The answer to the OP's question has been mentioned here, each MA is different and the dynamics of the rates has dramatically changed post-pandemic. Most Spas have not changed their fee structure since pre-pandemic, but expectations (from both patrons and attendants alike as to what should be included in the base fee or, frankly, what constitutes a GFE) may have shifted, right or wrong. Like Lovetoplease said, it seems that some MAs are not getting tipped or insufficiently, if so, (rightly or wrongly perceived is irrelevant) so are taking this into their own hands (some patrons may see it as off-putting but it takes the guess out of what the MA want for certain aspect of the MA experience). Ultimately, Twitter or social media is your best friend, take some time to chat with each propspective MA and find out what they offer (or not offer), if there is upcharge or not.