Compare · Dragon Medical One
Dragon Medical One pricing and cost, the Dragon Copilot migration, and the alternatives
The short answer
Microsoft publishes no list price for Dragon Medical One, so every per-user figure circulating online is an estimate rather than a quote. The only verifiable Dragon Medical prices in public are US federal contract awards. A search of USAspending.gov on September 1, 2026 returns 25 prime contract awards naming Dragon Medical between FY2017 and September 2026, worth $41,022,603 in total. The spread is barbell shaped: three awards exceed $1 million, including a $23,945,472 brand-name Dragon Medical One enterprise-wide award to the Department of Veterans Affairs running June 2025 to May 2027, while 18 of the 22 priced awards are under $50,000 and the median priced award is $16,306. Microsoft is also steering the installed base onto Dragon Copilot, and the radiology experience inside Dragon Copilot is still in preview in the United States, so a radiology group pricing this in 2026 is pricing a product in transition.
Ask what Dragon Medical One costs and you get a wall of numbers with nothing behind them. One comparison site quotes a monthly per-clinician rate. Another quotes an annual license. A third quotes a three-year subscription. None of them cite a source, because Microsoft does not publish one. Dragon Medical One is quoted per organization through a reseller, against clinician count, term length, deployment scope and whatever else is in the bundle, and the quote you get is not the quote the practice down the road got.
So this page does not add a twenty-sixth invented range. US federal agencies buy Dragon Medical, and federal contract awards are public record with a contract number attached to every dollar. Everything in the table below came out of USAspending.gov on September 1, 2026 and you can check any line of it yourself. Public-sector schedule pricing is not commercial pricing and nobody should pretend otherwise. What it does show, with no ambiguity at all, is the shape of the deal: who you actually buy from, how big the two normal purchase sizes are, and how little of the money ever touches the vendor directly.
The second thing worth knowing before you price anything is that the product is moving. Microsoft announced Dragon Copilot on March 3, 2025 at HIMSS, combining the Dragon Medical One speech engine with the ambient listening from DAX Copilot, and made it generally available to US partners on May 1, 2025. Microsoft's own product page now carries a migration path titled "Migrate from Dragon Medical One to Dragon Copilot." By HIMSS 2026 Microsoft was reporting more than 100,000 clinicians on Dragon Copilot. For a radiology group there is a catch in the timing, and it is the single most important line on this page: Microsoft states that the Dragon Copilot radiology experience, paired with PowerScribe One, is "currently in preview in the United States." Physicians and nurses are generally available. Radiology is not.
That matters commercially, not just technically. If you are being quoted a multi-year Dragon Copilot agreement on the strength of a radiology capability that is in preview, you are paying today for a roadmap. That is a legitimate thing to buy, and plenty of groups do it deliberately. It is not a legitimate thing to buy by accident, which is what happens when the radiology line item is folded silently into an enterprise clinical documentation renewal.
Last updated September 2026
Worklist
Structured report
DraftRun the assistant to draft this report for review.
Illustrative sample · not a real patient study, not a diagnosis
Decision support for qualified clinicians. Radiological.ai does not provide a diagnosis and is not a substitute for professional judgment.
Flag · prioritize · draft · you review and sign
There is no Dragon Medical One list price. There are 25 federal contract awards worth $41 million, 92 percent of which went through one reseller rather than to the vendor, and that single fact should change how you run the negotiation.
Side by side
What US federal agencies actually paid for Dragon Medical
Public prime contract awards, each traceable to a contract number. Not a private rate card, but the only verifiable Dragon Medical pricing that exists anywhere.
