Hello, and thank you for your question! Generally speaking, there are two things that will determine the efficacy and cost of a microneedling session - (1) the depth of the needles, and (2) any other substance that is applied to the skin after the needling portion of the treatment. Generally speaking, the microneedling devices that can be used at home penetrate the skin to a depth of .25 mm-.5 mm - enough to give a "glow" and help with skin tone/quality and texture - but not deep enough to really get after lines, creases or scars. The machines that are used in a doctors office can penetrate as deep as 2.5 to 3 mm (5 to 6 times as deep as the ones for home use) and as such are much better at treating deeper lines and scars. If there is nothing else being done in the treatment (as in - nothing being placed on the skin after) all that matters is the needle depth. You will not get a more effective treatment for more money if both are going to a depth of 2.5 mm. The rest of the cost difference usually is determined on what substances and medications are being placed on the skin after a treatment. There is a huge range here - which probably represents the difference in cost you are seeing. You can treat the skin after microneedling with something as simple and cheap as a hyaluronic acid, something as expensive as dilute botox, or something as complicated as Platelet Rich Plasma. As to whether these add-ons are worth it - to me the jury is still out. There is a great deal of research being done in these areas, and over the next few years I think that we will learn a great deal about which of these post-needling topical treatments are worth the money, and which ones are not. In my practice I am not using them yet - and our microneedling costs $300 a session. This may change as the research becomes clear. I hope this helps, and good luck!