What a full-arch case actually costs you to acquire

Most practice owners can tell me what a full-arch case is worth. Almost none can tell me what one costs to get.

That second number is the only one that decides whether marketing is a good idea for your practice, and it takes about four minutes to work out. Here it is.

The arithmetic

You need four numbers, and three of them are already in your practice.

One: what a started case is actually worth to you. Not the quoted fee. The revenue you collect on a case that gets accepted and paid, single arch or dual, after any financing discount. You know this number better than anyone.

Two: how many consultations it takes you to start one case. Look at last quarter. Count the full-arch consults you held, count the cases that started. If you held twelve and started four, that is three consults per started case.

Three: what you would spend to produce those consultations. This is the number practices guess at, so hold it loosely for now.

Four: what you are willing to pay for one started case.

That fourth number is the one that matters, and it is the one nobody sets in advance.

Why cost per lead tells you nothing

Every agency report I have seen leads with cost per lead. It is the wrong metric and it is wrong in a specific way: it counts the cheapest thing in your funnel.

A lead is a person who filled in a form. Some fraction of them answer the phone. Some fraction of those book. Some fraction of those show up. Some fraction of those accept treatment. Some fraction of those pay.

If your cost per lead is $80 and it takes twenty leads to start a case, your cost per case is $1,600, not $80. And if your agency optimises for cost per lead, they will happily buy you cheaper leads that convert worse, and the report will look better every month while your surgical day stays empty.

Count the thing you actually sell. For a full-arch practice that is a started case, and nothing above it in the funnel is worth reporting on.

The uncomfortable version

Run your own numbers first, then read this.

A practice funding $300 a day in media across ninety days spends about $27,000. Add a fixed management fee of $7,500 and the all-in figure is $34,500. Fifteen started cases against that is roughly $2,300 each.

Now put your case value beside it.

At $20,000 a case, $2,300 to acquire is an easy yes and you should be annoyed nobody showed you this sooner. At $8,000 it still works comfortably. At $5,000 it works but the margin for error narrows. At $2,000 it does not work at all, and no amount of clever targeting fixes arithmetic.

That is why I ask about case value before anything else, and why I turn practices down on it. A campaign that produces patients at $2,300 each is a success for one practice and a disaster for another, and the difference has nothing to do with the campaign.

What to do with the number

Once you have your cost per started case, three things get easier.

You can tell whether a marketing proposal is serious. Anyone who quotes you a monthly fee without asking your case value is selling you activity. The number they should be interested in is the one at the bottom of your funnel, not the top.

You can decide how much capacity to open. If a started case is worth $18,000 and costs $2,300 to acquire, the constraint on your growth is not budget. It is how many cases your surgical day can hold. That is a different problem and it has a different fix.

You can stop arguing about clicks. A conversation about cost per case is a business conversation. A conversation about impressions is not.

The part I cannot tell you

I do not have an industry benchmark for your cost per case, and I would not trust one if I had it. The number moves with your market, your case value, your consult-to-start rate, and how fast your front desk answers the phone. A figure averaged across a thousand practices in a thousand markets tells you nothing actionable about yours.

What I can tell you is that the number exists whether or not you calculate it, and that practices who know theirs make better decisions than practices who do not.

Work it out. Four minutes.

Louisville Web Lab works with independent, family-owned, high-ticket practices. If a single case is worth thousands and your schedule has room, see how the Empty Chair Offer works. If you would rather not spend on advertising until something works, start here instead.