Dr. Holloway Was Paying CT Payments 3.34%. The Higher His Care Plans Got, the More It Cost.
Dr. Holloway Was Paying CT Payments 3.34%. The Higher His Care Plans Got, the More It Cost.
The search to reduce CT Payments fees usually starts the same way for chiropractors on ChiroTouch — not with a statement audit, but with a sale. A patient walks out the door having paid eighteen hundred dollars upfront for a twenty-four-visit care plan. Sixty seconds later the deposit notification lands on the front desk computer and somebody does the math in their head and the number is off by more than it should be. That moment is when most chiropractors first decide to reduce CT Payments fees, before they even know what the alternative looks like.
Dr. James Holloway runs Holloway Chiropractic & Wellness on Pearl Street in Boulder, Colorado. Solo doctor of chiropractic, one part-time associate, one front desk lead, one part-time billing assistant who comes in Wednesdays and Fridays to work the insurance side. Mixed cash and insurance practice — about 55% cash patients on care plans, 45% insurance copays plus deductibles. ChiroTouch Advanced on the $299 monthly plan because he needs the clearinghouse for the insurance side. CT Payments running through everything for four years.
Card volume averaged $48,000 a month over the last twelve. The processing fees on that volume averaged $1,603 — about 3.34% effective rate. Dr. Holloway had never calculated that number until February of this year when a colleague at a state chiropractic conference mentioned offhand that his own practice was running at 2.31% on a standalone merchant account. Dr. Holloway drove home that weekend and pulled twelve months of CT Payments statements. The gap was real. About $490 a month, $5,880 a year his practice was paying that another chiropractic practice in a similar configuration was not. The case to reduce CT Payments fees was the $5,880 staring back at him from the spreadsheet.
Dr. Holloway never asked what his CT Payments rate was during four years on the platform. The line item on each patient ledger said “CT Payments — $X.XX” and the math reconciled. The blended effective rate was a number he had to calculate, not a number ChiroTouch surfaced for him. Most chiropractors who later move to reduce CT Payments fees have never run the calculation on their own statements — which is exactly the conditions under which a 70 to 110 basis point integration premium goes uncontested for years.
Why Chiropractors End Up on CT Payments
ChiroTouch is the dominant practice management platform in chiropractic. SOAP notes built around the way chiropractors actually document adjustments. Patient ledgers that handle the cash-versus-insurance split most healthcare software cannot. Care plan billing that lets you sell a twenty-four-visit plan and draft against it visit by visit, automatically. CT ProClear or CT MaxClear for the insurance clearinghouse depending on which clearinghouse the practice prefers. The product works. It is the industry standard for a reason and the chiropractic conversation about leaving ChiroTouch is rare and usually painful.
The conversation worth having — the one that actually moves the needle on practice profitability — is one layer down, at CT Payments. It is the ancillary payment processing service ChiroTouch bundles inside the platform. CT Payments turns on with a few clicks during ChiroTouch onboarding. There is no separate rate quote, no merchant account application, no statement review at the point of activation. The practice signs the standard CT Payments agreement, the terminal arrives in the mail, and card processing starts working. The whole experience is designed to be invisible — which is the same invisibility that makes it hard to reduce CT Payments fees later.
CT Payments is not a standalone merchant account. It is a payment processing service operated through ChiroTouch’s payment partner, packaged so that the rate, the contract, the terminal, and the support all sit inside the ChiroTouch relationship. ChiroTouch publishes the software pricing ($159/mo Core, $299/mo Advanced) but does not publish CT Payments rates. The rate is in the agreement the practice signed at onboarding, in the dense paragraph nobody read. Any chiropractor trying to reduce CT Payments fees has to start by digging out that paragraph.
What does not get said during the onboarding pitch: that the rate the practice will pay on CT Payments is meaningfully higher than what the same practice would pay on a standalone merchant account on interchange-plus pricing — typically 70 to 110 basis points higher, depending on card mix and ticket size. On Dr. Holloway’s $48,000 monthly volume, that gap is real money. On a chiropractor running larger volume or larger average tickets, the gap grows linearly. To reduce CT Payments fees in any meaningful way, the conversation has to move past the integrated platform pitch and into actual statement math.
Where the 3.34% Effective Rate Actually Comes From
Dr. Holloway’s twelve-month effective rate of 3.34% breaks down across three transaction patterns that all live in a chiropractic practice in different proportions. Understanding the breakdown is the first step to reduce CT Payments fees because each slice tells a different story.
The walk-in adjustment — $85 to $110 typical ticket, paid on a swipe at the time of visit, mostly a basic consumer credit card or debit. These transactions pay CT Payments’ base card-present rate, which on Dr. Holloway’s actual statements runs around 2.99% plus $0.15 per transaction. Across the year, the effective rate on this slice of his volume came out to roughly 3.13% once the per-transaction fees were averaged in. Lots of small tickets means the fixed component dominates.
The new patient consultation — $180 to $220 typical ticket, often paid on a rewards card because new patients tend to use whatever card has points. Same base rate, but the larger ticket dilutes the per-transaction fee impact. Effective rate on this slice ran 3.06%.
