practice Phone Price Index records the published seat price for each vendor with a check date and a source. This guide covers everything that is not in that column. The aim is a fair 3-year total, which is the only number that compares two quotes properly.
What one-time charges appear at signup?
Four charges commonly appear before the first monthly bill.
Setup or implementation fees. Dental-focused vendors often charge a one-time implementation fee. Weave’s is reported at $500–$750 (reported one-time implementation fee (costbench, iplum); per location for multi-location groups, checked 2026-10-13). Mango Voice’s pricing page says a one-time implementation fee is required but does not publish the amount. Spruce Health charges a one-time SMS registration fee of $19.50 (one-time SMS registration fee per organization (vendor page); desk-phone hardware billed separately, checked 2026-10-13). General business platforms often waive setup for self-serve accounts but may charge for professional onboarding.
Hardware. Desk phones are either bundled into a per-location price, sold outright or leased monthly. A lease looks small per month and costs more than the phone over a 3-year term. Ask for the purchase price of the same handset and compare. ZentryVoice sells desk phones outright at $119 each, pre-provisioned, and they are optional: soft extensions on desktop and mobile work without them. Weave includes Yealink desk phones with every plan, which is part of what its per-location fee covers.
Number porting. The FCC’s consumer guide says companies may charge to port a number and suggests asking whether the fee can be waived. Some providers charge per number or per port order. ZentryVoice does not charge a porting fee. The number porting guide covers the process.
SMS campaign registration. Business texting from a local number in the United States requires 10DLC registration with The Campaign Registry. Carriers charge registration and monthly campaign fees to the provider, and some providers pass them through as a one-time or recurring line. Ask whether the texting price includes registration.
Which regulatory fees and taxes get added?
Three groups of government-driven charges appear on most telecom bills, and most vendors pass them through rather than absorb them.
The federal Universal Service Fund (USF) charge. Every provider of interstate telecommunications, including interconnected VoIP, must contribute a percentage of its interstate and international end-user revenue to the Universal Service Fund. The FCC sets that percentage each quarter as the contribution factor and publishes it on its contribution factor page. The proposed factor for the fourth quarter of 2026 is 42.0 percent (DA 26-946, released 2026-09-14), a record for the second straight quarter. That does not mean 42 percent of the bill. Interconnected VoIP providers may apply the factor to a safe-harbor share of revenue rather than the whole bill, so the line item is typically a few percent of the total. The FCC’s consumer guide says carriers may recover the cost from customers but are not required to, and that the charge may not exceed the carrier’s actual contribution.
State and local 911 and E911 fees. These are set by states, counties and cities, usually as a flat amount per line per month. They apply to interconnected VoIP lines as well as traditional lines. The FCC’s annual 911 fee report to Congress, required by the NET 911 Act of 2008, lists each state’s fee and how the money was spent. The report covering 2019 put the average fee at about one dollar per line per month for wireline, wireless and VoIP alike. A 5-line office therefore pays a modest but real monthly sum that no seat price includes.
State and local telecom taxes. Sales taxes, gross-receipts taxes, utility users taxes and franchise fees vary by jurisdiction and often apply to VoIP service. The FCC guide lists these separately from federal charges and notes they may appear as gross-receipts taxes on the bill. Some vendors fold taxes into the seat price; most do not. Spruce Health, for example, notes on its pricing page that telecom taxes and fees have been passed through since 2025-11-01.
Ask every vendor one question: does the quoted price include regulatory fees and taxes, or are they added? Then ask for a sample invoice for an office in your state.
Which usage charges surprise practices?
Usage charges are the ones a practice discovers in month two.
SMS overages. Per-user plans often include a monthly text allowance per seat and bill above it. RingCentral’s tiers are reported to include 25, 100 and 200 texts per user per month, with a paid Business SMS Booster add-on. Nextiva lists 100, 500 and unlimited texts per user across its tiers. Appointment reminders, recall campaigns and two-way conversations add up quickly at a busy front desk. Ask what the allowance is, whether it pools across users and what the per-message overage costs. ZentryVoice prices texting at $15 per practice per month.
Fax. Fax is still how referrals, records requests and insurance paperwork move in healthcare and law. Vendors handle it three ways: included, sold as an add-on, or metered by page. Zoom Phone includes 50 fax pages per month on its lower tiers and unlimited on Business Plus. Nextiva lists online fax as an add-on. Some offices keep a dedicated analog fax line on top of the VoIP system, which means a second carrier bill and a second set of regulatory fees. ZentryVoice’s T.38 eFax is $15 per practice per month, per practice rather than per user.
Toll-free and international minutes. Most US plans include unlimited domestic calling. Toll-free inbound numbers are often metered, and international calls almost always are.
AI features. Call summaries, transcription and AI receptionists are increasingly sold as per-user or per-conversation add-ons. RingCentral lists an AI Receptionist add-on and a Conversational Intelligence add-on on its pricing page. Weave’s Call Intelligence and AI Receptionist are reported as separately billed. ZentryVoice includes AI call summaries and voicemail transcription in the seat price.
