Can I pass card fees on to med spa clients?

Surcharging card payments is allowed in most US states with disclosure and network registration, but it is unpopular in aesthetics where clients expect a premium experience. Most med spas build the cost into pricing instead.

What does Enterprise Pay Gateway charge a med spa?

Our Starter plan is $49 a month plus 0.75% on transactions, dropping to 0.40% on Pro. Stripe's own processing fee is separate and goes to Stripe.

Is ACH worth it for memberships?

For memberships above roughly $150 a month, yes — the saving per charge is meaningful. Below that, card convenience usually wins because it fails less often.

Guide

Med spa payment processing fees: what you actually pay in 2026

Updated 9 September 2026 · 8 min read

A typical US med spa pays roughly 2.9% plus 30 cents per online card payment to the processor, plus whatever the booking or payments software charges on top. On a $450 treatment that is about $13.35 in card fees. Memberships and prepaid packages lower your effective rate because you pay the fixed 30 cents far less often per dollar collected.

The two fees every med spa pays

The first is the processing fee — the percentage and fixed amount the card networks and processor take on each charge. For online card payments in the US this is commonly 2.9% plus 30 cents; card-present terminal rates are lower, international and currency-converted cards are higher.

The second is the software fee. Booking platforms, practice management systems and payment platforms either charge a monthly subscription, a percentage on top of processing, or both. This is the number worth negotiating, because processing rates are largely set by the card networks.

What that costs on real med spa tickets

A $250 injectable appointment costs about $7.55 in processing. A $450 laser package costs about $13.35. A $2,400 body contouring series costs about $69.90.

High average tickets are why the fixed 30 cents barely matters for med spas and why the percentage matters enormously. A 0.3 percentage-point difference on $40,000 of monthly volume is $120 a month.

Memberships change the maths

Monthly memberships collect smaller amounts more often, so the fixed per-transaction fee bites harder. A $99 membership costs about $3.17 to collect — 3.2% effective, not 2.9%.

Prepaid packages do the opposite. Collecting $2,400 once instead of ten $240 visits saves roughly $2.70 in fixed fees and, more importantly, secures the revenue up front.

Failed card recovery matters more than fee shaving here. A membership that lapses because a card expired costs you the whole subscription, not a fraction of a percent.

Deposits and no-shows

Taking a card at booking, with a clear cancellation policy the client accepts in writing, is the single highest-return payment change most med spas can make. A 20% deposit on a $450 treatment protects far more revenue than any fee negotiation.

Keep the policy visible at booking and repeat it in the confirmation email. That written acceptance is also your strongest evidence if the client later disputes the charge.

How to lower your effective rate

Move recurring memberships to bank debit (ACH) where clients agree — it costs a fraction of card rates on larger amounts.

Consolidate: paying a booking platform's payment margin and a separate gateway fee means paying twice for one job.

Make your statement descriptor recognisable. Disputes cost a non-refundable fee on top of the lost revenue, and unrecognised charges are a leading cause.

Ask for volume pricing once you are consistently above roughly $50,000 a month. Platform fees are negotiable at that level even when interchange is not.

Frequently asked

Can I pass card fees on to med spa clients?: Surcharging card payments is allowed in most US states with disclosure and network registration, but it is unpopular in aesthetics where clients expect a premium experience. Most med spas build the cost into pricing instead.
What does Enterprise Pay Gateway charge a med spa?: Our Starter plan is $49 a month plus 0.75% on transactions, dropping to 0.40% on Pro. Stripe's own processing fee is separate and goes to Stripe.
Is ACH worth it for memberships?: For memberships above roughly $150 a month, yes — the saving per charge is meaningful. Below that, card convenience usually wins because it fails less often.