Infrastructure Decision: Cloud Provider Comparison

Amazon Web Services

$215

per month (all envs)

Baseline / Current Provider

Baseline

Best Value

Hetzner Cloud

$56

per month (all envs)

EU (Falkenstein) or US (Ashburn, VA)

Save 74% / $1,900/yr

Best US Managed

DigitalOcean

$130

per month (all envs)

US (NYC, SFO) — Managed DB + Redis

Save 40% / $1,020/yr

Vultr

$100

per month (all envs)

US (16 locations) — Self-managed

Save 53% / $1,380/yr

Production Cost Breakdown

Line-by-line comparison for equivalent production infrastructure (2 vCPU, 4 GB RAM)

Component	AWS	Hetzner	DigitalOcean	Vultr
Compute 2 vCPU, 4 GB RAM app server	$30/mo EC2 t3.medium	$8/mo CPX22 (80 GB NVMe)	$24/mo Droplet Premium (NVMe)	$24/mo Cloud Compute (NVMe)
Database (MySQL) Primary data store	$15/mo RDS db.t3.micro (managed)	$4/mo CX22 self-managed	$15/mo Managed MySQL (1 GB)	$4/mo On VPS, self-managed
Redis / Cache Session, queue, cache	$12/mo ElastiCache t3.micro	$0 On DB server	$15/mo Managed Redis (1 GB)	$0 On VPS, self-managed
Object Storage Documents, media, uploads	$3/mo S3 (50 GB + egress)	$5/mo 1 TB incl. (S3 API)	$5/mo Spaces 250 GB (S3 API)	$5/mo Object Storage (S3 API)
Load Balancer SSL termination, routing	$16/mo ALB	$10/mo LB11 (L4/L7)	$12/mo LB (L4/L7)	$10/mo LB (L4)
Bandwidth Data transfer out	$9/mo ~100 GB egress	$0 20 TB included	$0 4-6 TB included	$0 3-4 TB included
Backups + DNS + SSL Snapshots, domain, TLS certs	$6/mo EBS + Route53 + ACM	$2/mo 20% server cost + free DNS	$2/mo 20% server cost + free DNS	$2/mo Auto backups + free DNS
Production Total	~$91/mo	~$29/mo	~$73/mo	~$45/mo

Full Environment Stack

Total cost across dev + staging + production environments

AWS

Current provider

$215/mo

$2,580/yr

Production$91
Staging$60
Dev / CI$59
Shared storage$5

Hetzner Cloud

Best value — EU or US (Ashburn)

$56/mo

$672/yr — saves $1,908

Production$29
Staging$13
Dev / CI$9
Shared storage$5

DigitalOcean

Best managed services (US)

$130/mo

$1,560/yr — saves $1,020

Production$73
Staging$28
Dev / CI$24
Shared storage$5

Vultr

Best US coverage (16 locations)

$100/mo

$1,200/yr — saves $1,380

Production$45
Staging$26
Dev / CI$24
Shared storage$5

Feature Comparison

Capabilities that matter for this project's healthcare/diagnostics workload

AWS

✓Managed MySQL (RDS)Auto backup, failover, patching
✓Managed RedisElastiCache, zero-maintenance
✓Native S3Industry standard
✓Auto-scalingASG for traffic spikes
✓CloudWatchBuilt-in monitoring
✓20+ regionsGlobal coverage
⚠Complex pricingHidden egress/IOPS costs
⚠Paid support$29-$100+/mo plans

Hetzner

⚠Self-managed MySQLBackup scripts needed
⚠Self-managed RedisConfig + monitoring yourself
✓S3-compatibleLaravel temporaryUrl() works
✗No auto-scalingManual only (fine at this scale)
⚠Basic metricsAdd Netdata for full monitoring
⚠5 locationsEU focus + 1 US (Ashburn)
✓Simple pricing20 TB bandwidth included
✓EU data residencyGDPR built-in (German company)

DigitalOcean

✓Managed MySQLAuto backups, standby nodes
✓Managed RedisEviction policies, metrics
✓Spaces (S3 API)Full S3 compatibility, CDN
✗No auto-scalingManual resize only
✓Built-in monitoringMetrics + alerting included
✓14 regionsNYC, SFO, + global
✓Simple pricingPredictable, clear billing
✓App PlatformOptional PaaS deployment

Vultr

⚠Self-managed MySQLOr managed DB at $15/mo extra
⚠Self-managed RedisInstall + config yourself
✓Object StorageS3-compatible API
✗No auto-scalingManual only
⚠Basic metricsDashboard graphs only
✓32 locations16 in US alone — best coverage
✓Simple pricing3-4 TB bandwidth included
✓Bare metal optionDedicated servers if needed later

