Your med spa's books, invoicing, and finances. Completely off your plate.

Set up in minutes. An MBA-led team runs your books on autopilot. P&L by service line, injectable margins, and device break-even hit your inbox every Monday.

MBA-led team · No onboarding fee · 30-day satisfaction guarantee

Service-Line P&L Mon 9:00 AM
Botox / Dysport$48,200 revenue
68.4%
Fillers$36,900 revenue
62.1%
Laser$22,400 revenue
71.8%
Body Contouring$14,100 revenue
38.2%
End to End

All-in-one CFO built for med spas.

Replace your patchwork of finance tools with a single system built from the ground up for med spas.

MBA-Led CFO Team

A real CFO reviews every number AI categorizes, every week. Not a queue. Not a chatbot.

  • Daily bookkeeping
  • Weekly P&L by service line
  • Direct CFO access
RC
MK
JS
PT
+ MBA team
CFO · 9:04 AM
Found a $45K Allergan invoice gap. Margin was 34%, not 80%.

Injectable economics, every Monday

Margin per syringe and days of inventory derived from vendor portals + POS consumption. Drift on biostim caught the same week the Galderma price hike landed.

Injectable margin, this week 69.2%
Botox / unit
$14 charge − $5.60 COGS
$8.40
HA Filler / syr
$850 charge − $502 COGS
$348
Biostim / syr
▼ Galderma price hike Mar 1
$258
Days of inventory
Target 14–28 d
18 d

Room utilization by week

All four treatment rooms tracked side-by-side. See which room is paying for itself and which is sitting idle, every Monday.

Utilization, last 8 weeks 4 rooms
Room 1, injection94% Room 2, injection88% Room 3, device70% Room 4, esthetics68%

Inventory management

Every unit tracked by lot. Stockout alerts before you run dry. Expiration alerts before you toss product. Vendor rebate progress so you hit the next tier.

! Botox 200u Need to fill soon
Vycross filler Expiring soon
Allergan Tier 2 On track
$ Galderma ASPIRE Accruing
Sculptra Healthy

Marketing ROI

Meta and Google ad spend matched to attributed revenue. AI flags creative fatigue and reallocates budget the same week — not at the end of the month.

Meta Ads $3,420 spend 3.3x
Google Ads $1,980 spend 3.4x
TikTok Ads $420 spend 1.0x
Blended ROAS 3.2x
Total spend $5,820
Attributed revenue $18,640
nCAC · 28 new patients $208
How It Works

Live in 48 hours. Running on its own by Monday.

One 15-minute call. Your dashboard goes live before the end of the week.

01

Connect your accounts

One 15-minute call. Read-only access to your QuickBooks or Xero plus your injectable vendor portals. Nothing else changes in your accounts.

QuickBooks / Xero Connected
Allergan / Galderma Syncing
Bank feeds Connected
Mindbody / Zenoti Connected
02

AI runs every night

Your dashboard is live in two days. AI categorizes every transaction overnight. A human reviews every number before you see it.

25 agents. Running nightly. Feeding each other data.

03

Back to running your practice

P&L in your inbox every Monday by 9 AM, broken out by service line. Direct CFO access any time.

Med spa consultation
Read-only access only. Encryption verified annually by Intuit and Xero. We see your data. We never move it.
Why Spa Ledger

Why your bookkeeper or QuickBooks can't do this.

Your bookkeeper reconciles for taxes. We reconcile for margins. AI categorizes transactions and matches your Allergan invoices to treatment volume every night. A human reviews every number before your Monday P&L goes out.

DIY QuickBooks Generic Bookkeeper Med Spa Bookkeeper ($795+/mo) Spa Ledger ($499-599/mo)
FrequencyWhen you log inMonthlyMonthlyDaily dashboard + weekly P&L
AI categorization + human reviewNoNoNoYes, every night
Injectable COGS trackedNoNoNot standardYes, every week
Device break-evenNoNoNoYes
Service-line P&LNoNoNoYes
Deferred revenue handledNoNoSometimesYes, from day one
Sales tax by service typeNoNoNoYes
Simple Pricing

One plan. Two ways to pay.

Same weekly P&L either way. Annual saves $1,200 a year.

Monthly
$599/month

Month-to-month. No onboarding fee. 30-day satisfaction guarantee. Cancel anytime.


