Compare · Visage PACS

Visage PACS by Visage Imaging, What Visage 7 Costs and the Alternatives

The short answer

Visage PACS is Visage 7, the enterprise imaging platform from Visage Imaging, a subsidiary of the Australian company Pro Medicus. It is priced per transaction, not per seat, and sold on long contracts. Across 36 US contracts Pro Medicus disclosed from 2023 to 2026, the median is A$23.5 million over seven years.

Search for Visage PACS and the first page is Visage talking about Visage: its own site, training videos, a cloud case study and investor news. Search for Visage PACS alternatives and you get software directories. Nobody has put the numbers a buyer needs next to each other, even though Pro Medicus publishes more contract data than any other PACS vendor, because it is listed on the Australian stock exchange and has to announce material deals.

This page is for two kinds of reader. The first is a health system or large radiology group with a Visage 7 proposal on the table, trying to judge whether the price per transaction is fair and what else belongs on the shortlist. The second already runs Visage and likes the viewer, but wants AI help in the read without another migration. We sell to the second reader, and we say so plainly below.

The Reading Station

Assistant ready

Worklist

Not for diagnostic use

Structured report

Draft

Run the assistant to draft this report for review.

You review & sign

Decision support. The radiologist reviews and signs every study.

Drafted in · you review & sign Worklist re-prioritized

Decision support for qualified clinicians. Radiological.ai does not provide a diagnosis and is not a substitute for professional judgment.

See the comparison

Flag · prioritize · draft · you review and sign

Visage sells the imaging platform itself: the Visage 7 diagnostic viewer, the Workflow worklist, the Open Archive and a cardiology module, now installed only in the cloud. Radiological.ai sells none of that. It is an assistant that sits alongside the PACS you already run, flags suspected findings as studies arrive, reorders the worklist and drafts the structured report for the radiologist to sign. You would replace Visage with another PACS. You would add us to Visage.

Side by side

Visage 7 against the other enterprise PACS on a US shortlist

The vendors a US health system is most often quoted alongside Visage. Every row is a published fact or a public record, not a benchmark we ran.

What to compare	Visage 7	Other enterprise PACS (Sectra, Fujifilm Synapse, Merge)
Who owns it	Pro Medicus Ltd (ASX: PME), which bought Visage Imaging in January 2009. Offices in Melbourne, Berlin and San Diego.	Sectra AB (Sweden), Fujifilm (Japan) and Merge, now a Merative business owned by Francisco Partners.
How it is priced	Per transaction, meaning per study, on multi-year contracts. Renewals in fiscal 2026 all came with higher fees per transaction.	Mix of subscription on exam volume, license plus maintenance, and hosted options, depending on vendor.
Price published	No rate card, but contract values are disclosed deal by deal to the stock exchange. That is the most public pricing of any enterprise PACS.	No. Sectra has disclosed one unnamed US contract. The others disclose almost nothing.
Deployment	New installs are cloud only, on AWS, Microsoft Azure or Google Cloud.	On premises, hosted or cloud, depending on vendor and contract.
Where it wins	Viewer speed. Visage 7 was Best in KLAS 2023 for universal viewer at 90.2, and KLAS reports radiologists prefer it for speed.	Sectra leads US PACS satisfaction, 13 years of Best in KLAS. Fujifilm gains where PACS and cardiology share one platform.
Where buyers push back	Cost. KLAS calls it the primary barrier to buying Visage, and user comments cite many fees.	Usually migration effort, support consistency and how well the viewer performs on large studies.
US federal prime awards	12 awards, $126,789, none since 2011, mostly for Amira research software. The VA runs Visage PACS in VISN 23 through other channels.	Merge 136 awards, $10.9M, mostly cardiology. Fujifilm Synapse 202 awards, $78.2M. Sectra none.
Switching cost	High, like any PACS: priors migration, integrations, hanging protocols and retraining.	The same. Budget migration as its own line with its own timeline.

Visage facts come from Pro Medicus full-year results for fiscal 2023 to 2026, ASX announcements and Visage product pages, collected September 28, 2026. FDA data is from the openFDA 510(k) database. Federal award data is from USAspending.gov, award types A to D, fiscal 2008 to 2026. The KLAS findings are from the KLAS blog post of August 27, 2025.

What the public record shows

Visage 7 contract values a buyer can check

Pro Medicus reports contract values in Australian dollars. The rows below are a sample of the 36 US contracts it disclosed from fiscal 2023 to 2026, including renewals and module add-ons.

Customer	Disclosed value and term	What it tells a buyer
Trinity Health	A$330M, 10 years, cloud (Nov 2024)	The largest disclosed Visage deal. A 10-year term is common at the top end, so the exit terms matter as much as the price.
UCHealth	A$170M, 10 years (Jul 2025)	Includes cardiology. Bundling cardiology moves the total a long way, so price it as a separate line.
Beth Israel Lahey Health	A$90M, 7 years, cloud (May 2026)	A large academic system on the cloud model. About A$12.9M a year.
Northwestern (renewal)	A$37M, 5 years (FY2026)	An existing customer renewing. Pro Medicus says every fiscal 2026 renewal came at a higher fee per transaction.
Valley Health, Virginia	A$25M, 7 years, cloud (Aug 2026)	Full stack plus cardiology for a regional system. Close to the median of all 36 deals.
St. Luke's, Boise	A$23M, 7 years, cloud (Aug 2026)	Another regional system at the median, about A$3.3M a year.
Lurie Children's	A$5M, 7 years (FY2025)	The smallest disclosed deal. Visage sells into specialty hospitals too, not only the largest systems.
All 36 US contracts	A$1.51B total, A$23.5M median, 7-year median term	Half of the deals fall between A$15.1M and A$36M. The median works out to about A$3.6M a year.

