For my area we have several -
the state CVB - no annual fee, just $ for inclusion state tourism guide, free display of rack cards at state welcome centers (close by centers do send customers even though there are 5+ hotels in the area) and free listing with link on their website. (all paid via tourism taxes) The cost is min. and I find it and the centers to be helpful in sending me business.
the regional CVB (Greater Big City) This one costs $$$ and although I know they do a lot of advertising with that money, most is done for the Big city. A lot of the $ is used to send the employees on 'promotional trips' and lobbying at the state level, primarily for the big city, not the subburbs so it is more like being a member of the big city chamber instead of the CVB. (not a member too costly for the value in my area)
my county CVB - no fee. They publish a nice tourism guide with no cost to be included. They also produce a quarterly newspaper with articles, listings of all area attractions, hotels, restaurants and all the events being held during the quarter. This is a nice addition and is used by travelers as well as locals. They have 2 area tourist centers with rack card displays and 'hosts' in each as well as hosts in the 2 State welcome centers that boarder our county. They also have a website with free listings and a request form for future visitors to request the paper publications. At last count they had 15-20 employees and a substantual yearly budget - funded by tourism taxes collected, small % from property taxes, and some from the state level. NOW all this has gotten me only a hand full of guests over the last 7+ years they have doing all this! I do see it changing but there is still too much politics surrounding this CVB at this time. (I could write a book on this but will spare you!)
Then there are the associations - but see there is another thread on that one!.