Google or Instagram: what a neurotoxin lead costs in 2026

Summer is the thinnest stretch on most injector calendars. Regulars travel in July and August, and the fall rebook wave does not arrive until September. That makes early June the time to decide where the second half of the year’s ad money goes, and the question owners put to us most is whether it belongs on Google or on Instagram.

This year’s answer has fresh numbers behind it: WordStream by LocaliQ released its 2026 Google Ads benchmarks on May 18. None of the big studies has an injector or med spa category, so the useful move is to read the closest rows and keep their labels attached.

What a Google lead costs in the nearest categories

WordStream’s 2026 study covers 13,474 search campaigns run from April 2025 to March 2026. Its medians for the three rows that matter here:

• Beauty & Personal Care: cost per click $4.62, click-through rate 6.75%, conversion rate 10.35%, cost per lead $39.25.
• Physicians & Surgeons: cost per click $4.76, conversion rate 12.43%, cost per lead $40.04.
• All industries: cost per click $5.42, conversion rate 8.18%, cost per lead $66.69.

A year earlier, the publisher’s 2025 study put Beauty & Personal Care at $60.34 per lead. On these figures the category got cheaper on both counts: clicks cost less, and more of them turned into leads.

LocaliQ’s healthcare report from December, covering October 2024 to September 2025, splits the medical side further. Dermatology came in at $18.54 per lead on a 25.33% conversion rate, while Plastic & Cosmetic Surgery came in at $102.51. An injector practice lands somewhere across that range depending on whether its searchers behave like skin patients or like surgery shoppers, one more reason to measure your own.

What a lead from Facebook ads cost last year

WordStream’s Facebook ads benchmarks for the leads objective, published last September and with data from April 2024 to June 2025, gave Beauty & Personal Care a median of $3.06 per click, a 2.55% click-through rate, a 5.29% conversion rate and $51.42 per lead. Physicians & Surgeons came in at $47.47.

Side by side, Instagram looks dearer per lead than Google. The comparison is not that clean. A lead form inside a Facebook ad captures interest from someone scrolling past; a search lead comes from someone who went looking. We expect form leads to need more follow-up before they book, which is why we compare the two on appointments kept rather than on leads.

The rules shape the result more than the auction does

Two Google policies change what a search campaign can do for an injector:

• Drug names. Advertisers in the US may put prescription drug terms in ad text and on landing pages without certification, but bidding on those terms as keywords requires it, and “botox,” “dysport” and “xeomin” sit on Google’s list. Campaigns bid on treatment words and carry the brand inside the ad.
• Audiences. Google files injections under the Health category of its personalized advertising policy, so these campaigns run without Customer Match, remarketing segments or lookalikes.

Meta has its own pair. Ads that promote a prescription drug are open only to advertisers certified with LegitScript and authorized by Meta, and ads may not imply the viewer’s personal attributes. The example Meta gives of a line it rejects is “Ready to upgrade your skin to look younger?”

So the Google campaign runs on keywords alone, and the Instagram campaign sells the injector and the treatment rather than the brand. Neither limit appears in a benchmark table, and both will shape your own numbers.

What one neurotoxin client is worth

ASPS, the American Society of Plastic Surgeons, puts the average fee at $435 for botulinum toxin injections in its latest statistics. The Botox Cosmetic label puts the effect at approximately 3 to 4 months and notes that dosing more often than every 3 months has not been clinically evaluated. A client who stays on schedule therefore books three or four times a year. At that average fee, three visits come to $1,305 and four to $1,740, before any filler.

Set a $39.25 or $51.42 lead against that and the price of the lead matters less than two other rates: how many leads turn into a first appointment, and how many first appointments turn into a second.

Demand is not the constraint. ASPS counted 9,883,711 neuromodulator procedures in 2024, up 4% on the year before, in figures it released last June. Holding on to the clients you win is where practices lose money.

The missed call and the unread DM

Healthcare had the highest missed-call rate in CallRail’s report from January 2025, at 32%. Across every industry it studied, Google Ads drove 37% of calls and texts, business listings on Google 23% and organic search 22%.

Instagram adds a second inbox to that problem. A question about lip filler sent by DM after hours and answered the following afternoon is a lead you paid for and lost, exactly like a phone that rang out. Budget for whoever answers both before adding spend to either channel.

BrightLocal’s review survey, published in February, adds one more input. In its 2026 edition, three consumers in four (74%) said reviews older than three months do not count for them, and the share asking ChatGPT or another generative AI tool for local recommendations jumped from 6% to 45%. Whichever channel finds the client, both send them to your reviews before they book.

What we are telling clients

• Split the money by job: Google for people searching a treatment, Instagram for showing the injector’s work, with no drug-name keywords and no brand-led Meta copy.
• Judge each channel on appointments kept, not on leads or form fills.
• Attach a rebook reminder to every neurotoxin appointment at the three-month mark, sent from your own CRM.
• Cover the phone and the DMs in the evenings before raising spend on either platform.
• Ask every client for a review at the two-week follow-up, so the last three months never look empty.

The cheapest new appointment is still the one booked by a client you have already treated. For how these pieces fit together, see how we work with injector practices, and for the Instagram side, how we run Meta ads that clear review.