The honest answer: it depends, but not as much as agencies want you to think. Here's what a chiropractic, SoftWave, or med spa marketing budget really looks like in 2026, and where the games get played.
The two costs you're actually paying
Every paid marketing setup has two separate line items. Mixing them up is how owners get confused (and overcharged).
- Management fee. What you pay the agency (or yourself) to run the campaigns.
- Ad spend. What you pay the platforms (Meta, Google) to show your ads. This goes to Facebook, not the agency.
Keep those separate in your head. An agency that blends them into one number is usually hiding a markup on your ad spend.
What management fees run
For a specialist agency, management fees typically land somewhere between a few hundred and a couple thousand dollars a month. Generalists sometimes charge less, but they don't understand cash device economics, so you often pay less to get less.
We quote after we look at your market and offer. No setup fee. Billing doesn't start until your ads actually go live.
What to budget for ad spend
Plan for enough spend that the platforms can learn. Below a real monthly test budget, you're basically paying for an experiment you never finish.
Spend is yours. You pay it directly to the platforms, you control it, and you keep the account.
The costs that should make you flinch
- Big upfront setup fees. Charging thousands before a single ad runs shifts all the risk to you.
- Markups on ad spend. If they won't show you the raw platform numbers, assume there's a cut.
- Long lock-ins. A fair agreement gives enough time to optimize without trapping you for a year.
So what's the real number?
It depends on your market, your offer, and how aggressive you want to grow. The right number is the one that can actually produce booked, paying patients rather than a pile of dead leads.
Want the honest version for your market? Book a call and we'll give you a straight estimate. Or start with how we work with chiropractors.