How Much Does Therapy Cost? Prices With And Without Insurance

Without insurance, in-person sessions typically cost around $100–$350 each, and one 2024 study found an average listed self-pay rate of about $143.

For online therapy with insurance, BetterHelp is in network with most major health plans including United, Cigna, Aetna, and more. With insurance, many members pay $15 or less. Some pay $0.

The price you pay can vary widely depending on your location, the type of provider you see, and whether you have insurance coverage. For many people, cost can feel like a barrier to starting therapy. Understanding your options may help you find support that fits your budget.

Below, explore typical therapy costs, insurance basics, pricing factors, and lower-cost options.

BetterHelp insurance availability, coverage, and cost may vary by state, plan, provider network, therapist availability, and deductible status.

How much does therapy cost without insurance?

Without insurance, in-person therapy typically costs around $100–$350 per session. A 2024 study of about 175,000 U.S. therapists' listed rates found an average self-pay rate of about $143 per session. Your actual price may vary based on where you live, who you see, and how often you meet.

In-person therapy may cost more than online therapy, depending on the provider, in part because in-person providers may have office costs that online care doesn't. The table below compares common ways to pay for therapy.

Hidden costs of in-person therapy

A quoted rate of $150 or $200 per session may not reflect everything you'll actually spend. Here are some expenses that often go unaccounted for:

• Travel time and transportation: A 45-minute session can take extra time once you factor in commuting, parking, or transit. For some people, that may require taking time off work or arranging for childcare.
• Cancellation fees: Some therapists charge for late cancellations or missed sessions, so it can help to ask about the policy before your first visit.
• Waitlist delays: In some areas, it may take a while to get a first appointment with a new therapist. Delayed care can mean delayed relief and sometimes more intensive treatment down the line.
• Location premiums: Living in a high-cost city may put you at the higher end of the range. Rural residents may face long drives or limited provider options that create their own financial and logistical burdens.

Online therapy may help reduce many of these hidden costs, since there's no commute and no parking fee. Understanding what insurance covers can also help reduce your overall expenses.

How much does therapy cost with insurance?

With insurance, how much therapy costs depends on your plan's deductible, your copay or coinsurance, and whether your therapist is in-network. According to the American Psychiatric Association, federal law requires that mental health services be covered similarly to other medical care in most cases. Your plan's Summary of Benefits can show your outpatient mental health costs.

Many insurance plans cover mental health services, though the extent of coverage can vary. Contacting your insurance provider before starting therapy may help you plan.

If you're comparing benefits during open enrollment, a guide to choosing a plan for mental health care can walk you through what to look for.

In-network vs. out-of-network therapists

If your plan includes mental health coverage, an in-network therapist may come with lower out-of-pocket costs. The term "in-network" means your insurance carrier has a contract with specific providers that sets the rates for their services. HealthCare.gov notes that in-network copayments are usually less than out-of-network copayments.

Some out-of-network therapists may still work with your insurance, though their services may cost more. You can also ask about the option to "self-pay," which means paying the provider directly without using insurance.

How deductibles, copays, and coinsurance work

Based on HealthCare.gov definitions, here's the order in which these costs often apply during a plan year:

1. Before you meet your deductible, you may pay the full allowed amount for each therapy session.
2. Once you meet your deductible, your plan begins to pay part of the cost of covered sessions.
3. You may then owe a copay, which is a fixed amount you pay for each covered visit.
4. Some plans use coinsurance instead, which is a percentage of the allowed amount, such as 20%.
5. If your costs reach your plan's out-of-pocket maximum, your plan may pay for covered services for the rest of the plan year.

Some plans also set limits on covered sessions or require pre-authorization. And public programs follow their own cost rules, which can be helpful to know if you're 65 or older or have a lower income.

Does Medicare or Medicaid cover therapy?

Original Medicare Part B covers individual and group psychotherapy with eligible providers. According to Medicare.gov's page on outpatient mental health care, you typically pay 20% of the Medicare-approved amount after you meet the Part B deductible. Eligible providers can include clinical psychologists, clinical social workers, marriage and family therapists, and mental health counselors.

Medicare.gov lists telehealth as one setting for these services, so it may help to learn about Medicare coverage for online therapy.

Why some therapists don't accept insurance

In the same 2024 study, about one-third of independent-practice therapists took no insurance at all, and rates of acceptance varied widely by state. This may be due to lower reimbursement rates, administrative work, and a wish for more control over their practice.

If you find a therapist you'd like to work with who doesn't take insurance, you might ask about sliding-scale fees or other payment options. Online therapy offers another path, and insurance may play a role there too.

Can you use insurance for online therapy?

You may be able to use insurance for online therapy, depending on your plan and the providers available in your state. BetterHelp accepts insurance and is in-network with most major health plans. With insurance, many members pay as little as $15. Some pay $0. You can check to see if your insurance covers online therapy by answering a short quiz tailored to your preferences and goals for therapy. 

BetterHelp also accepts HSA and FSA cards and is recognized as an eligible expense by most HSA and FSA providers. When using insurance, certain BetterHelp features may be limited or unavailable, including chat-based sessions, groups/classes, and select self-help tools.

What factors influence the cost of therapy?

Therapy costs may depend on the type of therapy, your location, and the therapist's credentials. Session length, frequency, and format can also play a role, along with insurance and financial aid. 

The Health Resources and Services Administration (HRSA) designates mental health shortage areas across the U.S., and you can search by address. The table below summarizes how each factor may affect cost.

