Flat-Fee Retainers, Not Percentage of Spend
Most Google Ads agencies in the U.S. charge a percentage of ad spend — typically 10-20% of what you spend on Google. The math sounds reasonable until you notice the conflict of interest: the agency makes more money when you spend more. There is no incentive to keep your budget lean, to pause underperforming campaigns, or to recommend smaller spend when the ROI is not there. Bigger budgets equal bigger fees.
MIS Services Inc charges flat monthly retainers — $499, $999, or $1,999 per month depending on account complexity. Your ad spend goes directly to Google and is never marked up through us. We do not earn more if you spend $10,000/month versus $3,000/month. Our incentive is to deliver results, not to push spend higher.
We have been managing Google Ads accounts since 2013 — across home services, healthcare, legal, eCommerce, B2B, and professional services. We work all seven Google Ads campaign types (Search, Shopping, Display, YouTube, Performance Max, Demand Gen, App Campaigns), with deep expertise in Performance Max controls and HIPAA-compliant healthcare ads (Consent Mode v2, Enhanced Conversions without PHI, server-side GTM).
Below: the seven campaign types we manage, our HIPAA-safe Google Ads framework, transparent flat-fee pricing, and how to start.
Full Google Ads Stack Coverage
Search Campaigns
High-intent keyword targeting. The bread and butter of most Google Ads accounts. Tightly themed ad groups, exact-match keyword strategy, negative keyword discipline, ad copy A/B testing.
Shopping Campaigns
Product Listing Ads (PLAs) for eCommerce. Merchant Center feed optimization, custom labels for bidding strategy, structured data for product attributes.
Performance Max
Google's AI-driven omnichannel campaign. We work all 20 PMax control levers — asset groups, audience signals, brand exclusions, campaign-level negatives, search themes, channel timeline reporting, value-based bidding.
YouTube Ads
TrueView in-stream, bumper ads, non-skippable, Discovery. Awareness and consideration campaigns. Especially powerful for service businesses needing to explain a complex offering visually.
Display & Remarketing
Visual display network campaigns, retargeting site visitors, similar audiences. Lower-intent traffic but supports the full funnel.
App Campaigns + Demand Gen
App install and app engagement campaigns for mobile-app businesses. Demand Gen for social-feed-style placements. Both gaps in most Google Ads agency offerings.
What Most Google Ads Agencies Don't Build for Healthcare Clients
Most Google Ads agencies running healthcare accounts in 2026 are out of compliance with HIPAA and do not know it. Standard Google Ads conversion tracking, standard remarketing audiences built from condition-specific landing pages, and standard Enhanced Conversions all transmit Protected Health Information without authorization when used on healthcare sites. The Office for Civil Rights opened investigations into 60+ healthcare organizations in 2022-2023 for exactly these patterns.
We build healthcare Google Ads campaigns differently. HIPAA-safe conversion tracking (no PHI in the conversion data layer), Consent Mode v2 properly configured, Enhanced Conversions without PHI (hashed first-party data with PHI stripped before submission), server-side Google Tag Manager to give us control over what data Google receives, and BAA-signed call tracking (CallRail HIPAA plan) for call-conversion campaigns.
Healthcare clients also avoid the audience-building patterns that violate HIPAA — no custom audiences from "Request Depression Treatment" landing-page visitors, no remarketing pixels firing on condition-specific confirmation pages. We use first-party data only, segregated to non-PHI signals. The result: Google Ads campaigns that perform AND keep the practice compliant.
Three Tiers. Ad Spend Separate — Never Marked Up.
Most U.S. Google Ads agencies charge 10-20% of ad spend (conflict of interest) plus hidden minimums. We charge flat. Your spend goes to Google. Period.
Starter
Small business spending $500-$3,000/month on Google Ads
- ✓ 1-2 campaign types (Search + Local)
- ✓ Up to 5 ad groups
- ✓ Monthly performance report
- ✓ Quarterly competitive audit
- ✓ 1× 30-min strategy call/month
Practice
Established business spending $3,000-$15,000/month, multi-campaign
- ✓ Everything in Starter
- ✓ Up to 15 ad groups across 3-4 campaign types
- ✓ Performance Max management
- ✓ HIPAA-safe setup (if healthcare)
- ✓ Conversion tracking + attribution
- ✓ Monthly strategy call
Network
Enterprise / multi-location spending $15,000+/month
- ✓ Everything in Practice
- ✓ Multi-location campaign architecture
- ✓ All 7 campaign types managed
- ✓ Custom dashboard + attribution
- ✓ Bi-weekly strategy reviews
- ✓ Dedicated senior PPC strategist
Frequently Asked Questions
Ready for Honest Google Ads Management?
Free 30-minute Google Ads audit. We review your account structure, wasted spend, conversion tracking, and the highest-ROI 90-day actions. Healthcare? We also audit HIPAA compliance posture.