Prices verified August 2026 against vendor pages; see the pricing index for every captured figure and its source URL.
Run your own numbers in the cloud PACS cost calculator with your real monthly volume.
The spread is that wide because "PACS" covers everything from a hospital network's federated archive to one box in a dental clinic. The honest way to make sense of PACS pricing is by deployment model, so that is how this page is organized. If you first want to know whether a small system covers you at all, read what a mini PACS is. And if you are pricing this out before your center even exists, the software line is only one piece of a much bigger budget; see how to start an imaging center for the full launch checklist and equipment costs. And if you are shopping the budget end specifically, the affordable PACS guide prices per-study meters, capped cheap tiers, open source and flat rates against each other, with the break-even volume for each.
Cost per study at 200, 1,000 and 5,000 studies a month
Sticker prices hide the meter. Divide each published plan by the studies it has to carry and the models separate. Every dollar figure below is a published price captured 2026-08-28; where a vendor's published plans stop short of a volume, the cell says so rather than extrapolating.
| Pricing model, published example | 200 studies / month | 1,000 studies / month | 5,000 studies / month |
|---|---|---|---|
| Flat per locationMiniPACS, $300 per month, unlimited studies | $300 / $1.50 per study | $300 / $0.30 per study | $300 / $0.06 per study |
| Per-study tiersOmniPACS Cloud: $99 for 30 cases, $250 for 100, $562 for 250, $1,400 for 700 | $562 (Tier 2, 250 cases) / $2.81 per study | not computable from published prices: largest published tier is 700 cases | not computable from published prices: largest published tier is 700 cases |
| Storage tiers (assumption)PostDICOM: $79 for 100 GB, $149 for 500 GB, $299 for 1,000 GB, $499 for 2,000 GB, extra 500 GB $50; assuming 50 MB per study and 12 months of studies kept in the plan | $149 (Professional, 500 GB) / $0.75 per study | $299 (Premium, 1,000 GB) / $0.30 per study | $599 (Enterprise 2,000 GB plus two 500 GB add-ons) / $0.12 per study |
| Open source, self-installedOrthanc, dcm4chee: $0 license | $0 license / $0 per study, labor not published | $0 license / $0 per study, labor not published | $0 license / $0 per study, labor not published |
| Per-study, quote onlyProtonPACS, Candelis ImageGrid Cloud, AdvaPACS: model stated, no dollar figure published | not computable from published prices | not computable from published prices | not computable from published prices |
Formula. Cost per study = monthly plan price divided by studies per month. Flat: $300 / 200 = $1.50; $300 / 1,000 = $0.30; $300 / 5,000 = $0.06. Per-study tiers: the cheapest OmniPACS plan whose included cases cover the volume, $562 / 200 = $2.81; above 700 cases OmniPACS publishes no plan, so 1,000 and 5,000 are not computable. Storage tiers: assumed 50 MB per study and one year of studies resident in the plan (200 studies x 50 MB x 12 = 120 GB, Professional at $149; 1,000 studies = 600 GB, Premium at $299; 5,000 studies = 3,000 GB, Enterprise 2,000 GB at $499 plus two 500 GB add-ons at $50 = $599), then the same division. The 50 MB and 12-month figures are our assumptions, not PostDICOM's; a CT-heavy clinic or a longer retention rule moves you up a tier sooner.
Your volume, the flat rate
Formula: $300 per location per month divided by your studies per month. The rate does not move with volume; the division is the whole calculation.
Cost by deployment model
How much does a cloud PACS cost per month?
Published cloud PACS plans run from $79 per month (PostDICOM Essential: 100 GB, 1 user, annual billing) to $1,400 per month (OmniPACS Tier 3: 700 cases). Most cloud vendors publish nothing and quote per site; OnePACS, RamSoft, Intelerad and AdvaPACS all say "volume based" or "per study" without a dollar figure. Cloud vendors price by usage: per study, per gigabyte stored, per user seat, or a blend, so the bill grows with the practice. You avoid buying hardware, but you rent access to your own archive forever. Plug your volume into the cloud PACS cost calculator to see where you fall, and read cloud PACS vs on-site for the non-price trade-offs.
How much does a self-hosted PACS cost?
Two published answers. Open source is $0 in license: Orthanc and dcm4chee cost nothing to run, and you supply the install, security, backup and maintenance labor; commercial Orthanc support packs are quote only. Flat commercial self-hosted is MiniPACS at $300 per location per month ($3,600 per year, billed yearly) with one-time setup from $1,500. That covers the archive, the browser viewer with studies opening in about 0.6 seconds (measured), reporting, share links, disc export, and encrypted backups, with no per-study, per-seat or storage fee. Adding the Vendo referral portal makes it $640 per month. Full detail is on the pricing page and the capability list on features; the deployment story is on self-hosted PACS.
Enterprise on-prem: quote only
The traditional hospital model: perpetual licenses, dedicated hardware, professional services to install it, then an annual maintenance contract. No vendor in this segment publishes a price; Sectra, Intelerad, RamSoft, Konica Minolta Exa and Carestream Vue all sell on quote. It exists for multi-department, multi-site federation and integration with hospital systems. For a single clinic this model prices in capabilities that never get switched on. The wider market context, including how much of the industry runs on these contracts, is in PACS statistics.
What is the cost per study?
The only openly published per-study rates are OmniPACS's, from $3.50 per study on the 30-case plan down to $2.00 per study on the 700-case plan. On a flat plan the per-study cost is whatever your volume divides it into: MiniPACS is $1.50 per study at 200 studies a month and $0.06 at 5,000. ProtonPACS, Candelis and AdvaPACS state a per-study model without a figure, so their cost per study is not computable from published prices.
The hidden costs
The advertised subscription is the floor, not the bill.
