I have some understanding of the difficulty of competing with a cost cutter. My father ran a luggage store in a low income area when ‘factory outlets’ were opening.
I have no doubt that Costco overhead is lower than that of standalone clinics, but I would bet they trade off a lot of markup in favor of selling in a lot of volume. The 1st audi I consulted told me my only choice was to spend $6,000 on HAs when a complete shoulder replacement (with 2 surgeons doing the work) probably didn’t cost me $600. I’d have been much more open to $2,000 for aids an the 1st year of service, with follow-up service costing me reasonable prices. That probably would have gotten him pretty close to $6K over 4-5 years. That’s a lot less than $6K up front - but he would have gotten a lot more than $0.
Standalone clinics may have some advantages in expertise and in relationships with customers. I’m on my 5th Costco person, and I’d rather not have to deal with the parade.
Have you considered charging prices closer to Costco’s. Do you have professional associations? Has anyone modeled and tested different business models?
I don’t know the answers to my questions. They do not mean to tell you how to run your business, just to elicit answers, since I’m forever curous.