Marketing agency pricing is hard to compare because agencies rarely publish it, and two quotes for "SEO and ads" can describe completely different work. One may include weekly articles, landing pages and daily ad management; another, a monthly report and a few keyword changes. This page explains each pricing model healthcare agencies use, what a retainer should include, and gives you a line-by-line worksheet for comparing quotes. Medfy's fixed monthly price is at the end for contrast.
Few people search the term ("marketing agency pricing" gets about 70 searches a month in the US, per Google Ads Keyword Planner data via DataForSEO, US, 12-month average to Sep 2026), but it's usually someone holding two proposals. For the full budget picture, see our guide to practice marketing costs.
The five pricing models agencies use
| Model | How it works | Works well when | Watch for |
|---|---|---|---|
| Monthly retainer | A fixed fee for a defined scope | The scope is written and stable | Vague scopes; work quietly shrinking |
| Percent of ad spend | A share of your ad budget as the management fee | Large accounts with many campaigns | Fees rising with spend, not with work |
| Project fee | One price for a defined deliverable, like a website | One-off builds and migrations | Change requests billed on top |
| Hourly | Time billed at a rate | Short reviews, ad-hoc fixes | No cap; hard to forecast |
| Performance or pay-per-lead | You pay per inquiry, call or appointment | Short tests with clear definitions | Who owns the lead and the patient information |
Many agencies combine models, for example a retainer for SEO and a percentage for ads, plus setup fees. That's fine if every part is written down.
We don't quote typical price ranges. Most healthcare agencies don't publish their prices, and we found no current, named, healthcare-specific source we could verify. When an agency does publish a price page, note the date and the scope it covers.
What a retainer should include
A retainer should read like a job description, not a menu. Ask for:
- Monthly deliverables, with numbers: "four articles", "two landing pages", "weekly search-term review".
- The people and hours behind them, and who your day-to-day contact is.
- Channels covered and those that are excluded.
- A monthly report tied to calls, forms and booking clicks by source, not just traffic.
- A regular meeting, with an agenda and notes.
- Live access to your ad accounts, analytics and Google Business Profile.
- Ownership: domain, website and every account stay in the practice's name.
- HIPAA: if the agency will host forms, manage a CRM or handle call recordings, a signed BAA.
- Exclusions: photography, video, ad spend and anything else billed extra.
Percent of ad spend: when it helps and when it hurts
When it helps. For a large, complex account, more spend can mean more campaigns, more ad groups and more testing. A percentage keeps the fee proportional to that work.
When it hurts. For most small practices, the work doesn't double when the budget does. And the fee model quietly rewards spending more.
Hypothetical arithmetic (the 12% rate is invented for the example, not a market rate): a practice spending $2,000 a month on Google Ads pays a $240 fee. It raises spend to $4,000 for a new service, using the same two campaigns. The fee doubles to $480, for roughly the same work.
If you accept a percentage model, ask for a minimum and a cap, a written scope that doesn't shrink as spend falls, and ad spend billed by Google and Meta directly to your card. That last point matters most: when spend runs through the agency's invoice, a markup can hide inside it. Our guide to Google Ads management pricing compares flat and percentage fees at three spend levels.
Setup fees, minimum terms and contracts
Setup fees should buy something you can see: an account audit, conversion tracking for calls and forms, landing pages, a cleaned-up Google Business Profile. Ask for the list. A setup fee for "onboarding" with no deliverables is a red flag.
Minimum terms protect the agency's setup investment. That's reasonable up to a point. Ask for the setup to be priced separately instead, so you can leave without paying for months of work you don't want.
Contracts should cover renewal, cancellation notice, ownership of accounts and the website, ad-spend billing and the return of data at exit. Our checklist of contract terms to check goes clause by clause.
Before you sign anything, take a baseline with our free marketing audit. It scores six areas from 0 to 100, which helps you test whether a quote's scope targets your real gaps.
Performance and pay-per-lead deals
Paying only for results sounds safe. The details decide whether it is:
- What counts as a lead? A form fill, a call of any length, a booked appointment? Get the definition in writing.