Sources: Pro Medicus full-year results for fiscal 2023, 2024, 2025 and 2026 (reported August 18, 2026), and ASX announcements of November 28, 2024 (Trinity Health), May 18, 2026 (Beth Israel Lahey Health) and August 21, 2026 (Valley Health). Values are A$ as announced. At 2025 to 2026 exchange rates an Australian dollar has been worth roughly two thirds of a US dollar.

Side by side

Radiological.ai vs Visage PACS, honestly

A fair look at what each does well. Both are capable tools. Here is where they differ.

What matters	Radiological.ai	Visage PACS
What you are buying	Software that flags suspected findings on the image, prioritizes the worklist and drafts the structured report.	The PACS: Visage 7 viewer, Workflow worklist, Open Archive and optional cardiology, hosted in the cloud.
Relationship to your PACS	Works alongside it. It reads from the PACS you already run, Visage included.	It is the PACS, or the viewer on top of your archive. Adopting it means replacing what you have.
Unit of cost	Per reading radiologist, published: $399 a month on the Practice plan or $199 a month billed annually, and $598 a month on the Group plan or $299 a month billed annually.	Per transaction on a multi-year contract. Disclosed US deals run from A$5M to A$330M.
Project size	Days to weeks. No image migration.	Months. Priors migration, interfaces, hanging protocols and training.
Who signs the report	The radiologist. The assistant never signs anything.	The radiologist, in whichever reporting system you run.
Best suited for	Groups happy with their PACS, Visage or otherwise, who want more studies per radiologist hour.	Health systems replacing a PACS that is slow on large studies and willing to pay a premium for viewer speed.

Comparison reflects general, publicly understood positioning. Capabilities change, so check each product for the latest.

This page covers one enterprise PACS. For the category, PACS software separates the deployment models, and PACS pricing and cloud PACS cost benchmarks quotes against federal PACS awards and lists the line items every quote bundles.

If the other names on your shortlist are Sectra or Fujifilm, the Sectra PACS system and Sectra One cost and Fujifilm Synapse PACS alternatives work through those quotes the same way. If you run Merge today, Merge PACS alternatives covers the ownership history and the 2026 recalls.

If the PACS is fine and the real ask is AI, how the assistant integrates with your PACS explains what connects to what, and our pricing is published per radiologist.

Why groups pick Radiological.ai

One assistant across the whole read

Model the transaction price on your growth

Per-transaction pricing looks cheap at today's volume and grows with every study you add. Ask for the price per study, the annual minimum, the escalator, and what happens to the rate if volume grows 30 percent over the term. Renewals in fiscal 2026 all came with higher fees per transaction.

Benchmark against the disclosed deals

Visage is the one enterprise PACS where you can check a quote against real contracts. Divide the total by the term and compare it with systems of your size: the median disclosed US deal is about A$3.6M a year, and regional systems cluster near A$3M to A$4M.

Separate the PACS decision from the AI decision

Many PACS replacements start because radiologists want AI help. If the viewer is not the problem, adding an assistant that reads from your existing PACS gets you there in weeks instead of a multi-year migration. If the viewer is the problem, fix the PACS first.

Decision support, a radiologist always signs

Every flag is a prompt to look again and every report is a draft. The responsible radiologist reviews, edits and signs each study. We publish no accuracy figures and make no diagnostic claims.

Good questions

Visage PACS vs Radiological.ai, answered

Visage PACS is Visage 7, the enterprise imaging platform from Visage Imaging, a subsidiary of Pro Medicus. It combines a server-side rendered diagnostic viewer, the Workflow worklist, the Open Archive and a cardiology module. New installations run in the cloud on AWS, Microsoft Azure or Google Cloud.

Pro Medicus Ltd, an Australian company listed on the ASX as PME, bought Visage Imaging in January 2009. Visage has offices in San Diego, Berlin and Melbourne. Pro Medicus reported fiscal 2026 revenue of A$261.7 million, up 22.9 percent, and says it holds about 11 percent of the US market.

Visage does not publish a rate card. It charges per transaction on multi-year contracts, and Pro Medicus discloses contract values to the stock exchange. Across 36 US contracts disclosed from 2023 to 2026, the median is A$23.5 million over a seven-year median term, about A$3.6 million a year.

Yes. Visage says new installations are cloud only, on AWS, Microsoft Azure or Google Cloud Platform, and several recent deals, including Trinity Health, Beth Israel Lahey Health and St. Luke's in Boise, were announced as cloud contracts. Older customers may still run it on premises.

Visage holds 510(k) clearances including K082269 for Visage PACS 6.0 in 2008, K142196 for Visage Ease Pro in 2015 and K201411 for Visage Breast Density in 2021. There is no separate listing under the name Visage 7, so ask the vendor which clearance covers the version you are buying.

The enterprise PACS most often quoted against Visage in the US are Sectra, Fujifilm Synapse, Merge and Intelerad, with GE and Philips losing ground according to KLAS. A different kind of alternative is to keep your PACS and add an AI assistant that reads from it, which avoids a migration.

Yes. Visage offers its own AI Accelerator, and independent assistants read studies from the PACS over standard DICOM and send results back to the worklist. The radiologist keeps reading in Visage 7, and the assistant adds flags, priority and a draft report that the radiologist signs.

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See every radiology use case

From the blog: what the PowerScribe 360 end of life means for radiology groups, how much radiology AI costs, and the full comparison of the best AI radiology software in 2026.

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.

See pricing

Decision support for qualified clinicians. Radiological.ai does not provide a diagnosis and is not a substitute for professional medical judgment.