Best Payroll and PEO Providers for Med Spas (2026): 9 Compared

For med spa owners and practice managers. Updated October 2, 2026 · Prepared by Prospyr. Prospyr makes practice software, not payroll or HR services, and none of the companies below is a Prospyr product or partner. Each summary reflects what the company publishes on its own website, checked October 2026. Prices, promotions and benefit options change often, so get a written quote and read the service agreement before you switch.

What does a payroll provider or PEO do for a med spa?

A payroll provider pays your team and files the payroll taxes; a PEO (professional employer organization) does that and also becomes the co-employer of your staff, so your practice can offer its group health insurance, workers' compensation and HR support. For a med spa, the choice usually comes down to size and benefits. A practice with a handful of employees and simple pay often does well with payroll software. A practice with 10 or more employees that wants better health plans and HR help often looks at a PEO.

The 9 payroll providers and PEOs at a glance

How we chose this list

Few payroll companies name med spas as a market, so most of this list is general payroll and PEO providers. We checked four things on each company's own website:

1. Payroll basics. Federal, state and local tax filing, W-2s and 1099s, and multi-state pay for practices with staff in more than one state.
2. Benefits path. Can a growing practice add health insurance, retirement plans and workers' compensation without changing providers?
3. Published terms. Does the company publish prices, minimums or contract length?
4. Fit for a practice team. Does it name healthcare employers, or offer features a med spa uses, such as contractor payments, time tracking and credential tracking?

Payroll services come first when they publish prices; PEOs follow. The order is our editorial view, not a measure of results. If you are still deciding how to pay injectors and nurses, start with our list of provider compensation consultants.

1. OnPay

OnPay is online payroll software for small businesses. It lists Payroll Essentials at $49 a month plus $6 per worker, as of October 2026.

What stands out:

• Included at no extra charge. W-2s, 1099s and year-end filings; unlimited pay runs and schedules; federal, state and local tax filings; pay in as many states as you need; and phone, chat and email support.
• No setup fees. It states there are no implementation or integration fees.
• Add-ons. HR tools at $15 plus $2 per worker and time tracking at $15 plus $4 per worker. Health insurance, workers' compensation and 401(k) plans are available, with premiums billed separately.

Right for: a single-location med spa with W-2 staff and a few 1099 contractors. Ask: how to set up commission pay for injectors and estheticians, and how tips are reported.

2. ADP

ADP reports serving more than 1,100,000 businesses worldwide and states it pays 1 in 6 US workers. For businesses with 1 to 49 employees it offers RUN Powered by ADP for payroll and HR, and ADP TotalSource as its PEO. It also lists time and attendance, retirement plans, health benefits, workers' compensation and business insurance.

What stands out:

• Two paths. Start with RUN payroll and move to the TotalSource PEO if you want co-employment benefits later.

Right for: a practice that wants a large, established provider and may grow into a PEO. Ask: for a written quote, the full price including add-ons, and who your support contact is.

3. Paychex

Paychex has a healthcare page that lists payroll with pay-on-demand and 1099 contractor management, HR services, benefits, time and attendance, and its PEO. Its PEO page reports 30 years of PEO experience and more than 2.5 million worksite employees supported.

What stands out:

• A named support team. The PEO assigns a main point of contact, an HR business partner, a safety specialist and a payroll specialist.
• Benefits. It advertises large-group health insurance and retirement plans, plus workers' compensation administration.

Paychex also markets payment processing to healthcare businesses. This list covers its payroll and PEO services only.

Right for: a practice that wants payroll today and the option of a PEO without changing vendors. Ask: how its stated savings figures were measured, and the PEO fee per employee.

4. TriNet

TriNet offers a PEO with benefits, payroll, HR guidance and compliance support, plus HR Plus, a non-PEO option for growing teams. It reports more than 22,000 businesses as customers and about $70 billion in payroll processed in 2025.

Right for: a multi-provider or multi-location practice that wants large-company benefits and HR experts on call. Ask: the fee per employee, the benefit plans available in your state, and how much notice you need to leave.

5. Deel US PEO

Deel offers a US PEO covering payroll and tax filing in all 50 states, a dedicated HR business partner, handbook templates, leave administration, EPLI coverage, and benefits including national medical plans, 401(k), dental and vision.

What stands out:

• Published starting price. From $125 per employee a month, as of October 2026.
• Context on fees. Deel states PEOs often charge about $1,000 per employee a year or 2% to 11% of payroll.

Right for: a practice that wants to compare PEO pricing against a published number. Ask: the minimum contract term, and what leaving early costs.

