They have a set fee for a year of services that the office provides. The services include nutrional counseling, behavorial counseling, monthly support group meeting, exercise opportunities..... a good range of services. If you go to one of his informational sessions at St. Agnes he includes the current price in the information packet that he sends you home with. His staff coordinated with the insurance company and got me through the whole process in three months. I am currently 5 1/2 months out and feeling fantastic. I had my second fill last week and I am hoping that can jump start my weight loss, I am hoping to lose another 20 pounds before the year is up.