The care plan upfront purchase — this is where the math gets painful, and where any plan to reduce CT Payments fees finds its biggest dollar impact. Dr. Holloway sells twenty-four-visit plans at $1,800, longer multi-month plans at $2,400, and occasional six-month wellness packages at $3,200 to $4,200. Care plan customers tend to put these on rewards or premium cards because the ticket is big enough to be worth the points. CT Payments charges the same percentage on a $2,400 transaction as on an $85 transaction — but the dollars compound. A $2,400 care plan at 2.99% costs $71.76 to process. The same transaction on a standalone merchant account at interchange-plus pricing around 2.10% costs $50.40. The gap is $21.36 on a single sale.
Dr. Holloway sells roughly 14 care plans per month at an average ticket of $2,100. That is $29,400 in monthly care plan volume — more than 60% of his total card volume. The 89-basis-point gap between CT Payments and interchange-plus compounds to $262 per month on care plans alone. Across twelve months: $3,144 in care plan processing premium he cannot escape inside CT Payments. The math gets worse as the practice grows. Every additional care plan sold widens the gap and strengthens the case to reduce CT Payments fees before the next year compounds the bill.
The blended effective rate of 3.34% is the weighted average across these three patterns. The care plan slice is where the real money is hiding because the dollars-per-transaction are large enough that percentage-based markup compounds fast. A chiropractor running heavy care plan volume — which describes most cash-leaning practices — pays a CT Payments premium that scales with the success of the practice. The better Dr. Holloway gets at selling care plans, the more he pays to process them. This is the structural reason to reduce CT Payments fees early rather than late.
Why Integrated Healthcare Payment Processors Default to Higher Rates
CT Payments is not an outlier. The same pattern shows up across every vertical-specific practice management platform that bundles a payment processor — Dentrix, Eaglesoft, Cornerstone, AVImark, Mindbody, Vagaro, Toast, Lightspeed, Housecall Pro, ServiceTitan, QuickBooks Payments. The software company makes meaningfully more revenue per customer when it owns the payment rail in addition to the software subscription. The flat-rate model produces predictable margin per practice. The bundled convenience is real, but it is priced into the rate at 50 to 110 basis points above what a standalone merchant account on interchange-plus pricing produces on the same volume.
For a chiropractor on ChiroTouch the math is the same as for a salon on Vagaro, a restaurant on Toast, or an electrician on Housecall Pro. The integration premium is built into every transaction. Federal Reserve interchange data shows wholesale interchange has been broadly stable since 2021. The variance across processors is markup, not interchange.
Andre Mitchell, plumber in Columbus, found it at $38K/month on Housecall Pro. Luis Vargas, HVAC contractor in Albuquerque, found it on ServiceTitan. Valeria Restrepo, salon owner in Raleigh, found it on Vagaro. Marco Bellini, bike shop owner in Portland, found it on Lightspeed. None left their platform. All moved the payment processor underneath it. Chiropractic is the same shape, and the playbook to reduce CT Payments fees follows the same pattern.
The pricing logic is structural rather than incidental. CT Payments does not have a meaningfully different cost structure than a standalone interchange-plus merchant account at the wholesale level — both are paying the same interchange to the same card issuers. The difference is the markup ChiroTouch’s payment partner adds on top, which funds the integration revenue ChiroTouch collects in addition to the software subscription. It is the price of the bundle.
Dual Pricing: How Chiropractic Practices Eliminate Card Processing Costs Entirely
Switching to interchange-plus pricing cuts Dr. Holloway’s effective rate from 3.34% to roughly 2.10% and puts about $5,880 a year back in the practice. That is real money, and for many chiropractors it is the right move. But it is not the most aggressive way to reduce CT Payments fees, and it is not the play we would actually recommend leading with.
The model that fits chiropractic best is dual pricing. Under a dual pricing program, the practice posts two prices: a cash price (what the visit or care plan costs) and a card price (the cash price plus a small service fee, typically 3–4%, that offsets the processing cost). Patients who pay with HSA, FSA, debit, or check pay the cash price. Patients who choose a credit card cover the cost of their own payment method.
The net effect on the practice: card processing cost goes to near zero. Not reduced — eliminated.
| Path | Effective Rate | Annual Savings vs. CT Payments |
|---|---|---|
| Stay on CT Payments | 3.34% | — |
| Switch to interchange-plus | ~2.10% | ~$5,880 |
| Switch + add dual pricing | Near zero | Most of the full processing cost |
Chiropractic is one of the verticals where dual pricing tends to land well with patients. Three reasons:
- HSA and FSA cards bypass the service fee entirely. These cards process as debit, so they qualify for the cash price. Patients spending healthcare savings dollars — a meaningful share of any chiropractic patient base — see no change at all.
- Care plan pricing is already an open conversation. Chiropractic care plans are quoted, explained, and discussed before the patient commits. A 3–4% cash-versus-card line fits naturally into a conversation that already covers visit counts, plan length, and total cost — it is not a surprise at checkout.
