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Most small sites run with the "cheapest" option, but to get high exposure, they have to pay for product placement based on the amount of impressions per hour. The more impressions will equate to more clicks, but in the long run it could be cheaper. It's generally used to get people to just see your banner, but not actually click on it. If the intent is a click, such as for campaign donations, you pay accordingly and that begins to cost a boat load, especially if they show up on premier sites or during prime-time windows.
While the source website might see pennies on an impression, the ad service (Google AdWords, Yahoo Ads, Facebook, etc.) is charging a shitload, almost like how the recording industry charges 99 cents for a song download and the artist sees a penny. The campaign is still paying out a shitload of money.
The misconception is that people continue to click on a link, multiple times a day, thinking that they are hammering an advertiser. In reality, whether you click once or twenty times, at the end of the day, only one click per IP address is counted. That means you can click on the same ad, but it has to be 24+ hours after the last click to get the second charge counted.
Also, to ensure countage, you will need to make sure the landing page completely loads, and then click one link below that. Some sites/ad services weed out false clicks by ensuring that the viewer actually "visits" the site, and does something beyond seeing the landing page.
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