“How much does an onsite clinic cost?” is the first question almost every HR leader and CFO asks — and the honest answer is that the sticker price is the least useful number in the conversation. The number that decides whether an onsite clinic is worth it isn’t what the clinic costs; it’s what the clinic costs after you subtract the claims it keeps off your health plan.
This guide does both. We’ll give you real 2026 cost ranges by model, explain exactly what’s inside the per-employee number, and then walk the math that matters — net cost after redirected care — for a self-funded employer with 100 to 1,000 employees, which is where the pricing model has changed the most.
The short answer
For a self-funded employer, onsite and shared clinic pricing in 2026 generally lands in these ranges:
| Model | Typical all-in cost | Best fit |
|---|---|---|
| Dedicated full-time clinic | ~$450–$650 per employee per year (PEPY) | One worksite with 800+ on-site employees |
| Shared / part-time clinic | ~$150–$350 PEPY | 100–1,000 employees, or a few days a week of demand |
| Near-site (shared across employers) | ~$100–$250 PEPY | Smaller headcounts or dispersed worksites |
Those are gross numbers. The net number — after the clinic redirects spending that would otherwise hit your medical and pharmacy claims — is frequently negative, meaning the program pays for itself and then some. We’ll get to that math below, but the headline is: the right way to price an onsite clinic is on your own claims data, calculated, not estimated.
What you’re actually paying for
The per-employee figure bundles a handful of real costs:
- Clinical staffing — the provider (typically a family or internal-medicine NP/PA, sometimes an MD) plus a medical assistant. This is the largest line.
- Operations and technology — scheduling, an EHR, secure messaging, eligibility management, and reporting.
- Space and equipment — either employer-provided space (lowers your PEPY) or vendor-provided/near-site space (raises it).
- Program management — onboarding, member engagement, compliance, and the quarterly reporting that proves the program works.
Two things are usually not marked up: labs and dispensed medications. More on that next, because it’s where a lot of “savings” claims quietly fall apart.
Labs, imaging, and pharmacy: pass-through, not markup
A credible onsite program passes labs, imaging, and on-site medications through at the negotiated rate it actually pays — not a marked-up retail price. That matters for two reasons:
- It’s where a large share of the savings comes from. A basic metabolic panel that a hospital outpatient lab bills your plan $80–$140 for costs a few dollars at a negotiated reference-lab rate. Dispensing common generics on-site at acquisition cost avoids both the retail markup and the pharmacy-benefit spread.
- It’s a fast test of vendor honesty. Ask any prospective partner whether labs and meds are billed at cost or at a markup. If the answer is fuzzy, the savings number they’re showing you is too.
This is the same principle behind cost redirection — the program’s value is in moving real spend from expensive sites of care to negotiated ones, then showing you the receipts.
The number that matters: net cost after redirected care
Gross PEPY is what you pay the clinic. Net cost is gross PEPY minus the claims the clinic prevents from hitting your plan. The big redirection buckets:
- Primary care visits that would otherwise be a $145 commercial office visit, an urgent-care visit, or — far too often — an ER visit.
- Labs and imaging billed at negotiated rather than hospital-outpatient rates.
- Common medications dispensed at cost instead of through retail pharmacy.
- Avoided downstream cost — the hardest to price but the most valuable: catching the pre-diabetic A1c, the rising blood pressure, the diagnosis that would otherwise come too late.
A simplified, illustrative model for a 400-employee self-funded group on a shared clinic:
| Line | Annual |
|---|---|
| Gross clinic cost (400 EE × ~$250 PEPY) | $100,000 |
| Redirected primary-care + urgent-care/ER visits | −$70,000 |
| Labs + imaging at negotiated rates | −$25,000 |
| On-site medications at cost | −$18,000 |
| Net first-year cost | ≈ −$13,000 (net savings) |
That table is a model, not a quote — your actual numbers depend on your claims. But it illustrates the point: even before the compounding value of earlier diagnosis and chronic-condition management, a well-run shared clinic can land at or below break-even in year one. (For the longer arc, see the year-one onsite clinic playbook.)
”Does the math work under 1,000 employees?”