Type of therapy (individual, couples, group)

The format of care can play a major role in pricing. Couples sessions may cost more because they can run longer and involve two people, and you can learn more about couples therapy costs separately.

Location and cost of living

Sessions in higher-cost metro areas may cost more. Rural residents may face other barriers, such as travel distance and fewer nearby providers.

Therapist credentials and experience

Education, training, and years in practice can also shape session prices. For instance, a master's-level marriage and family therapist may charge less than a doctoral-level psychologist who specializes in complex conditions.

If you're comparing therapists and psychiatrists, it may help to understand the cost of seeing a psychiatrist.

Session frequency and length

How often you meet may affect the total cost of care. Someone attending 50-minute sessions twice a week may pay more than someone attending one 30- or 45-minute session each week or twice a month.

As an illustration, weekly sessions at about $143 each could come to roughly $570–$720 per month, depending on whether there are four or five sessions. Your therapist can help you estimate how many sessions you may need.

These factors can explain why prices vary, but they don't fully answer why therapy can feel so costly.

Why is therapy so expensive?

Therapy can be expensive because of low insurance reimbursement, a shortage of mental health providers, and the recurring nature of care. Each of these factors can push providers toward self-pay rates. Understanding the reasons may make it easier to look for options that fit your budget.

The authors of the 2024 Health Affairs Scholar study suggest several reasons prices may stay high:

• Low reimbursement: Medicaid rates averaged about $83 per session, compared with about $143 for self-pay rates in the same study.
• Insurance deterrents: A 2015 American Psychological Association survey, cited in the study, found low reimbursement was the main reason psychologists didn't accept insurance.
• Provider shortages: The authors argue that too few providers, spread unevenly, may let therapists stay out of networks and charge more.
• Recurring visits: Psychotherapy often involves repeated visits over a long period, so costs can add up.

A session fee may also reflect work outside the session, such as notes and treatment planning.

Knowing why therapy can cost more may make the options below feel more useful.

What are affordable therapy options?

Affordable therapy options may include sliding-scale fees, community health centers, employee assistance programs, and university training clinics. Therapy groups, HSA or FSA funds, and online therapy with financial aid may also lower what you pay. The sections below explain how each one may work.

If paying full price isn't an option right now, there are several paths to affordable therapy without insurance. Options to consider include:

• Joining therapy groups, where costs are split among participants
• Asking local providers about sliding-scale rates
• Looking into community health centers
• Checking employer benefits for an EAP
• Exploring university or training clinics
• Using HSA or FSA funds
• Trying online therapy with financial aid options

Sliding-scale fees

Income-based rates allow some therapists to offer lower prices to clients who might not otherwise afford care. It can help to learn how sliding-scale therapy works.

Being upfront about your budget can help you find a provider who works with your financial situation.

Community mental health clinics

Local clinics may offer free or discounted services and other health resources to residents. You can ask whether counseling is offered at a nearby site.

These clinics can be a helpful starting point for low-cost counseling, even if you're paying out of pocket.

Employee assistance programs (EAPs)

Your workplace may offer support you haven't used yet. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), employee assistance programs usually offer assessments, referrals to treatment, and short-term counseling.

EAPs may include a limited number of short-term counseling sessions, and the number can vary by employer. Your HR or benefits team can tell you what your plan includes.

University and training clinics

Campus clinics and training centers may offer free or low-cost therapy from supervised counseling students or therapists-in-training. These sessions often involve supervision by licensed professionals, so it can help to ask how a clinic's program is set up.

Can you use an HSA or FSA for therapy, and is it tax deductible?

You may be able to use HSA or FSA funds for therapy, and therapy costs may be tax deductible in some cases. In IRS Publication 502, the IRS lists therapy as a medical expense when it's received as medical treatment. Rules can vary, so your plan administrator or a tax professional can confirm what applies to you.

Flexible spending accounts (FSAs) and health savings accounts (HSAs) let you pay for eligible healthcare costs with tax-advantaged funds. FSA eligibility may depend on your employer's plan. BetterHelp accepts FSA and HSA cards, which can make it easier to use these benefits for mental health care.

Tax deductions follow separate rules. If you itemize, you may be able to deduct unreimbursed medical costs, including therapy, above 7.5% of your adjusted gross income. Amounts paid from an HSA or reimbursed by an FSA or insurance can't be deducted.

For a closer look at the requirements, read more about deducting therapy on your taxes. HSA and FSA funds may also apply to online therapy, which raises the question of how its pricing compares.

How much does online therapy cost?

Online therapy may be priced per session or as a subscription, and BetterHelp subscriptions typically cost $70–$100 per week, billed every four weeks. Pricing may depend on your location, referral source, preferences, therapist availability, and any discounts or promotions. Financial aid may be available to those who qualify.

Most in-person therapists charge per session, so each appointment is billed separately. A subscription bundles live sessions and extra tools into one recurring rate. Understanding how payments work for online therapy may help you compare the two.

A BetterHelp subscription typically includes:

• One live 30- or 45-minute session per week with a licensed therapist
• In-app messaging between sessions, with therapists responding as soon as they can
• Digital worksheets and guided journaling for self-reflection
• Group sessions focused on education
• Classes covering a range of mental health topics
• The option to switch therapists at no extra cost

Online therapy may offer real advantages if you're weighing the cost and logistics of care. Without a commute, you may save money on transportation and avoid taking time off work. BetterHelp has a network of 30,000+ licensed therapists, and most people are matched within 24–48 hours.