Agencies will typically be the most expensive; independent providers will be the least expensive. However, home care agencies are also easier to use, since the agency finds and places the provider, handles payroll and any problems that may arise, and usually provides coverage for sick or absent providers. Agencies that are licensed and bonded are generally a good choice, although there are always exceptions. You have avenues of recourse (complaints, legal action) when dealing with agencies that are liable for problems. There is no real recourse (except firing) when dealing with independent providers or ones found through registries.