The 5-year math
What does a PACS cost over 5 years?
Multiply the published plan by 60 months. MiniPACS at $300 per month flat is $3,600 per year and $18,000 over five years, $19,500 with setup from $1,500, known on day one. The published cloud plans at today's list price run from $4,740 (PostDICOM Essential, 100 GB) to $84,000 (OmniPACS Tier 3, 700 cases per month), and the cheap end is capped by storage or study count, so a growing clinic climbs the tiers. With Vendo included, MiniPACS is $7,680 per year, still a number you can write into a budget once and stop thinking about.
| Published cloud plans | MiniPACS (flat) | |
|---|---|---|
| Monthly | $79 (100 GB) to $1,400 (700 cases), moves with volume | $300 per location, fixed |
| Year one | $948 to $16,800, plus migration where charged (OmniPACS: $1,500) | $3,600 plus setup from $1,500 |
| Five years | $4,740 to $84,000 at today's list price | $18,000 ($19,500 with setup) |
| Exit | Possible egress fees to retrieve studies | The archive already sits on hardware or a cloud account you control, so there is nothing to buy back |
How to buy without regret
Price the meters at your real volume, not the vendor's example volume. Get migration and exit costs in writing. Then look at the product itself: the MiniPACS live demo is the real system on synthetic data, no sales call; enter a work email and we send you a one-time link so you can judge what the $300 buys yourself. If you are still building a shortlist, the roundup of best PACS systems lines the main options up side by side.
FAQ
How much does a PACS system cost per month?
Published PACS prices verified in August 2026 run from $79 per month (PostDICOM Essential, 100 GB, annual billing) to $1,400 per month (OmniPACS Tier 3, 700 cases) for cloud plans, and $300 per location per month flat for self-hosted MiniPACS, or $640 per month with the Vendo referral portal added. Open-source servers such as Orthanc and dcm4chee are $0 in license. Enterprise PACS vendors such as Sectra, Intelerad, RamSoft and Konica Minolta publish no monthly price at all and sell on quote.
What is the cheapest way to run a PACS?
The cheapest license is open source at $0 (Orthanc, dcm4chee), but only if someone on staff can install, secure and maintain the server; otherwise that person's hourly rate becomes the real subscription. For a clinic without that engineer, the cheapest published bill at very low volume is a capped cloud plan such as PostDICOM Essential at $79 per month for 100 GB and one user, or OmniPACS Cloud Explorer at $99 per month for 30 cases. Above a few hundred studies a month a flat rate wins: MiniPACS is $300 per location per month and the bill does not move with volume.
What does an enterprise PACS cost?
No enterprise PACS vendor in our August 2026 index publishes a price: Sectra, Intelerad InteleShare, RamSoft OmegaAI, Konica Minolta Exa, Carestream Vue and Candelis ImageGrid all sell on quote, negotiated per site on study volume, modalities, locations, storage and integrations. That model exists for hospital networks federating many departments; for a single clinic it buys capacity that never gets used, and the price is whatever the negotiation produces.
Are there hidden costs in cloud PACS pricing?
Frequently. The advertised subscription is the floor, not the bill. Watch for per-study fees that scale with your volume, per-seat fees that scale with your staff (PostDICOM lists extra users at $25 to $30 per month), one-time migration charges to get your archive in (OmniPACS publishes $1,500 for a 250 GB migration), and data egress fees to get it back out when you leave. Ask every vendor for the exit cost in writing before you sign.
Is self-hosted PACS cheaper than cloud PACS?
Over five years, usually yes for a single location doing real volume. At $300 per month flat, five years of MiniPACS is $18,000 in software, $19,500 with setup from $1,500. Five years of a published cloud plan at today's list price runs from $4,740 (PostDICOM Essential, 100 GB) to $84,000 (OmniPACS Tier 3, 700 cases per month). The cheap cloud tiers are capped by storage or study count, so a growing clinic climbs the tiers and the crossover with the flat rate comes fast.
What is included in the MiniPACS price?
The $300 per month covers the full system for one location: DICOM archive, browser viewer with studies opening in about 0.6 seconds (measured), reporting with signed PDFs, share links that live 7-90 days, disc export, and encrypted backups. One-time setup starts at $1,500. Adding the Vendo referral portal brings the total to $640 per month. There are no per-study, per-seat, or storage fees.
How much does it cost to implement a PACS?
Implementation cost depends on the model. Self-hosted MiniPACS setup starts at $1,500 one time, on top of the $300 per month subscription. Cloud vendors often add a separate migration or installation charge: OmniPACS publishes $1,500 one time for a 250 GB data migration, Purview says installation begins at $999, and most others quote per project, so ask for that number before you sign. Enterprise on-prem implementation adds professional-services fees to install, on top of the license and hardware.
How much does a cloud PACS cost per month?
Published cloud PACS plans verified in August 2026 run from $79 per month (PostDICOM Essential, 100 GB, 1 user, annual billing) to $1,400 per month (OmniPACS Tier 3, 700 cases); most cloud vendors publish no price and quote per site. A flat self-hosted alternative like MiniPACS is $300 per location per month with no per-study fees. Cloud meters mean the bill grows with your volume, while the flat rate is known on day one and billed yearly at $3,600 per year.
Which PACS has flat monthly pricing and no per-study fees?
MiniPACS has flat monthly pricing at $300 per location per month with no per-study, per-seat, or per-gigabyte fees. The rate is billed yearly ($3,600 per year) and does not move with your volume; adding the Vendo referral portal makes it $640 per month, and one-time setup starts at $1,500. By contrast, published cloud PACS plans are metered by study count (OmniPACS, $2.00 to $3.50 per study) or by storage and seats (PostDICOM, 100 GB to 2,000 GB tiers at $79 to $499 per month).
