The Local AI Visibility Index
Madera Medical Spa / Aesthetics
We asked 5 AI answer engines 10 questions a prospective client would actually ask, then measured which of the market’s 45 med spas got named. 41 of them never came up once.
- Market
- Madera, CA
- Med spas
- 45
- Questions
- 10
- Engines
- 5
- Measured
- July 2026
Every med spa in the market · one dot each · ordered by Google Maps rank · lit = named by at least one engine
91.1%
of Medical Spa / Aesthetics med spas in Madera were named in none of the 50 AI answers we collected.
Finding 01
Does ranking well on Google mean AI recommends you?
It helps, and it is nowhere near enough. Of the 15 best-ranked med spas in Madera, 4 got named by an AI engine — 26.7%. Of the 15 ranked lowest, 0 did. The single most-named med spa in this market ranked 2nd on Maps, coming up in 24% of answers.
Google rank and AI answers are decided by two different systems looking at different things. Your map position comes from how close you are, what category you are in, and how people engage with your listing. Whether an AI names you depends on whether it can find, read and trust a description of your med spa in the sources it pulls from. Ranking first buys you better odds. It does not buy you the answer.
| Where they rank on Google Maps | Named by AI | Share |
|---|---|---|
| The 1st third — best ranked on Maps | 4 of 15 | 26.7% |
| The middle third | 0 of 15 | 0% |
| The bottom third | 0 of 15 | 0% |
Finding 02
How many local businesses actually appear in AI answers?
Very few, and the ones that do take most of it. Of 45 med spas measured, 4 were named at least once and 41 were never named. The three most-named med spas took 98.3% of every mention in the market.
The most-named med spa came up in 24% of answers; the fourth came up in 1%. A short shelf at the top, and a long floor underneath it.
Bar length is the share of all 50 answers, so a full bar would mean every answer named them.
Finding 03
Are the best-reviewed med spas invisible to AI?
Often, yes. Take the 11 strongest med spas in Madera — the top 25% once you combine Google rank, star rating and number of reviews — and 7 were never named by any engine. That is 63.6% of the best med spas in town, missing from every answer.
One of them ranks 5th on Maps with 5.0 stars, and was named zero times across all 50 answers. One of them ranks 11th on Maps with 5.0 stars, and was named zero times across all 50 answers. Their clients rate them highly and Google ranks them well. The AI engines do not know they exist.
Finding 04
Do Google reviews affect whether AI recommends you?
Not measurably. In Madera the med spas AI named average 4.85 stars and the ones it never named average 4.78 — near enough to identical that ratings are clearly not what is deciding it.
4 med spas here were named by at least one engine, rating between 4.6 and 5.0 stars. 40 were named by none, rating between 3.4 and 5.0. The two groups overlap almost completely.
Reviews do real work in the map pack and in how clients choose. This measures something narrower: whether they are what makes an AI say your name. In Madera the answer is what the numbers above say it is, and it is not the same answer in every market we measured.
Finding 05
Do ChatGPT, Gemini and Perplexity recommend the same med spas?
No. Asked the same questions about the same market, the closest any two engines came to agreeing was 50% of themed spas they named — and the furthest apart pair agreed on just 0%.
Each engine surfaced a different slice of the market: Gemini named 6, Perplexity named 5, Google AI Overview named 4, ChatGPT named 1, Claude named 1. Showing up in one does not mean showing up in the others, so checking yourself against a single assistant tells you very little.
| Engine pair | Agreed on |
|---|---|
| Perplexity & Google AI Overview | 50.0% |
| Gemini & Google AI Overview | 42.9% |
| Gemini & Perplexity | 37.5% |
| Claude & Google AI Overview | 25.0% |
| Claude & Perplexity | 20.0% |
| Claude & Gemini | 16.7% |
| ChatGPT & Claude | 0.0% |
| ChatGPT & Gemini | 0.0% |
| ChatGPT & Perplexity | 0.0% |
| ChatGPT & Google AI Overview | 0.0% |
How we measured it
We pulled every Medical Spa / Aesthetics med spa Google Maps returns for Madera — 45 of them, after combining duplicate listings of the same med spa — then asked 5 AI answer engines the same 10 client questions and recorded which ones each engine named.
- Who is in it
- 45 med spas, from everything Google Maps returns for "medical spa" in Madera, CA. A med spa with more than one listing is counted once. 3 listings that share one organization's website are counted as that organization, because AI engines cite the organization's site rather than any individual listing.
- What we asked
- 10 questions a client would actually ask, kept identical across ChatGPT, Claude, Gemini, Perplexity and Google's AI Overview. 50 answers in total, July 2026.
- How we scored it
- The share of answers that named or cited a med spa, weighted by how many people use the engine that named it.
- How we ranked reputation
- Google Maps position, star rating adjusted for how many reviews back it up, and review count on a sliding scale that levels off around a thousand.
- Scope
- One market, one category. Every number on this page describes Madera and comes from that market alone — results differ between markets and we do not carry them across. We never name individual med spas. AI engines change over time; this describes July 2026.
For anyone who wants the statistics
The findings above are counts, which is how most people want to read them. Here are the same relationships as correlations, for readers who prefer them.
| What we measured | How closely it tracked | What that means |
|---|---|---|
| Google Maps rank | −0.417 | A clear connection |
| Review count | −0.06 | No connection |
| Star rating | +0.039 | No connection |
Reading the middle column: 0.0 means the two things had nothing to do with each other. 1.0 would mean they moved together perfectly. A minus sign means they moved in opposite directions. Anything under about 0.2 either way is noise.