I am answering without reading cuz well there are a lot of posts already and if i read I wont answer. lol. I pay for the visit if we see the vet. Our old vet also went out of business for whatever reason and it sucks cuz she would charge like 30 for the visit for both boys even together and in that visit she would clean then, clip nails and express the anal glands. Then if anything above that was needed we of course would pay for prescriptions or what not. Now at the new vet we use it seems to be much more expensive. We only pay the vet visit if seen by dr BUT on top of that we have to pay for anals, nails etc so I am not sure what they include in a visit aside from the vet looking at them. So hard to find a good vet for good cost and I have been sad since mine went out of business. Wish I could track her down! In the end I would say you have been very lucky up until now.