The State of Med Spa Google Presence 2026: 555 US med spas on Google
Med spas score almost perfectly on the care itself: staff, results and cleanliness are about 98% positive in patient reviews. The one theme where complaints outnumber praise is booking and communication. We analyzed public Google data for 555 US med spas across 20 metros, with city figures for 19 of them, to show where the real, fixable gaps are.
- Care quality is near-universal: staff, results, pain and cleanliness reviews are about 98% positive.
- Booking and communication is the one theme where negative reviews outnumber positive ones: about 54.2% negative.
- Average Google rating 4.87 across 555 med spas: a near-perfect rating is table stakes.
- The median med spa has 148 reviews but gets only about 5.83 new reviews a month.
- Owners reply to 61% of reviews on average; 34.8% of spas reply to fewer than half.
- Every practice welcome — retainers from $499/mo, Goals-Driven engagements, Performance-Linked Payout Models available.
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- 25+ US healthcare clients
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- HIPAA compliance training across client and delivery teams
- Contracts and invoices in USD
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“They were able to get all my ideas and work with me over a period of three to four months and create this amazing website. It's super customized, very modern, and it incorporates all the elements that I had wanted — the patient portal, nice pictures, a very interactive website, patient reviews. I would highly recommend their company to anyone who wants to make an excellent website.”
Great care, frustrating front door
Short answer: patients praise the people and the results almost without exception. Their frustration collects in one place: getting booked and getting answered.
Six numbers that describe the typical US med spa on Google
Short answer: near-perfect ratings and solid review counts, but new reviews arrive slowly and many go unanswered.
Ratings, reviews, website and opening figures: full study, 555 med spas. New reviews per month and reply rate: review subsample, 115 med spas. See the methodology.
What about 3,000 med spa reviews reveal
Short answer: the clinical experience is almost universally praised; booking and communication is the weak spot.
2,990 reviews, each classified into one theme with sentiment by Google Gemini. Counts come from an automated pass and are directional; the pattern (booking and communication as the one negative-leaning theme) was reproduced in an independent re-run.
- People and outcomes dominate. Staff and bedside manner make up about 48% of reviews and results about 34%, both more than 97% positive.
- Price, before/after outcomes, scheduling and upselling are small themes, each with a meaningful minority of negative reviews (roughly 16–20%).
- Booking and communication is the only theme that skews negative. It is a small slice of all reviews, so treat it as a clear signal rather than a precise measure. It is also the most fixable problem on the list. Read the review deep-dive.
How many reviews med spas have
Short answer: about one in six med spas has fewer than 50 Google reviews and about one in eight has 500 or more. Same near-perfect ratings, very different depth.
n = 555 med spas.
A public visibility score: most are solid, none are strong
Short answer: on a 0–100 score built only from public signals, the median med spa scored 63. About two-thirds landed in the "solid" band and none reached "strong".
Mean 62 · median 63 · n = 86 (early-look records; the score was not recomputed on the full run). The formula and weights are on the methodology page. It reflects visible gaps, not a proven Google ranking formula.
What held med spas back was not their ratings. It was thin review velocity and inconsistent replies to reviews. Both are habits rather than budgets. See the review gap.
Review depth by metro
Short answer: San Diego, Boston and New York med spas carry the deepest review bases; Las Vegas and Nashville the shallowest. Ratings are near-identical everywhere.
| Metro | Med spas sampled | Median reviews | Avg rating | Website linked | Open weekends |
|---|---|---|---|---|---|
| San Diego | 20 | 289.5 | 4.85 | 100% | 85% |
| Boston | 20 | 244.5 | 4.89 | 100% | 90% |
| New York | 33 | 226 | 4.87 | 100% | 81.8% |
| Miami | 20 | 217.5 | 4.91 | 95% | 80% |
| Philadelphia | 20 | 195 | 4.88 | 100% | 90% |
| Dallas | 34 | 176.5 | 4.82 | 94.1% | 76.5% |
| Denver | 20 | 166 | 4.89 | 100% | 75% |
| Scottsdale | 47 | 156 | 4.9 | 97.9% | 66% |
| Chicago | 37 | 154 | 4.87 | 100% | 83.8% |
| Houston | 36 | 148 | 4.79 | 94.4% | 83.3% |
| Seattle | 20 | 138 | 4.88 | 100% | 70% |
| Atlanta | 20 | 128.5 | 4.87 | 100% | 85% |
| Orlando | 64 | 124 | 4.91 | 98.4% | 64.1% |
| Austin | 20 | 123 | 4.9 | 100% | 40% |
| Los Angeles | 38 | 118 | 4.84 | 94.7% | 81.6% |
| San Francisco | 20 | 116.5 | 4.74 | 100% | 75% |
| Washington DC | 20 | 102.5 | 4.92 | 100% | 85% |
| Nashville | 37 | 85 | 4.92 | 100% | 56.8% |
| Las Vegas | 20 | 58.5 | 4.92 | 100% | 55% |
Cities with 20–64 med spas each; smaller samples swing more, so read medians as typical rather than exact. Phoenix (9 med spas) is not reported on its own because it falls below our minimum of 10.
Great care, quietly marketed: four opportunities
Short answer: med spas earn near-perfect ratings for their staff and results, but their Google presence often lags the quality of the service.