Extra numbers and extensions. Some plans charge for each additional phone number, each ring group or each extension beyond a quota. ZentryVoice includes unlimited extensions.
What does leaving cost?
Exit charges are the costs a practice does not see until it tries to switch.
Early-termination fees. Annual and multi-year contracts usually carry a fee for cancelling early, often the remaining months of the term. Weave’s reported term is annual (reported: 1-year minimum, auto-renew, billed monthly). 8x8’s contracts are reported as 12 to 36 months with early-termination fees. The FCC’s consumer guide tells customers to review their contract for early-termination fees and outstanding balances before switching. It also notes that the old provider cannot refuse to port the number because of them. It can still bill them.
Auto-renewal. Annual terms that renew automatically unless cancelled in a notice window can lock the office in for another year. NexHealth’s FAQ, for example, describes a 90-day non-renewal notice on annual plans. Put the notice date in the practice calendar on the day you sign.
Port-out charges and data export. Some vendors charge to release numbers or to export call recordings, voicemail and text history. Under HIPAA, a business associate agreement must address what happens to protected health information at termination (45 CFR 164.504(e)(2)(ii)(J)). Ask how records are returned or destroyed and whether export costs anything.
A month-to-month plan has none of these costs. ZentryVoice is month-to-month, which means the cost of leaving is the current month.
Which fee types should be on the comparison sheet?
The table lists each fee type, when it appears and the question that surfaces it. Use it as a checklist when collecting quotes.
Fee types that headline seat prices leave out
| Fee type | When it appears | Typical basis | Question to ask the vendor |
|---|---|---|---|
| Setup or implementation fee | Once, at signup | Per account or per location | Is there a one-time charge, and is it per location? |
| Hardware | Once (purchase) or monthly (lease) | Per handset | What is the outright price of the same phone? |
| Number porting | Once, per port order | Per number or per order | Is porting in free? Is porting out free? |
| SMS registration (10DLC) | Once, plus possible monthly campaign fee | Per brand or campaign | Is registration included in the texting price? |
| Federal USF charge | Monthly | Percentage of interstate revenue (FCC contribution factor) | Is the USF charge passed through? At what rate? |
| State and local 911/E911 fees | Monthly | Per line | How many lines are billed 911 fees? |
| State and local taxes | Monthly | Percentage, varies by jurisdiction | Does the quote include taxes for my state? |
| SMS overages | Monthly, when exceeded | Per message above allowance | What is the allowance, and does it pool? |
| Fax | Monthly or per page | Per account, per page or a separate line | Is fax included, metered or a separate line? |
| AI features | Monthly | Per user or per conversation | Which AI features cost extra? |
| Early-termination fee | On cancellation during a term | Remaining months or a flat fee | What is the term, and what does leaving cost? |
| Auto-renewal | At term end | Another full term | What is the non-renewal notice window? |
What does a 5-seat office pay over 3 years?
A 3-year total is the fairest way to compare two systems, because it captures one-time charges and spreads them across the term the office will actually use.
Take a 5-seat office with texting, eFax, two desk phones at the front desk and a Technical Support plan. On ZentryVoice, computed from the published price list, that office pays $150 per month in recurring charges and $488 one-time for the two phones. The first year comes to $2,288 and the 3-year total to $5,888.
That total excludes regulatory fees and taxes, which depend on the office’s state. It also excludes any one-time setup charge, which is shown in the signup wizard.
To build the same total for another vendor, multiply the monthly seat price by 5 and by 36. Add the texting and fax add-ons for 36 months, then the setup fee and hardware. Add any early-termination exposure if the office might leave inside the term. The per-user versus per-location guide walks through the arithmetic for a per-location plan, and the one platform versus separate vendors comparison does it for a three-vendor stack.
How ZentryVoice handles this
ZentryVoice publishes every recurring line item on the pricing page, with a calculator that produces the monthly, first-year and 3-year total for any seat count up to 16 extensions.
- Seat: $20 per user per month, including voicemail transcription, AI call summaries, live reporting, unlimited extensions and soft extensions on desktop, iOS, Android and web.
- Add-ons: texting $15 per practice per month and eFax $15 per practice per month, each charged once per practice.
- Hardware: optional desk phones at $119 one-time, pre-provisioned, arriving in 2–3 business days.
- Support: optional Technical Support at $15, $20 or $30 per month by extension count, or Technical Support plus Advanced Warranty at $30, $35 or $40.
- Term: month-to-month, 30-day trial, no early-termination fee, no charge to port numbers in.
- One-time charges: any one-time setup charge is shown in the signup wizard with the full line-item total before you confirm.
Regulatory fees and taxes vary by state. The vertical guides cover compliance requirements by practice type, and the BAA guide covers which vendors in a stack need an agreement.