Weighted Scoring Matrix

Scored 1-5 per category, weighted by importance for this project

Criteria (weight)	AWS	Hetzner	DigitalOcean	Vultr
Cost (30%)	1	5	3	4
Managed Services (20%)	5	1	4	2
US Data Centers (15%)	5	2	4	5
S3 Compatibility (15%)	5	4	4	4
Simplicity (10%)	2	4	5	4
Bandwidth Included (5%)	1	5	3	3
Ecosystem / Scaling (5%)	5	2	3	3
Weighted Total	3.00	3.40	3.70	3.60

How to read: Scores reflect this project's specific needs (small team, single-server scale, healthcare data). If cost weight increases to 40%+, Hetzner wins outright. If managed services weight increases to 30%+, DigitalOcean or AWS lead.

US Hosting Locations

Datacenter options within the United States for each provider

Detail	AWS	Hetzner	DigitalOcean	Vultr
US Locations	6 regions Virginia, Ohio, Oregon, N. California, GovCloud x2	1 location Ashburn, VA	3 locations New York (x3), San Francisco (x3), Toronto	16 locations NYC, LA, Chicago, Dallas, Atlanta, Miami, Seattle, SJC, + 8 more
Nearest to East Coast	us-east-1 (Virginia)	Ashburn, VA	NYC1/2/3	New Jersey / Atlanta / Miami
Nearest to West Coast	us-west-2 (Oregon)	N/A (Ashburn only)	SFO1/2/3	Los Angeles / Silicon Valley / Seattle
S3 Storage in US	Yes — all US regions	EU only (fsn1, nbg1) Pair with Cloudflare R2 for US storage	Yes — NYC, SFO	Yes — US regions
Private Networking	VPC (per-region)	Free (Ashburn zone)	VPC (per-region, free)	VPC 2.0 (per-region, free)
HIPAA Eligibility	Yes — BAA available	No BAA offered	No BAA offered	No BAA offered

HIPAA note: If diagnostic.ly handles Protected Health Information (PHI) subject to HIPAA, only AWS offers a Business Associate Agreement (BAA). For the other providers, you would need to ensure PHI is encrypted at rest and in transit, and handle compliance at the application layer. Consult legal counsel for HIPAA requirements.

Proposed Architecture

This architecture works on any provider — shown for Hetzner/Vultr/DO with private networking

App servers (public)

Database (private only)

Object Storage (S3 API)

Private network

DigitalOcean alternative: Replace the self-managed prod-db server with Managed MySQL ($15/mo) + Managed Redis ($15/mo). This eliminates the need for backup scripts and DB maintenance at the cost of ~$26/mo extra.

Code & Configuration Impact

What changes in the application codebase — same for all providers

✓ No Application Code Changes

✓S3 storageUses AWS_ENDPOINT env var — works with any S3 API
✓Pre-signed URLstemporaryUrl() works on all S3-compatible stores
✓DatabaseDB_HOST env var — point to any MySQL server
✓RedisREDIS_HOST env var — same driver everywhere
✓Queues & EmailRedis queue + SendGrid SMTP — provider-independent

⚠ Minor Updates Needed

⚠JenkinsfileUpdate SSH target IP, remove AWS Secrets Manager
⚠.env filesSet S3 endpoint + credentials for chosen provider
⚠CI pipelineAdd staging deploy stage before production
⚠Backup scriptsOnly if self-managing MySQL (not needed for DO managed)

Recommendations

Two paths depending on whether you prioritize cost or convenience

Option A — Best Overall Value

Hetzner Cloud (US — Ashburn, VA)

74% cost reduction with the same architecture. Self-manage MySQL and Redis in exchange for massive savings. Ashburn datacenter provides low latency to US East Coast users. Object storage stays in EU (fine for file storage latency) or pair with Cloudflare R2 for US-based S3 with zero egress fees.

Best for: teams comfortable with Linux server management who want maximum savings.

$56

Monthly (all envs)

$1,900

Annual Savings

Code Changes

1-2d

Migration

Option B — Best US with Managed Services

DigitalOcean (NYC or SFO)

40% cost reduction while keeping managed MySQL and Redis — no backup scripts, no DB tuning, automatic failover. Multiple US locations with great connectivity. Spaces (S3-compatible) storage in US with built-in CDN. Excellent developer experience and documentation.

Best for: teams who prefer managed databases and want to minimize ops work.

$130

Monthly (all envs)

$1,020

Annual Savings

Code Changes

0.5-1d

Migration

If HIPAA compliance is required: AWS is the only provider here offering a BAA. Consider keeping AWS but right-sizing instances, or use a HIPAA-compliant hosting provider like Atlantic.Net or Liquid Web. Alternatively, encrypt all PHI at the application layer and use any provider with proper security controls.