Async-first compounded GLP-1 with a rarity for this list — free health coaching — at a flat one-price-all-doses rate. Fast and friendly up front; the strict, non-refundable fine print is the trade-off.
Telos Rx
Ranked #5 · Grade B
Rx-Readiness86:100
A fast, fully async start with a needle-free sublingual tirzepatide option and — a genuine upgrade since our last check — flat pricing stated in writing. The catch is a state list it still won't publish.
Strut Health
Ranked #10 · Grade B−
Rx-Readiness81:100
The async, needle-optional value play: oral or injectable semaglutide and tirzepatide from a low starting price, no video visit, ~3 days to a script — listed with its February 2026 FDA warning letter in plain view.
Compounded semaglutide from $129 a month and tirzepatide from $199, held at the same price at every dose, plus a separate microdose line from $109 for anyone who wants a gentler metabolic effect rather than maximum weight loss. Lttl covers all 50 states and Washington D.C., says it prescribes and ships within 48 hours, and attributes compounding to U.S.A.-licensed pharmacies it does not name. The catalog runs well past weight loss into NAD+, sermorelin, glutathione and B12 from $79, so read the longevity menu as a separate business from the GLP-1 you came for. Prices are published as starting points rather than a single rate, and the first-order discount of up to $140 is promotional.
Trimi Health
Ranked #3 · Grade B+
Rx-Readiness88:100
The price-first partner: some of the lowest flat, all-inclusive compounded pricing we track, nationwide and async — strong if the monthly number is your deciding factor and you read the annual-prepay fine print.
Live Vital
Ranked #16 · Grade C
Rx-Readiness77:100
$99/mo semaglutide, $183/mo tirzepatide, all 50 states, a named physician personally reviewing every intake, and a real 5-7 day timeline — on a broader peptide platform where GLP-1 pricing is genuinely invisible unless you know to pull the page's own data bundle.
Pepti
Ranked #17 · Grade C
Rx-Readiness77:100
Pepti publishes the lowest semaglutide price in this entire roster — $99 a month, flat at every titration dose, with the medication, physician review, shipping, refill management and unlimited messaging with your prescribing doctor all inside it. Tirzepatide is $199 on the same all-in, flat-at-every-dose basis. That number is low enough to deserve skepticism, so it is worth saying exactly where it comes from: Pepti states it on a dedicated cost page, repeats it in its FAQ ('we keep pricing flat and transparent at $99/mo all-in'), and prices the comparison against Hims, Henry Meds and Mochi on the same page. It names two prescribing physicians and says its medication is compounded by FDA-registered 503A or 503B pharmacies, though it never names which. The real limits are reach and format: it ships to 36 states rather than 50, it is cash-pay only and bills no insurance, and its needle-free oral GLP-1/GIP drops cost $349 — well above its own injection.
Trellis Vitality
Ranked #11 · Grade B−
Rx-Readiness81:100
Trellis Vitality is the cheapest genuinely-disclosed option on this page: $150 a month for compounded semaglutide and $199 for tirzepatide, month to month, with every dosage available at the same price and no membership fee, no consult fee and a $0 assessment. Commit for three or six months and those fall to $140/$133 and $189/$179. It names the pharmacy that compounds the medication — Vials Rx, described as a US state-licensed, cGMP-compliant facility — which is the disclosure most of its cheaper competitors skip, and it covers all 50 states with board-certified clinicians reviewing intake. The caveats are about what it doesn't sell and doesn't say. There is no FDA-approved brand option, no oral formulation, and none of its pricing appears on the homepage at all — you have to reach the GLP-1 product page to find a single number, which makes it look more opaque than it actually is. There is also no postpartum, breastfeeding or PCOS content anywhere.
NewSelf
Ranked #36 · Grade C
Rx-Readiness70:100
FDA warning letter #721472 (Feb. 2026), which names newself.com. A flat, dose-independent price for both molecules — $99.97/mo semaglutide, $144.49/mo tirzepatide, same price at every dose — nationwide, though it requires 3 months upfront.