| What was bought | Award amount | Term and what it tells you |
|---|---|---|
| VA, brand-name Dragon Medical One enterprise-wide speech recognition as a service | $23,945,472 | Two years, June 2025 to May 2027. The largest verifiable Dragon Medical One purchase in public record, and the clearest evidence that the product is now sold as an enterprise SaaS agreement rather than as licenses. |
| VA, Dragon Medical One implementation and project management task order | $13,530,801 | Five years, September 2019 to September 2024. Rollout labor was contracted separately from the software and it came to a very large number on its own. |
| VA, Nuance project management, software maintenance and customer support | $2,541,524 | Twenty-one months from September 2019. The only award in the whole set that went directly to Nuance Communications rather than through a reseller. |
| Defense Health Agency, Dragon Medical software and documentation bundle with maintenance | $714,000 | Twelve months, September 2021 to September 2022. Maintenance and support are bundled into the purchase rather than assumed to be included. |
| Indian Health Service, Dragon Medical software and services for one health center | $48,850 | Six weeks, March 2021. Software plus services for a single site, which is the top of the small-purchase band. |
| HRSA, twelve months of Dragon Medical One | $19,406 | August 2023 to July 2024. A clean single-year Dragon Medical One figure for one small federal organization, with no implementation or hardware attached to the description. |
| Indian Health Service, Dragon Medical Practice Edition 4 with RPMS integration and installation | $22,364 | Twelve months from September 2019. Note the integration and installation sitting inside the same award as the license. |
| Bureau of Prisons, Dragon Medical Practice Edition 4 with PowerMic | $20,574 | April 2019. Microphone hardware is bought alongside the software, not inside it. |
| Indian Health Service, brand-name Nuance Dragon Medical One license and IT equipment | $12,250 | Three months from September 2025. One of the most recent awards in the set and still structured as a small brand-name purchase. |
| VA Hines VAMC, Nuance Dragon Medical One dictation software | $5,261 | January 2024. The smallest priced Dragon Medical One line in the record, useful mainly as a floor. |
Compiled September 1, 2026 from USAspending.gov, the US government public record of federal contract awards. A keyword search for DRAGON MEDICAL, filtered to prime award actions of type A, B, C and D with award periods from October 1, 2016 through September 1, 2026, returns 25 awards totaling $41,022,603. These are public-sector awards bought under federal schedule pricing, usually through resellers, so they are not a quote for a private practice or radiology group. Figures are award values rather than amounts finally outlaid. Verify any individual award yourself at usaspending.gov before you use it in a negotiation.
The shape of the market
What 25 federal Dragon Medical awards tell a buyer
The headline totals are less interesting than the distribution. Read these five numbers before you take a quote.
| Measure | Figure | What it means for your quote |
|---|---|---|
| Total award value across 25 contracts | $41,022,603 | The entire visible federal Dragon Medical market over ten years, which is small enough that no single quote should be treated as a benchmark. |
| Share that went through Carahsoft, a reseller | 91.7% | You are almost certainly buying from a distributor with margin in the number, so a second reseller quote is a fair and normal ask. |
| Share that went directly to Nuance Communications | 6.2% | The party quoting you usually does not own the roadmap. Get product commitments in writing from Microsoft, not from the channel. |
| Median value of the 22 priced awards | $16,306 | The typical Dragon Medical purchase is a departmental one, not an enterprise one, and it is priced accordingly. |
| Priced awards under $50,000 | 18 of 22 | There is almost nothing in the middle of this market. You are either a small site buy or an enterprise agreement. |
| Share of all dollars in the two largest VA awards | 91.4% | Enterprise-wide deals dominate the spend. If you are being quoted enterprise terms for a department, that is a mismatch worth naming. |
All figures computed September 1, 2026 from the same USAspending.gov pull described above: 25 prime awards naming DRAGON MEDICAL, award periods October 1, 2016 through September 1, 2026. Three awards carry a recorded value of zero and are excluded from the median.
Side by side
Radiological.ai vs Dragon Medical One, honestly
A fair look at what each does well. Both are capable tools. Here is where they differ.