- Care plan tickets are large enough that the savings is concrete. On a $2,400 care plan, the cash-versus-card difference is roughly $72–$96. Patients can see exactly what their payment choice costs them, and many will choose debit, HSA, or check over a rewards credit card for that visible savings — which is the entire point.
The catch — and this is where CT Payments specifically blocks the better path — is that the integrated CT Payments flow inside ChiroTouch does not natively support dual pricing. CT Payments runs one price field. To run dual pricing properly, the practice needs either a terminal that prompts cash versus card at point of sale, or a point-of-sale overlay that applies the service fee automatically. Both are standard equipment on a regular merchant account. Neither is available through CT Payments.
In other words: the same captive-payments arrangement that produces the 3.34% effective rate also blocks the cleanest fix for it. To reduce CT Payments fees down to near zero, the practice has to step outside the CT Payments product — which, as the next section explains, does not require leaving ChiroTouch itself.
High-volume insurance-only chiropractic practices with small average tickets see less benefit — the patient pays little out of pocket, so the cash-versus-card choice rarely comes up. Practices that bill almost everything to insurance after the visit, rather than collecting at point of sale, also find dual pricing awkward to apply. Outside those cases, dual pricing fits a care-plan-driven chiropractic practice as well as it fits any vertical we work with.
Three Cases Where Staying on CT Payments Is the Right Call
For honest framing, here are the contexts where the math does not favor a move to reduce CT Payments fees:
(1) Volume below $15,000/month. The percentage gap produces a small enough dollar figure that operational simplicity is worth more than the savings. Most solo new-practice chiropractors are in this band; the math becomes a clear win above $25,000/month. (2) Practice does almost no care plan business — high-volume insurance-only chiropractors with sub-$60 average tickets see less of the compounding effect. (3) Practice is mid-acquisition or planning to sell within twelve months — switching processors mid-transaction is operationally messy and the buyer may renegotiate the merchant account anyway.
Outside those contexts, the math on the rate gap usually wins, particularly for cash-leaning chiropractic practices with meaningful care plan volume. A chiropractor selling fifteen or more care plans per month at typical $1,800-$2,400 tickets is paying an integration premium that scales with the financial success of the practice. The better the practice runs, the more the premium costs. The decision to reduce CT Payments fees rarely involves leaving ChiroTouch. The platform stays. Only the payment rail underneath changes.
Most chiropractors who explore the option discover the operational lift is much smaller than the savings — and the savings compound month over month for as long as the practice runs. Chiropractic vertical pricing patterns also route naturally to healthcare merchant services as a category, where the rate structures across dental, chiropractic, optometry, and small medical practices share more similarities than differences.
Frequently Asked Questions
The pricing logic is structural. ChiroTouch — like Vagaro, Toast, Housecall Pro, ServiceTitan, and other vertical SaaS platforms — generates revenue per customer beyond the software subscription by owning the payment rail. The flat-rate CT Payments model produces predictable margin per practice and bundles a convenience premium into the rate. Wholesale interchange (paid to card issuers, set by the card networks) is the same regardless of who processes the transaction. The variance is the markup the processor adds on top, which on CT Payments runs typically 70 to 110 basis points higher than what a standalone interchange-plus merchant account would produce on the same volume. To reduce CT Payments fees, the practice moves the payment processing layer to a standalone merchant account while keeping ChiroTouch as the practice management platform.
No. ChiroTouch — including SOAP notes, patient ledgers, care plan billing, scheduling, the clearinghouse integration (CT ProClear or CT MaxClear), and the entire practice management workflow — stays exactly as it is. Only the payment processing layer underneath gets replaced. A standalone merchant account integrates with ChiroTouch through the same APIs CT Payments uses. The patient experience and staff workflow look effectively identical before and after. The conversation about how to reduce CT Payments fees is not the same as the conversation about replacing ChiroTouch.
Below $15,000 per month in card volume, the percentage gap produces a small enough dollar figure that integrated payment simplicity earns its premium — most solo new-practice chiropractors are in this band. The math improves around $20,000 per month and becomes a clear win above $25,000 per month. For practices doing meaningful care plan volume — fifteen or more upfront care plan sales per month at typical $1,800-$2,400 tickets — the threshold drops because the per-transaction compounding effect is larger. A cash-leaning chiropractor doing strong care plan business at $30,000+ monthly volume typically saves $4,000-$7,000 annually after they reduce CT Payments fees by switching to a standalone merchant account.
Other vertical platforms where this pattern shows up
Send Us a Recent CT Payments Statement. We’ll Run the Math.
If you’re on ChiroTouch with CT Payments and you want to know what the gap looks like on your specific volume and care plan mix, send one recent statement to Brookside. We will calculate your effective rate, model what a standalone merchant account on interchange-plus pricing would cost on the same volume, and tell you the annualized dollar difference. The math takes us about fifteen minutes. The decision to reduce CT Payments fees only makes sense once you see the actual number on your practice. Learn more about payment processing consumer protections from the CFPB.
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