Can Someone Tell Me How the Charges Are Made for Botox?

I have been given a price of $330 PER injection site. My friend told me she's never heard of being charged by the injection site. She said it is her experience, that MD's charge per syringe of Botox, NOT by one injection site.

Doctor Answers 11

Choose your Botox doc by your results and not by the cost per unit or area

There are different techniques to injecting botox or dysport to get different results. Also the size of the area or how dynamic the muscles are helps determine the amount of botox to use. Men have larger foreheads and need a lot more botox than women as a rule. What is important is the results you get so don't go cheap or you are wasting your money and will pay more in the long run to get touch ups which are not free.

When your doc charges by the unit, you have no idea going into it how many units your doc feels you will need to accomplish the results you want. You yourself will under estimate the amount of units you need by such an amount that you will be shocked when you pay your bill, whereas if you know you want the crow's feet or frown lines or forehead creases done, then if your doc charges by the area then you know exactly what you are going to have to pay and you can plan accordingly with your money whether you can afford it or not right now.

It all boils down to your results and your doctor patient relationship. Even if he does a great job most of the time, there will be a 1 out of 10 times when the botox doesn't seem to work as well and a touch up is needed even in the best of your hands.

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 43 reviews

How are Botox Charges Determined?

I agree that you should be charged by the UNITS, not the area. Some areas simply require more units, and that is directly proportional to our cost. On the other hand, there is usually remarkable consistency in the number of units needed--usually around 30 per area. We do quote by the area for that reason. It is very consistent for our staff and ambiguity. As a patient I would always wonder: did I "need" more units because I was dressed well and looked like I could afford it? Of course, if someone truly needed LESS units, I would adjust my fees lower. I NEVER adjust them higher!

Michael Coverman, MD
Austin Dermatologist
5.0 out of 5 stars 1 review

Physicians vary in how they price Botox

Dear Jlosc

BOTOX (and now Dysport) are very technique dependent services. The standard treatments are only so good. Advance injectors will individualize treatments. At the low end of the market, injectors are advertising BOTOX by the unit at prices that are less than the cost of the material. Obviously no one can stay in business giving things away so there is usually a check (including giving you less BOTOX than you pay for). Other office will charge by the area. Recognize that there is no general agreed definition of what is an area. Certainly you want to know exactly how much BOTOX you will be receiving whether the office charges by the area or by the "syringe". Treatment priced by the injection is just another variation on this theme.

It is my personal belief that not all BOTOX treatments are the same. As an injector, I do not expect that my patients will know how many units of BOTOX they will need, or what areas they should be treated in. It is my approach to offer BOTOX as a service. We also tell the patient exactly how many units of BOTOX they are being treated with so that if they get service elsewhere they know what was done before. It is worth noting that you are best served if you are treated by the doctor and look for a doctor from the aesthetic speciality core: Dermatology, General Plastic Surgery, Otolaryngology, Ophthalmology.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Never by "syringe"

Syringe pricing is for fillers. Botox prices depend on several factors: the number of units required, as well as the experience of the doctor (you get what you pay for...). Dilution, syringes, and volume mean nothing. It is the amount of toxin injected and where and the expertise of the injector that determines fair pricing. A few doctors charge by the area, but that is hard to do since some patients need 20 units where other patients need 45. You want your charges to reflect what you need and what is done in order to be fair.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

Most Charge by the Unit, Some charge by the area.

Most dermatologists and plastic surgeons charge by the unit. Some charge by the area. Unlike fillers, we do not charge by the syringe. There might be an exception: a physician who has the same number of units in each syringe and tabulates his charges that way. But what do they do if the syringe was only half full?

I personally think charging by units is the most reasonable approach. Just an hour ago, I injected a touch up on a woman and used only 9 units in the glabellar and 6 units on her forehead. The charge was $120. Using the charge you were quoted, $330 an area the charge would have been $660 for the same effect. Compare $660 versus $120. Now multiple that times three for a year's worth and then times 10 for ten years. My math: $16, 200. You could buy a car with the extra money if not a house if real estate keeps tumbling.

Another advantage, as Dr. Chen points out, is that we can keep track of the effect better. If a patient says that an area was undertreated last time, or did not last long enough, we can see exactly how many units were placed and where they were placed. We can increase the unit number accordingly.

Let me also mention a topic which comes up on Real Self wilth some regularity. That is dilution. The effect of Botox ( and Dysport) is totally dependent on the number of units being placed. Some of us use very little dilution, especially working around the eyes or lower face. We do not want the material to spread to unwanted areas. No Quaz. Other places we may want more spreading so we use a more dilute product. More diluted= more liquid into the area. Less diluted= less liquid. I know an excellent injector who dilutes 10 cc in his Botox. Patients have large hive like areas after visiting him. It does not mean they are getting more Botox: or weaker Botox for that matter. It all depends on the number units placed.

Hope that helps.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

Most injectors charge per unit of Botox

The fairest way to pay for BOTOX is by the unit. Because different people have different requirements in each area, it's best to pay for exactly what you use. If you have a weak frown muscle, why should you pay the same price as someone who has a very strong muscle (which requires more BOTOX units). The way that the physicians are billed is by the unit by Allergan as well.

When you pay by the area, you don't always know how much BOTOX you are getting. If you pay per syringe, that's variable too. Because BOTOX comes as a powder, it requires the physician to add saline so it is able to be injected. If all physicians used the same reconstitution mixture, than you could compare apples to apples when you compared syringe prices. This is not the case. Doctors add 1-5cc to the bottle of Botox, depending on the physician's preference. When you pay per unit, it really doesn't matter to you how much is added, because the physician makes the calculation as to how much he needs to inject to get that certain amount of units that's right for you.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Botox is normally charged by injection area or by unit

Botox can be charged by unit or by the area to be injected. However, how you are charged is not as important as having an experienced injector. I believe that Botox is best performed by a skilled and knowledgeable physician, because he/she understands anatomy.

Our clinic typically charges by the area, and we guarantee our results, so you do not pay if you would like a top-up on your Botox (i.e. additional units in that same area) after the results take effect. This works extremely well, and we have a high level of patient satisfaction using this method. In contrast, patients who pay for Botox by the unit often wish they had gotten a little bit more, but will have to pay additionally per unit at the Botox provider they went to.

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 150 reviews

Botox cost

Generally, clinics provide a per unit price, and you simply multiply that amount with the number of units administered during treatment. I haven't heard of charging per syringe.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Botox and Cost

It varies significantly from office to office. The most important aspect is to choose a reputable and experienced injector. Some will charge you by area and some like us will charge you by unit.  In our case, it is $12/unit. 

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 42 reviews

Botox charges

All of my colleagues and I either charge by the unit or by the area. I charge by the unit because it is an absolute, quantifiable measurement of how much botox you are receiving. Furthermore, if you as a patient know how many units were injected into a certain area, you can use the response as a gauge of how many units you should receive in that location in the future.

I hope I have not confused you. Good luck.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.