- Fix booking and communication. The one theme that skews negative. Faster replies to calls and messages, simpler online booking and clear follow-up are the highest-leverage reputation moves.
- Build a steady review routine. With a median of about 5.83 new reviews a month, a simple, consistent ask (at the moment the client says they're happy, by one-tap link, never with undisclosed incentives) keeps profiles current. See the FTC's rules on reviews before starting.
- Reply to every review. 34.8% of med spas reply to fewer than half of their reviews. Replies are free and visible; never confirm someone is a client or discuss their treatment.
- Deepen the profile. Websites are near-universal, but descriptions, service lists and posts are often thin. See profile completeness and our med spa citation list.
More from this study
Review themes and sentiment, with paraphrased examples.
Review velocity, reply rates and how to close the gap.
What Google profiles include, and what they miss.
Sample, sources, formulas, model, limitations and the CSV download.
Method in brief
- Sample: 555 US med spas across 20 large US metros, pulled with one consistent method. Review velocity, reply rates and themes come from a 115-spa review subsample drawn at random with a fixed seed.
- Sources: public Google profile and review data (via the Google Places API and SearchApi), collected in September 2026.
- Themes: 2,990 reviews classified by Google Gemini into one of nine themes with sentiment.
- Verification: every figure was re-derived from the raw data before publication; the booking and communication finding reproduced exactly in an independent re-run.
- Privacy: aggregates only. No business is named, and no group smaller than 10 is reported.
Full details, formulas and known limitations: Methodology & data · Download the dataset (CSV). Data collected with Angryturtle, ICG's local search intelligence platform.
What US med spa patients expect, and where they don't get it
Findings from our study of 555 US med spas across 20 metros and about 3,000 patient reviews. Read the findings below, or download the complete report.
Related pages from the US team
Med spa marketing agency USA
How we help US med spas grow.
Citation sites for US med spas
The 30 listings every med spa should be on.
Med spa advertising compliance
HIPAA and advertising rules for aesthetic practices.
Med spa membership marketing
Turning one-off clients into members.
Every practice welcome — Goals-Driven engagements from $499/mo
We benchmark your last 90 days, agree monthly goals with you, and track them live on Ichelon Agency OS with a report every Monday. Performance-Linked Payout Models are available. Our US leadership is based in Dallas, and strategy calls run in US business hours.
Common questions
What is the average Google rating for a US med spa?
Across the 555 US med spas in our study, the average Google rating was 4.87 stars. Because nearly all med spas have near-perfect ratings, the rating itself rarely sets one apart.
What do med spa patients complain about most?
Booking and communication. It was the only review theme where negative reviews outnumbered positive ones, at about 54.2% negative. Staff, results, pain and cleanliness were all about 98% or more positive. Theme counts come from an automated classification and should be read as a pattern rather than precise counts.
How many new Google reviews does a med spa get each month?
The median was about 5.83 new reviews per month, based on reviews dated in the last six months (review subsample of 115 med spas).
Is the underlying data available?
Yes. The aggregate dataset (no business names) is available to download as a CSV, and the methodology page documents the sample, search terms, sources, formulas, the classification model and known limitations.
How reliable are these numbers?
Profile and city figures come from 555 med spas across 20 metros, a national margin of error of roughly plus or minus 4 points; city figures are published only where at least 10 med spas were studied. Review velocity, reply rates and themes come from a 115-spa review subsample. Every published figure was re-derived from the raw data before publication. The full study will tighten the margin.
A note on this guide: it explains marketing practice, not legal advice. Rules on privacy, advertising and insurance change and vary by state, so confirm anything compliance-related with your own counsel.
How does your med spa compare?
A 30-minute benchmarking call with the US team. We'll compare your Google profile with the study averages and tell you what we'd fix first.
Key findings
- The average Google rating across 555 US med spas is 4.87, so a near-perfect rating is table stakes.
- Staff, results, pain and cleanliness reviews are about 98% positive.
- Booking and communication is the one theme where negative reviews outnumber positive: about 54.2% negative.
- The median med spa has 148 reviews but gains only about 5.83 new reviews a month.
- Owners reply to 61% of reviews on average, and 34.8% of spas reply to fewer than half.
How to cite this report
State of Med Spa Google Presence 2026, Ichelon Consulting Group, 2026. https://ichelonconsulting.com/us/med-spa-google-presence-report-2026
Free to quote and reuse with attribution and a link to this page.
Related research
Questions this report answers
What is the average Google rating for a US med spa?
4.87 stars. Ichelon Consulting US analyzed public Google data for 555 med spas across 20 metros in September 2026, with city figures for 19 metros and a national margin of roughly ±4%. A near-perfect rating is now table stakes.
How many Google reviews does a typical med spa have?
The median med spa in the 555-spa study had 148 reviews but gained only about 5.83 new reviews a month. About one in six still had fewer than 50 reviews.
Do med spas reply to their Google reviews?
On average owners reply to 61% of reviews, but 34.8% of med spas reply to fewer than half. Review pace and reply rates come from a 115-spa review subsample of the 555-spa study.
Where do med spas lose patients according to reviews?
At the front door. Care-related themes were about 98% positive, but booking and communication was 54.2% negative, the only theme where complaints outnumbered praise in roughly 3,000 classified reviews. The study covers 555 US med spas.