What Should a 15-Person Orthodontic Practice Actually Pay for Software?

Orthodontics has a software cost problem most small-business guides never touch: two of the four pillars hinge on a head-to-head platform decision, not a shopping list. Ortho2 Edge and Cloud9 Ortho compete directly for scheduling and treatment records, and Sunbit and Cherry compete directly for turning a $5,000-8,000 treatment plan into a monthly payment a family will actually sign for at checkout. Get those two decisions right — pick one of each, never both — and the rest of the stack is comparatively cheap.

Here's what we actually see, tool by tool and pillar by pillar, when we run the numbers for an orthodontic practice around 15 employees — roughly one or two doctors, treatment coordinators, clinical assistants, and front desk.

Sales & Marketing: $50-1,665/mo

PatientPop ($400/mo) and RevenueWell ($350/mo) compete for the same job — a practice website, SEO, and automated review/recall generation — so running both is close to pure overlap; the $50/mo sticker gap between them is real but small next to the mistake of paying for one on top of the other. Weave ($400/mo) is not a marketing-platform substitute — it's front-desk phone and two-way texting, and it earns its keep by replacing a legacy office phone system and the manual reminder-calling that eats a receptionist's morning. Meta Ads ($800/mo) is the pillar's biggest and most variable line item: it's ad spend, not software, and a practice can turn it up or down chasing new-patient volume for pre-teen orthodontics and adult Invisalign candidates — which is exactly why it swings this pillar's range more than any tool choice does. Mailchimp ($65/mo) and EZ Texting ($50/mo) round out the pillar as the cheap layer for nurture campaigns; cutting them saves the least money and costs the most in missed treatment-milestone follow-up.

Core Operations: $300-750/mo — the practice-management decision that sets everything else

This is the pillar that decides how much of the rest of your stack talks to itself. Ortho2 Edge and Cloud9 Ortho compete directly for the job of scheduling, treatment charting, and contracts — pick one, never run both — and Dolphin Imaging sits alongside whichever you choose, not instead of it, handling cephalometric analysis and case-presentation imaging.

The $50/mo sticker gap between Ortho2 Edge ($450) and Cloud9 Ortho ($400) is the smallest part of this decision. What actually differs is the ecosystem each one pulls in: Ortho2 Edge lists native connections to Sunbit, DocuSign, and Stripe on top of the shared Weave and Dolphin Imaging links, while Cloud9 Ortho's native list is narrower — RevenueWell, Cherry, and the same shared tools. Pick Ortho2 Edge and you're implicitly also picking Sunbit and PatientPop as your path of least resistance; pick Cloud9 Ortho and that's RevenueWell and Cherry instead. Mixing and matching across the two ecosystems is where a lot of unplanned manual data entry comes from.

Dolphin Imaging & Management ($300/mo) is the one tool in this pillar that isn't a decision — it connects to both platforms equally. Skipping it for a practice actively doing case presentations and cephalometric tracing usually means falling back to loose photos on office computers, which is both a workflow gap and a records-continuity problem if a patient transfers care mid-treatment.

Finance: $0-440/mo — where patient financing earns its keep

QuickBooks Online Plus ($90/mo) is the general ledger your bookkeeper reconciles practice-management billing exports against. Gusto Plus ($200/mo) runs payroll for a mix of hourly clinical assistants and salaried treatment coordinators, and misclassifying that mix is a common, expensive mistake once a practice crosses a couple of locations. Stripe is functionally free here — card/ACH processing priced per-transaction rather than as a monthly fee — so it's rarely the thing worth auditing.

Sunbit ($150/mo) and Cherry ($100/mo) are the pillar's real decision: point-of-care financing that turns a $5,000-8,000 treatment plan into a monthly payment a family can approve in seconds at checkout, instead of a conversation that ends with "let us think about it." They compete directly for the same job, and — per the practice-management integration data above — each pairs natively with a different practice-management platform. Running both because a treatment coordinator has a preference, without checking which one your PM system actually syncs to, is a common way this pillar gets more expensive than it needs to be.

Admin & Security: $80-430/mo

Google Workspace ($170/mo) covers email and shared calendars for front desk and clinical staff. 1Password Business ($95/mo) stops staff from reusing the same password across insurance portals, imaging software, and financing-platform logins — a real finding in practices that have never run a password audit. Huntress Managed EDR ($85/mo) puts 24/7 human-monitored threat detection on the PCs and imaging workstations that handle protected health information, not just antivirus. DocuSign ($80/mo) handles e-signature for treatment consent, financing agreements, and HIPAA disclosures — and, notably, only lists a native connection to Ortho2 Edge, not Cloud9 Ortho, which affects how much of this pillar is automated versus manual depending on your PM choice.

What this adds up to

Add it up and a genuinely optimized stack for a 15-person orthodontic practice usually lands somewhere in the $3,348-5,441/mo range — but we regularly see practices paying $5,460-8,970/mo for the same functional coverage. The gap almost never comes from a practice needing more capability; it comes from a short list of repeatable mistakes.

The fastest way to see where your specific stack lands against these numbers is to run the free audit — it uses your actual headcount and current spend, not a generic estimate.