To determine the number of visits per month \( x \) where both plans would cost the same, we can set up the equations for each plan.
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First Plan: Cost is $20 per visit.
- Total cost for \( x \) visits: \( 20x \)
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Second Plan: Cost is $45 per month plus $5 per visit.
- Total cost for \( x \) visits: \( 45 + 5x \)
Now, we can set these two total costs equal to each other:
\[ 20x = 45 + 5x \]
Therefore, the correct equation that shows the number of visits per month that it would take for the two plans to be equal is:
\[ \boxed{20x = 45 + 5x} \]