| What matters | Radiological.ai | Dragon Medical One |
|---|---|---|
| Published price | Yes. Our plans are on the pricing page at $299 per reading radiologist per month and you can read them without a sales call. | No. Microsoft publishes no list price for Dragon Medical One or Dragon Copilot. Every figure online is a third-party estimate or somebody else deal. |
| What the product is for | Radiology reading. It flags suspected findings, prioritizes the worklist and drafts the structured report into your template. | Clinical documentation across medicine. It is a speech and ambient documentation layer, and it is genuinely excellent at that job. |
| Radiology status | Radiology is the only thing we build for. | Microsoft states the Dragon Copilot radiology experience, paired with PowerScribe One, is currently in preview in the United States. Physicians and nurses are generally available. |
| How you buy it | Direct. | Overwhelmingly through a reseller. In the federal record 91.7 percent of Dragon Medical award value went through Carahsoft and 6.2 percent went to Nuance directly. |
| Unit of pricing | Per reading radiologist per month, so a heavy volume month does not change the invoice. | Scoped per organization against clinician count, term and bundle. The federal record shows two normal sizes, roughly $16,000 and roughly $24 million, and very little between them. |
| What you are replacing | Nothing. It sits alongside whatever you report in today and connects to your existing PACS over standard DICOM. | The dictation layer clinicians already use daily, which makes it a change-management project as much as a software purchase. |
| Product stability | Early stage. We say so plainly on our about page and we are pre-launch. | Very stable as a dictation engine, in active transition as a product line. Microsoft is migrating the Dragon Medical One base onto Dragon Copilot and preserving commands, vocabularies, profiles, templates and AutoTexts. |
| Regulatory status | Decision support. We make no regulatory-status claims on this site. | Documentation tooling rather than a diagnostic device, with a very deep deployed base across US healthcare. |
Comparison reflects general, publicly understood positioning. Capabilities change, so check each product for the latest.
Dragon and PowerScribe are sold by the same company under names that overlap confusingly, and most groups pricing one are really pricing both. The PowerScribe vs Dragon Copilot breakdown sorts out which product does what, and PowerScribe pricing runs the same federal-record method over the radiology reporting product with 183 awards behind it. If you are not sure which Microsoft product your group actually runs, start at the Nuance PowerScribe alternatives page.
If the reason you are pricing anything is the retirement clock rather than dissatisfaction, read the PowerScribe 360 end of life dates first: annual renewals and maintenance ended on August 31, 2026 and full support ends August 31, 2027. The migration checklist covers the template and interface work that the federal awards above show being contracted separately, and what happens to PowerScribe templates and AutoText matters because Microsoft explicitly promises AutoText preservation on the Dragon Copilot path.
For the wider budget question, radiology software pricing puts federal award medians next to each other by software category, how much radiology AI costs works through the first-year total rather than the license line, and radiology software contract negotiation covers the terms that decide what you pay in year three. If you are building a shortlist rather than a budget, the best radiology reporting software roundup and radiology dictation software are the two places to start, and our own pricing is published in full.
Why groups pick Radiological.ai
One assistant across the whole read
Price the reseller, not just the software
Nine dollars in ten of federal Dragon Medical spend went through Carahsoft rather than to Nuance. That is not a scandal, it is how enterprise software is sold, but it has two consequences you can act on. First, the number in front of you has channel margin in it, so asking a second authorized reseller to quote the identical bill of materials is a normal and effective move. Second, the person quoting you does not set the roadmap. If a radiology capability is part of why you are buying, get that commitment from Microsoft in writing rather than from a slide the reseller made.
Find out whether radiology is generally available before you sign for it
Microsoft is clear on its own site that the Dragon Copilot radiology experience with PowerScribe One is currently in preview in the United States, while the physician and nurse experiences are generally available. Preview is a real and useful stage, and there are good reasons to be an early site. But a preview capability should be priced as a preview capability, with an exit if it does not reach general availability inside your term. Ask for the general availability date, ask what happens to your rate if it slips, and get the answer in the contract rather than the email thread.
Buy dictation and buy the read separately
Dragon Medical One is a speech and documentation layer for clinical medicine and it is very good at that. It does not look at the images. Radiological.ai is the other half of the problem: it connects to your existing PACS over standard DICOM, flags suspected findings, prioritizes the worklist and drafts the structured report into your own template, and the radiologist reviews, edits and signs every study. Bundling the two decisions into one renewal is how groups end up paying enterprise terms for a capability that is still in preview. Separating them costs nothing and keeps both negotiations honest.
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Dragon Medical One vs Radiological.ai, answered
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See how Radiological.ai reads alongside your group
One assistant that flags suspected findings, prioritizes the worklist, and drafts the structured report on X-ray, CT and MRI. You review and sign every study.
Decision support for qualified clinicians. Radiological.ai does not provide a diagnosis and is not a substitute for professional medical judgment.