Rhapsody costs $5,000–$12,000/month all-in for mid-market (license + maintenance + professional services). Mirth Connect is $0 license + $3,800–$12,500/month for productized managed support. The Mirth path is typically 30–50% cheaper per month and converges to a $1M+ 5-year TCO advantage.
What Rhapsody actually costs per month
Lyniate (the vendor behind Rhapsody after acquiring Orion Health's integration business) does not publish pricing. The numbers below come from invoices and quotes clients have shared with us during competitive evaluation in 2025–2026. Treat them as representative ranges, not authoritative — your actual quote will depend on tier, environment count, and contract terms.
For a representative mid-market deployment (20-channel estate, dev + staging + production environments, standard support tier), monthly Rhapsody cost typically breaks down as:
- Per-server license: $3,500–$7,000/month amortized (annual fee divided by 12). Multi-environment licensing roughly doubles this line.
- Annual maintenance / support fee: $1,000–$2,500/month amortized. Required for access to patches, version upgrades, and vendor escalation paths.
- Optional Lyniate professional services: $1,500–$3,500/month averaged (engagements are typically project-based but most mid-market customers run ~$30K/year of PS spend on net-new work).
- Total Rhapsody monthly cost: typically $5,000–$12,000/month depending on tier and environment scope.
Higher-end Rhapsody quotes we've seen — multi-server, multi-site, with enterprise support attached — exceed $200,000/year ($16,700/month). The cloud-managed Rhapsody offering changes the structure entirely; covered below.
What Mirth Connect costs per month
Mirth Connect itself is open-source under MPL 1.1. License cost is zero. The only recurring cost is for operations — either in-house engineering time or a productized managed-support contract.
Public Mirth Connect support tiers at mirth.support:
- Bronze: $3,800/month — 60 hours of senior engineer time, 4-hour business-hours SLA. Suitable for small clinics, single-site practices, <10 channels.
- Silver: $6,800/month — 120 hours, 15-minute critical SLA, 24/7 monitoring. Anchor tier for regional health systems with 10–30 channels.
- Gold: $12,500/month — 240 hours, 24/7 on-call, priority routing on all incidents.
- Enterprise: from $28,000/month — 4 FTE-equivalent, custom SLA, IP escrow.
For the same 20-channel mid-market deployment we cost-modeled on Rhapsody, the Silver tier ($6,800/month) is the typical fit. That covers the operational work — channel health, upgrades, incident response — that you'd otherwise pay Lyniate maintenance and in-house engineering time to handle.
Per-month comparison — same scenario, side by side
Representative 20-channel mid-market health system. Numbers are monthly, in USD.
| Line item | Rhapsody | Mirth (Silver) |
|---|---|---|
| License (amortized) | $3,500–$7,000 | $0 (open-source) |
| Maintenance / support fee | $1,000–$2,500 | Included in $6,800 |
| Operations engineering | In-house FTE ($22K+/month loaded) | 120 hrs included in $6,800 |
| Optional professional services | $1,500–$3,500 avg | Sprint engagements as needed |
| Recurring monthly total | $5,000–$12,000 | $6,800 |
The Mirth path lands at the middle of the Rhapsody range — but the Rhapsody number is license-only; you still need engineering capacity on top. Including a loaded in-house engineer (typically required for Rhapsody operations), Rhapsody all-in commonly runs $27,000–$34,000/month for mid-market. Mirth + Silver replaces both.
Why Rhapsody license cost is high
Three structural factors keep Rhapsody pricing in the upper band of the commercial integration-engine market.
- Per-server licensing model. Rhapsody licenses by deployed server instance. A standard health system deploying dev, staging, and production — plus a disaster-recovery instance — pays for four licenses. Cloud customers often pay for additional license counts to support auto-scaling. The math compounds.
- Acquisition consolidation. Lyniate acquired Rhapsody (via Orion Health) and Corepoint in the same window. Pricing across the consolidated portfolio has trended up post-acquisition — a pattern that healthcare IT procurement teams recognize and that drives a meaningful share of migration conversations toward open-source alternatives.
- Annual escalators. Most Rhapsody contracts include a 3.5–5% annual price escalator on both license and maintenance lines. Over a 5-year contract, that compounds to a 20–25% increase in monthly cost by year 5.
What about Lyniate's cloud-managed Rhapsody?
Lyniate offers a cloud-managed Rhapsody variant (sometimes called Rhapsody Cloud, or Rhapsody as a Service depending on the year and the Lyniate marketing cycle). The pricing structure differs:
- No per-server license — replaced by a flat SaaS-style monthly fee.
- Infrastructure, patching, and base monitoring included.
- Typical mid-market quotes we've seen: $8,000–$15,000/month all-in, but with constraints on customization, deployment options, and SLA terms.
- Multi-year minimums standard (typically 3-year initial term).
For some customers the cloud-managed option is cost-competitive with Mirth + Silver managed support. The trade-offs to weigh: ongoing license dependency on a single vendor, less flexibility in deployment topology, and ongoing escalator risk. The Mirth-open-source path eliminates the vendor-pricing-power dimension entirely.
5-year TCO converges to a $1M+ difference
Monthly cost is one number; multi-year cost is what actually shows up in the budget. For the same 20-channel mid-market scenario over 5 years (representative numbers, assuming 3.5% Rhapsody escalator and 3% Mirth support escalator):
- Rhapsody 5-year TCO: roughly $2.16M (license + maintenance + in-house engineer + optional PS + compliance).
- Mirth + Silver 5-year TCO: roughly $795K (migration sprint $34,500 in year 1 + Silver tier + optional in-house liaison).
- Net 5-year savings on Mirth path: roughly $1,365,000.
Full TCO breakdown including the migration sprint cost is on the Rhapsody migration cost page. The headline: even after paying for the productized Rhapsody → Mirth migration sprint ($34,500), the 5-year cost advantage on the Mirth path is well above $1M for most mid-market estates.
When Rhapsody pricing is actually worth it
Three situations where staying on Rhapsody is defensible despite the cost premium:
- Existing deep Rhapsody investment with low remaining contract term. If you're 12 months into a 36-month contract with two years of paid-up maintenance left, migration TCO break-even happens further out. Run the math both ways before decision.
- Specific Rhapsody features with no Mirth equivalent. Rare but real — some Rhapsody installations use proprietary tooling (e.g., specific Web Client workflows or RhapsodyDB query patterns) that would require workflow re-engineering during migration. The migration is still viable but the cost calculation should include workflow re-engineering, not just like-for-like channel translation.
- Stable in-house Rhapsody team with deep expertise.If you have 2–3 senior in-house Rhapsody engineers who don't want to migrate skills, the talent retention cost of a forced migration can outweigh the license savings. Less common in 2026 because the Rhapsody talent pool is shrinking, but still a real consideration.
Outside these scenarios, the cost case for Mirth+managed-support is consistently stronger than Rhapsody for mid-market deployments. The free Mirth Health Check includes a TCO comparison sized to your specific Rhapsody invoice.