- Who owns the lead? If you stop paying, do you keep the contact details and history?
- Is the lead exclusive? Some vendors sell the same inquiry to several practices.
- Where does the patient information sit? Ask where form submissions and call recordings are stored and who can see them.
- Is there a BAA? Under HIPAA, a vendor that creates, receives, maintains or transmits protected health information on your practice's behalf is a business associate (opens in a new tab), and you need written assurances (opens in a new tab) before sharing information with it. A vendor that runs forms or answers calls for your practice fits that description. A vendor that collects inquiries for its own business and then sells them is a different arrangement; ask your privacy advisor which one you're buying.
Pay-per-lead can also leave you renting demand instead of building it. Our guide to pay-per-lead vs owned demand weighs the trade-off.
This is general information, not legal advice. Confirm how it applies to your practice with a qualified advisor.
How to compare quotes line by line
Fill in one column per agency. If a quote doesn't answer a row, ask.
| Line item | Quote A | Quote B | Quote C |
|---|---|---|---|
| Pricing model and monthly fee | |||
| Setup fee and what it buys | |||
| Scope: channels covered | |||
| Scope: monthly deliverables (articles, pages, ad reviews) | |||
| Who does the work, and hours | |||
| Who owns the domain, website and accounts | |||
| Reporting cadence and metrics | |||
| How ad spend is billed (direct or through the agency) | |||
| Markup on ad spend or third-party costs | |||
| BAA offered, if patient information is involved | |||
| Minimum term and renewal | |||
| Exit: notice period, fees, handover timeline |
Worksheet: copy this table into a spreadsheet, or print this page and fill it in by hand during calls.
Two other cost guides help with specific lines: fractional CMO cost if a quote includes strategic leadership, and our guide to choosing a healthcare agency for everything beyond price.
A platform alternative: fixed monthly pricing
A platform replaces scoping and quotes with a published price. Medfy's pricing:
- Base plan, $349/month: your website rebuilt and hosted on your own domain with HIPAA-compliant forms, automated SEO with researched articles every week, AI visibility tracking, website analytics, Google reporting, the AI CMO dashboard and a patient CRM and inbox.
- Google Ads management add-on, $199/month.
- Meta ads + AI creatives add-on, $199/month.
- HIPAA AI chat widget add-on, $49/month.
Ad spend is paid directly to Google and Meta, never marked up. Billed monthly, cancel anytime. Medfy signs a BAA with each practice. See Medfy's fixed pricing.
A platform isn't a full agency. Medfy doesn't run review requests, post to social media, send email or SMS campaigns, provide call tracking numbers or offer multi-location features. If you need those, an agency quote, compared with the worksheet above, may be the better fit.
Frequently asked questions
How much do healthcare marketing agencies charge per month?
There's no reliable public figure, because most agencies don't publish prices and their scopes vary from ads only to full service. The monthly cost depends on the pricing model (retainer, percentage of ad spend, hourly or per lead), the channels covered, content volume and the minimum term. Get at least three written quotes and compare them line by line on the same scope.
Is a percentage of ad spend a fair agency fee?
It can be, for large accounts where more spend genuinely means more campaigns to manage. For a small practice it often isn't, because the fee rises whenever the budget rises, even if the work stays the same, and it rewards spending more. If you accept one, ask for a cap, a written scope and ad spend billed by Google and Meta directly to you.
What should a marketing retainer include?
A written list of monthly deliverables, the hours or people behind them, which channels are covered, a monthly report tied to calls, forms and bookings, a regular meeting, live access to your accounts, and what is excluded and billed extra. For a practice it should also state that accounts stay in your name and, if the agency touches patient information, that a BAA is signed.
Are pay-per-lead marketing deals worth it for practices?
Sometimes, for a short test, but read the terms carefully. Ask who owns the lead and the contact details, whether the same lead is sold to other practices, what counts as a billable lead, and whether the vendor keeps copies. If the vendor runs forms or calls on your behalf, it handles patient information for you and needs a BAA.