Clinics Corner: Pricing Dilemma in Audiology
Balancing Value and Competitiveness
As an audiologist and clinic owner in Toronto, I find myself facing a dilemma that many healthcare providers encounter: how do we set pricing that reflects both the value of our services and the realities of running a business? Every year, the Ontario Association of Speech-Language Pathologists and Audiologists releases a new schedule of fees for audiology services, and every year, the release of this schedule gets me thinking. While the schedule of fees provides a good benchmark that upholds our value as health care practitioners, it often feels disconnected from the economic realities of our industry, because so many clinics simply don’t follow it and set their own pricing.
On the one hand, we want to remain competitive in a crowded market and offer accessible services to as many people as possible. Still, we must also uphold the value of audiology healthcare – a value that goes far beyond simply selling hearing aids or conducting assessments. We provide an essential service that significantly impacts our patients’ quality of life. Yet, as the cost of rent, payroll, and goods continue to rise, we’re forced to ask: how do we price our services fairly without losing sight of their worth?
The Challenge of Balancing Costs and Value
An audiology practice is an expensive business to run. Unlike other healthcare fields, where insurance coverage is more robust, audiology faces a unique challenge: minimal insurance support for hearing assessments, counselling, and hearing aids. This leaves many clinics with the decision to bundle services into higher prices for devices, assessments, fittings, and ongoing care. However, this pricing strategy can quickly become unaffordable for many patients, especially when they already have to cover the high costs of hearing devices themselves.
Consider this: when someone comes in for a hearing test, it’s not just the test they’re paying for — they’re also paying for the time, expertise, and technology that goes into the process. Our clinic offers a comprehensive hearing assessment that includes air conduction and bone conduction testing, tympanometry, acoustic reflexes, and speech audiometry (including advanced speech testing). According to our schedule of fees, this should cost around $226. However, many clinics still offer hearing tests for as little as $45 to $120.
Some clinics even offer these assessments free of charge. I can only assume that the free offerings are driven by a desire to get patients in the door and eventually sell them a hearing aid, which is where the higher profit margins lie in hearing healthcare. But what happens to non-hearing aid audiology services? How are assessments priced for those patients? Is the schedule of fees used to balance value and service in the case of those service offerings or are those patients neglected because they don’t require a device?
Other healthcare fields have found a way to charge appropriately for their services. A typical eye exam in Toronto ranges from $170 to $250, and a dental exam can cost anywhere from $250 to $350. Yet, hearing exams, which require specialized knowledge and equipment, are often offered for free or at a fraction of that cost. This creates a problem, as it makes it difficult for clinics to set prices that adequately reflect our expertise and the costs of running a clinic while staying competitive and providing affordable care.
The Hidden Costs of Running a Hearing Clinic
In recent years, the cost of goods sold has only gone up. This includes everything from the cost of hearing aids to the technology used in assessments, supplies, utilities, and rent. Furthermore, many “surprise costs” in business often get overlooked. For example, equipment breakdowns and replacements are inevitable in operating a clinic.
Recent tariffs between the US and Canada threaten to drive up the costs of hearing aid devices and associated equipment even farther, which leaves us facing an uncomfortable reality: we need to raise prices to meet these increasing costs. As an owner, it’s my responsibility to ensure that the clinic remains financially sustainable in the face of all these uncertainties. At the same time, however, we don’t want to scare off potential patients, so what do we do? It’s a delicate balance. If we raise fees too much, we risk pricing out the very people who need our help the most. But if we don’t raise them enough, we risk running our businesses into the ground, unable to cover costs and pay employees. A clinic that is no longer operating cannot provide any follow-up.
Should There Be More Regulation in Audiology Fees?
One possible solution to this problem could be stricter regulations around minimum billing amounts for audiologists. A more consistent standard for pricing hearing tests, assessments, fittings, and ongoing services could help ensure that clinics charge fairly for the value they provide — and it could protect business owners from being forced to compete on price alone.
It would also help foster greater respect for audiologists as healthcare providers who deliver specialized and essential services, like optometrists and dentists. Our expertise should be reflected in our fees, rather than undercut by unsustainable discounting or a race to the bottom. After all, when we sell a hearing aid, we’re not just selling a device – we’re offering a comprehensive service that includes testing, prescribing, fitting, verification, and ongoing support. That has real value. Plus, audiologists have invested years of education – often holding Master’s degrees, Au.Ds, or Ph.D.s — and we bring specialized expertise to our patients. Our fees should reflect that expertise and the comprehensive care we provide.
For our clinics to grow, scale, and continue offering high-quality care, we need to collectively, as an industry, charge prices that reflect the value of our services and expertise.