  • Daily CFO dashboard
  • Weekly P&L by service line
  • Injectable COGS reconciliation (Allergan, Galderma, Merz, Evolus, Revance)
  • Device break-even per lease
  • Deferred package revenue tracking
  • Labor percentage tracked daily
  • Provider productivity tracking
  • Sales tax classification by service type
  • Year-end tax summary
  • Direct CFO access, one business day response
Get Started

No onboarding fee. Full refund if you are not satisfied after your first P&L.

Have questions? Book a 15-minute call

Questions? We have answers.

These are the questions med spa owners ask most. If yours is not here, book a call.

Book a Demo
Mindbody and Zenoti track your revenue. They do not track your injectable product costs, your Allergan invoices, or your device lease payments. Spa Ledger works inside your QuickBooks or Xero and pulls in those additional data sources that your POS never touches.
Bookkeepers close the books once a month. Most have never looked at your Allergan invoice, never calculated your device break-even, and have never shown you which service line is compressing your margin. Most clients keep their existing bookkeeper and add Spa Ledger on top. Your bookkeeper handles compliance. We handle the CFO layer.
When you sell a package, cash collected is a liability, not revenue, until services are delivered. QuickBooks records it as revenue when collected by default. That inflates apparent profitability and obscures which service lines are actually performing. We separate earned from deferred from day one.
Yes. For practices with two or more injectors, we track revenue per provider against their cost. Most owners answer the provider question by gut. We give you the math.
An MSO and PC structure separates the business management and clinical functions of a practice, required under corporate practice of medicine laws in many states. The intercompany management fee must be categorized correctly from day one or it creates tax and compliance issues. Note it on the intake form. We handle it.
Under IRC Section 213(d)(9), cosmetic procedures are excluded from deductible medical care. The same service performed for a medical reason may qualify as deductible. This affects FSA/HSA eligibility for your patients and, in most states, your sales tax obligations. A general bookkeeper treats all of it the same. We do not.
No. We work inside QuickBooks Online or Xero. You keep your existing account. We get read-only access. Nothing moves, nothing changes on your end.
No. That is exactly what we fix. Messy books are the most common starting point. We run a cleanup pass in your first week so everything is current before your dashboard goes live.
You do not leave your current bookkeeper. Spa Ledger operates alongside them. Your bookkeeper continues handling compliance and monthly close. We get read-only access to your existing QuickBooks or Xero and add the CFO layer on top. Onboarding takes 48 hours on our end. Nothing changes on yours.
Acquirers and investors review three years of clean, auditable financials before any conversation moves forward. Most owners start cleaning their books after an offer arrives. The ones who are prepared before the conversation get better terms and fewer surprises in due diligence. We can have your books acquisition-ready at any point.
Yes. Multi-location practices receive a separate P&L for each location alongside a consolidated view. Location-level P&L is the only reliable way to know which location to replicate before you sign a third lease. One retainer covers both.
Three things: your QuickBooks Online or Xero login, a list of your injectable vendor accounts (Allergan, Galderma, Merz, and any others), and your device lease documents if you have financed equipment. If your books are behind or disorganized, that is not a barrier. We run the cleanup pass. The 15-minute connection call is the only active step on your end.
From the Blog

Benchmarks every med spa owner should have memorized.

View all articles
Finance Benchmarks

What Is the Average Profit Margin for a Medical Spa?

A well-run single-location medical spa should produce 27.6% EBITDA at $1.5 million in annual revenue. Most practices run 8 to 14 points below that because injectable COGS, labor drift, and device lease costs are never reconciled against service revenue.

8 min read Read article
AI-Native CFO for Med Spas. $599/Month or $499/Month Annual.

Your injectable margins, device ROI, and labor percentage. Visible in two days.

Tell us about your practice. We call you the next business day.

Or book a 15-minute call directly

No onboarding fee. 30-day satisfaction guarantee. Full refund if not satisfied after your first P&L.

What happens after you submit
We call you the next business day to set up a 20-minute onboarding call.
We request read-only access to your QuickBooks or Xero and your injectable vendor logins. Nothing changes on your end.
Your dashboard is live in two days. Your first P&L arrives the following Monday.

Know someone who runs a med spa? If they sign on and stay past their 30-day guarantee window, you get one month credited to your account.