"The charge today is $2,700."
I could barely get the words out.
My stomach clenched. Chest tight. Face burning. Heart pounding feeling like I'd just told this pet owner something offensive.
I'd transitioned from human hospital settings into veterinary medicine a few months earlier.
Same medical work. Similar expertise. Comparable care and time.
However, this was the first time I had to say a number that high aloud.
I braced for the reaction.
For the shock on their face. For the negotiation. For the "Can we do a payment plan?" conversation.
For the uncomfortable silence I'd witnessed hundreds of times in human healthcare when people heard a price they couldn't afford.
The pet owner handed me their card.
No hesitation.
No intake of breath.
No asking what was included or whether everything on the bill was "really necessary."
Just here's my card.
I stood there, frozen in my own surprise.
"Hold on—" I heard myself say.
The owner looked up, confused.
I didn't even know why I'd stopped them. Part of me felt compelled to explain the charges. Break down the costs. Justify why it was $2,700. Make it okay that the number was that high.
"I want to add some food to this since I'm already here," they said, pulling me out of my spiral.
Then they scheduled another appointment for their other pet the following month.
I was stunned.
Not because they could afford it. Not because they were wealthy or had pet insurance (they didn't).
Because they didn't question the value.
Here's what hit me in that moment:
The discomfort I felt wasn't about the pet owner. It wasn't about whether $2,700 was too much or whether the service was worth it.
The discomfort was mine.
Years of working in systems where insurance-determined value had conditioned my nervous system to believe:
"This number is unreasonable. People will be upset. You're asking for too much."
The pet owner wasn't operating from those same rules. They evaluated based on trust in the veterinarian's expertise and the outcome. The price was high and it was also worth it.
The pricing block wasn't about the number. It was about what I'd been taught the number meant.
This same pattern appears frequently among healthcare practitioners.
Someone considers cash-based rates, whether still exploring insurance options or already building something new. When it's time to set the price, the number lands almost exactly where insurance reimbursement used to be.
$80 because that's what Medicaid paid.
$100 because that's the commercial average.
The system's ceiling became the internal ceiling. What insurance paid became what feels "reasonable."
What do you most want clarity on? ⬇️
What's your biggest block when it comes to pricing in a cash-based practice?
I'm working on something to help with pricing and mindset. Want early access when it's ready?
Reply "WAITLIST" to this email.
Here's the question worth sitting with:
What would this work be worth if insurance billing had never existed?
Not what feels safe. Not what other practitioners charge. Not what appears to be clients can afford.
What would the price be if it were based purely on the value, time, expertise, and transformation being offered?
Notice what comes up when you sit with that number. The gap between "the insurance-influenced number" and "the trust-based number" shows where the old conditioning is still running.
Something to try:
The next time a pricing decision arises, observe what happens in your body when you think about the number.
Tightness?
Heat?
Racing heart?
The urge to immediately discount or justify?
That physical reaction is information. It's showing where the old conditioning lives.
Name it:
"This is what I was taught about pricing. It's not the truth about value."
That awareness is the first step.
The work I'm building goes deeper, the nervous system practice that makes stating rates feel possible, the internal work that separates worth from what insurance taught, and the sustainable systems that support growth without overwhelm.
More on that soon.
Questions or thoughts? Hit reply. I read everything.
Warmly,
Suzy Wraines, Healing-Centered Business Coach
P.S. That pet owner didn't question the $2,700 because they trusted the value. I questioned it because I'd been conditioned to believe that number meant something about my worth. The work does not change the number. It's changing what the number means.