6. Morey CPA & Associates

Morey CPA & Associates is a San Clemente, California CPA firm that focuses on aesthetic medicine practices, plastic surgeons, dermatologists, med spas and wellness centers. Its payroll service runs on QuickBooks Online and covers payroll tax calculation and e-filing, direct deposit, 1099 filing, new employee setup and online reports. It also offers bookkeeping and tax planning.

Right for: a med spa that wants its payroll, books and taxes handled by one firm that knows aesthetic practices. Ask: pricing, how provider commissions are calculated and checked, and who runs payroll each week. For more firms like this, see our lists of bookkeeping services for med spas and tax strategists for practice owners.

7. Patriot Software

Patriot Software publishes two payroll plans: Basic Payroll at $17 a month plus $4 per worker, where you file taxes yourself, and Full Service Payroll at $37 a month plus $5 per worker, which files and deposits federal and state taxes for you. Prices are as of October 2026. Time and attendance and HR software are $6 a month plus $2 per employee each.

Right for: a small practice that wants the lowest published price and is comfortable doing more setup itself. Ask: how commission and bonus pay are entered, and whether local taxes in your city are filed.

8. VensureHR

VensureHR provides PEO services, payroll administration, employee benefits, and risk and compliance services, including workers' compensation, business insurance and EPLI. It names healthcare among its industries and reports serving more than 161,000 businesses and $158 billion in annual payroll since 2004.

Right for: a practice that wants payroll, benefits and business insurance reviewed together. Ask: for the free diagnostic, the PEO fee, and which carrier writes the workers' compensation policy.

9. isolved

isolved offers a payroll and HR platform with a healthcare page that lists credential and ongoing learning tracking, shift differentials, scheduling, ACA tools and OSHA requirement tracking. The practice types it names are mostly larger medical employers, such as hospitals, home health and specialty medical practices.

Right for: a larger or multi-location aesthetic group that wants license tracking and shift pay in the payroll system. Ask: the minimum company size it serves and the price per employee.

Questions to ask any payroll provider or PEO

1. How do you handle commission pay? Many med spas pay injectors and estheticians a percentage of service or retail sales. Ask how commissions are entered, whether they can be imported, and how they show on the pay stub.
2. How do you report tips? Ask how card tips reach payroll and how they appear on W-2s.
3. Can you pay 1099 contractors and W-2 staff together? Then ask your CPA or attorney whether your contractors are classified correctly; the provider will not decide that for you. See employment record requirements for med spas.
4. What does it cost after the promotion? Get the base fee, per-person fee, add-ons and year-end charges in writing.
5. For a PEO: what is the fee and how do I leave? Ask whether the fee is per employee or a percentage of payroll, the contract term, and what happens to your benefit plans if you exit mid-year.
6. Who answers when payroll is wrong? Ask whether you get a named contact and how fast corrections are processed.

Where Prospyr fits

Payroll is only as accurate as the numbers behind it. Prospyr's analytics shows revenue per provider and service mix, which gives your manager or bookkeeper a starting point for commission pay before each payroll run. For more on the process, read how to manage payroll for med spa staff, or book a practice demo.

Frequently asked questions

Should a med spa use a PEO or regular payroll?

It depends on size and benefits. Regular payroll is usually cheaper for a practice with a few employees and no group health plan. A PEO is worth pricing once you have around 10 or more employees and want better health insurance, workers' compensation and HR support, but compare the total fee against what you would pay for payroll plus a benefits broker.

How much does payroll cost for a small med spa?

Published prices on this list start at $37 a month plus $5 per worker for full-service payroll (Patriot Software) and $49 a month plus $6 per worker (OnPay), as of October 2026. PEOs cost more; Deel lists its US PEO from $125 per employee a month.

Can payroll software calculate injector commissions?

Most payroll tools pay a commission amount you enter, but they do not calculate it from your treatment sales. The commission figure usually comes from your practice software's sales reports, then goes into payroll as a line item.

Do I need a payroll provider that specializes in med spas?

Not usually. The tax filing is the same as any small business. What matters more is that someone, often your bookkeeper or CPA, checks commission math, tips and contractor classification each pay period.

Want your company considered?

We review this list quarterly. Payroll providers and PEOs that serve med spas can send their website and what they offer practices to info@prospyrmed.com. Inclusion is editorial and not paid.

Editorial scope

This list is based on each company's public website, checked October 2026 with AI-assisted research. Companies did not review this article before publication. It is not tax, legal or HR advice, a guarantee of results, or a substitute for checking references and reading the service agreement. Read our methodology or report a correction.