Chapter III · 6 min read
The Money
Unit economics, 50-state Botox pricing, and the $8.7B tourism leak.
MedSpa Unit Economics
Revenue, margins, and location growth (2019–2026)
The average medspa generates $1.4M — and the number keeps climbing.
Up from $1.3M in 2022. The average visit generates $527, and injectable-heavy practices report 20–25% net margins — among the highest of any outpatient category.
With 10,488 locations in 2023 (up 18% YoY), revenue per location is still climbing even as supply grows. That's the rare signal of a market expanding on both axes.
$1.4M
Avg annual revenue per medspa
20–25%
Net margin (injectable-heavy)
AmSpa 2024 State of the Industry, FotroMed 2025 margin study, Apex Leaders 2024 projections
Botox: $252 in Wyoming. $536 in Wisconsin. A 2.1× spread.
We priced Botox across all 50 states + DC. The gap isn't just cost-of-living — competitive density, patient demographics, and menu architecture all shape what a market will bear.
States with fewer providers per capita and more affluent patient bases command premiums — the highest- and lowest-priced markets are charted below.
Botox Pricing — Highest vs. Lowest States
Nat'l avg: $420Above Average
Below Average
Takeaway: A $284 gap between the cheapest and most expensive state. The spread tracks competitive density + patient affluence, not just cost of living.
Source: CareCredit, Direct Aesthetics, provider surveys (2024–2025). All 50 states + DC ranked in the interactive panel.
$252
WY (lowest)
$536
WI (highest)
CareCredit, Direct Aesthetics, and provider surveys (2024–2025)
The face accounts for 4 of the top 8 highest-margin procedures.
We mapped demand, pricing, and margins across 9 body regions. Botox leads with a search index of 100 and very-high margins ($350–$700). Lip filler follows with a social index of 88 — the second-most Instagram-driven procedure in the dataset, just behind Botox.
The takeaway: face-first menus maximize both search discoverability and margin simultaneously.
Body Regions × Margin & Search Demand
Face
5 procs
Neck
3 procs
Abdomen
3 procs
Glutes
3 procs
Legs
3 procs
Scalp
3 procs
Arms
3 procs
Chest
2 procs
Flanks
2 procs
Pattern: The face has the highest concentration of very-high-margin procedures AND the highest search demand — a rare alignment that makes face-first menus the default revenue strategy.
Source: CareCredit, Google Trends search indices, provider margin surveys (2024–2025)
$350–$700
Botox treatment range
88
Lip filler social index
CareCredit, Google Trends search indices, provider margin surveys (2024–2025)
Aesthetic tourism: an $8.7 billion parallel market.
Cosmetic surgery tourism alone is $4.5B. Hair transplants add $1.6B (heading to $5.3B by 2033). BBL tourism to Colombia and the Dominican Republic is $480M, and dental tourism adds $2.1B. These cross-border flows aren't just lost domestic revenue — they map where price beats trust.
Not all of this is US-origin demand — but each dollar flowing to Turkey or Thailand marks the frontier where a cheaper result wins out over proximity.
Medical Tourism by Category
Combined market:
$8.7B → $19.3B
Source: MarketIntelo, PubMed cosmetic tourism studies, GlobalData (2024)
$8.7B
Combined aesthetic tourism market
$19.3B
Forecast total by 2030–33
MarketIntelo + PubMed cosmetic-tourism studies (2024). Hair & dental sourced; cosmetic & BBL components modeled.
Botox pricing — all 50 states + DC
Average per-treatment price, ranked. National average $420.
Δ = vs. the $420 national average. Source: CareCredit / Synchrony cost study (per-state averages are vendor-blended and thin-sample at the extremes). Showing 51 of 51 jurisdictions.
Three readings of the same data.
- The same Botox treatment ranges $252–$536 across states — know where you sit.
- $527 average visit; injectables carry the 60–80% margin.
- Watch the tourism leak — price-sensitive patients are going offshore.
- $1.4M avg revenue per location at 20–25% net margins.
- Injectables ≈ 45% of revenue with 3–4×/yr repeat frequency.
- Pricing power varies 2.1× by geography — a real lever for platforms.
- Face-first menus maximize both search discoverability and margin.
- Capture tourism-leak demand with financing + trust signals.
- Benchmark per-state pricing before setting the rate card.