You can't be the price and the mission, even if this place is out of the way and in a not so nice neighborhood.
If you are going to get your pet spayed or neutered you should be ready for the possible itemized billing.
Do you want blood work done before the procedure? How about IV fluids given during the operation? What about additional pain killers for after the surgery?
Be prepared to answer these questions and for some additional spending if you want these things.
The parking lot is a disaster - there are no painted lines so it is up to people parking (the first to arrive) to make this into a nice tight set of parallel cars or a mayhem of double parked crooked cars trying to escape as each person drops off a pet.
Why 4 stars then? Humane Society is doing great work and has a charitable mission. With all the benevolent accomplishments they can blow cigar smoke in my face and i would still give them some stars. They don't do this - instead they are friendly to you and even friendlier to your pet.
They don't see dollar signs when you walk in the door and I really appreciate that. If I want perfection in my experience I would go to some overpriced dog surgery spa, instead this place does a better than average job and also serves your soul.
I apologize for the rant/preach but sometimes Yelp is about find the best place not only by how well a business does but by how good a business is.
P.S. if you forget your vaccinations you can have your vet fax them - you have up to an hour after you drop your pet off to get them these records. I know this from personal experience.