For two decades, the answer from the legacy onsite industry was effectively no — dedicated full-time clinics only pencil out around 800–1,000 on-site employees, so anyone smaller was told they were too small for onsite care. That was a limitation of the staffing model, not of onsite care itself.
The shared, part-time model breaks that floor. Instead of paying for a full-time provider you can’t fill, you pay for the days of clinical capacity your population actually uses — two days a week, a half-time provider, or a clinic shared across nearby employers. The fixed cost shrinks to match the headcount, so the per-employee math works at 150 or 300 employees the same way a dedicated clinic works at 1,000.
This is the single biggest reason onsite pricing has changed for the 100–1,000 EE market: the question is no longer “are we big enough?” but “how many days of capacity do we need?”
How onsite clinics are priced
You’ll see three pricing structures in proposals:
- Per employee per month (PEPM/PEPY) — a flat management fee for a defined level of service. Predictable; easiest to budget.
- Cost-plus — you pay the actual cost of staffing and operations plus a transparent management fee. Most aligned with the “no hidden markup” principle, and the easiest to audit.
- Per-visit or hybrid — useful for very small or highly variable populations, where you pay closer to actual utilization.
There’s no universally “right” structure, but cost-plus and PEPM are the most transparent. Be wary of any model where the vendor’s margin grows when your members use more expensive services — incentives should point the same direction as your savings.
What moves the price up or down
- Hours of operation — full-time vs. a few days a week is the biggest lever.
- Scope of services — primary + urgent care + labs + dispensing costs more than reminders-and-referrals, and saves far more.
- Space — employer-provided space lowers PEPY; vendor-built space raises it.
- Number of worksites — one clinic serving a campus is cheaper per head than several small sites. (When sites are dispersed, a near-site or shared model usually wins.)
- Telehealth and messaging — secure messaging and virtual visits extend a part-time provider’s reach without adding clinic days, improving the per-employee economics.
Questions to ask before you sign
- Are labs and dispensed medications billed at cost or at a markup?
- Is the savings figure calculated on our claims or estimated from a book of business?
- What’s the pricing structure — PEPM, cost-plus, or per-visit — and what exactly is included?
- What happens to the price if utilization is higher or lower than projected?
- What does the quarterly report actually show, and can we see a sample?
Our onsite clinic RFP template turns these into a scorecard you can send to every vendor.
Frequently asked questions
Is an onsite clinic worth it for a small or mid-sized employer? Increasingly, yes. With a shared, part-time model, employers as small as ~100–150 employees can reach break-even or net savings in year one, because the fixed staffing cost scales down to match the population. The legacy “you need 1,000 employees” rule applied to full-time dedicated clinics, not to the shared model.
How is an onsite clinic priced? Usually per employee per month (PEPM/PEPY), cost-plus, or per-visit. Cost-plus and PEPM are the most transparent. The all-in figure typically runs ~$150–$350 PEPY for a shared clinic and ~$450–$650 PEPY for a dedicated full-time clinic.
How long until an onsite clinic pays for itself? A well-run program often reaches break-even within the first 12 months on redirected primary care, labs, and pharmacy alone — before counting the compounding value of earlier diagnosis and chronic-condition management. The savings grow in years two and three as engagement rises.
What’s the difference between onsite and near-site? Onsite is at or adjacent to your worksite; near-site is a shared location serving several nearby employers. Near-site lowers the per-employer cost for smaller or dispersed populations. See onsite vs. near-site for how to choose.
Does onsite care only make sense if we’re self-funded? The savings are clearest on a self-funded plan, where redirected claims flow straight back to the employer. If you’re weighing the funding question, start with self-funded vs. fully insured.
The bottom line
The sticker price of an onsite clinic — $150 to $650 per employee per year depending on the model — is real, but it’s the wrong number to anchor on. The number that decides the question is net cost after redirected care, and for a self-funded employer with 100 to 1,000 employees, a shared clinic frequently lands at or below zero in year one and compounds from there.
If you want that number for your population, it should be modeled on your actual claims — calculated, not estimated. That’s the only version of “how much does an onsite clinic cost” worth making a decision on.