The subscription model, priced
BetterHelp, the largest online-therapy subscription, states its cost as $70 to $100 per week without insurance, with an average $23 per-session copay for insurance-eligible members. The subscription includes a weekly live session by video, phone or live chat, plus messaging with your therapist between sessions; you can switch therapists at any time and cancel at any time. Live chat and audio sessions are for members rather than insurance-based users, a detail worth knowing if the messaging formats are the draw. That works out to roughly $280 to $400 per four weeks, before the promotional discounts that are usually running (our affiliate link takes 20% off the first month, which is disclosed wherever it appears on this site).
The per-visit model, priced
Marketplaces sell single visits instead of memberships. Sesame lists telehealth visits from $34 with the cash price displayed before you book and no subscription; therapy and psychiatry visits are priced by the individual clinician, so the floor price is a floor, not a promise. Per-visit works well for an evaluation, medication follow-ups, or therapy at a cadence a weekly subscription does not fit. Our Sesame review covers the mechanics.
What insurance changes
Everything, when it works. A therapist in your plan's network turns the price into your specialist copay, and BetterHelp's insurance-eligible tier prices at an average $23 per session. The friction is supply: in-network therapists with open slots are scarce in much of the country, which is the gap the cash-pay services grew into. Two checks before paying cash anywhere: search your insurer's directory for telehealth therapists (the no-show rate for listed availability is high, so call), and ask any cash-pay service for a superbill, since some plans reimburse out-of-network mental health care.
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BetterHelp Our score 2.4/5
Mental health and therapy
Pricing as of Sep 18, 2026
From $70 to $100/week without insurance; BetterHelp reports an average $23 copay per session with eligible insurance
How to choose
Weekly structure and messaging between sessions favor a subscription. Occasional visits, medication management, or trying therapy for the first time favor per-visit. Severity is its own axis: active crisis, safety concerns or severe symptoms belong with local care or crisis services, not an app queue; call or text 988 any time, free. If you are unsure where you stand, our PHQ-9 and GAD-7 self-tests are the same screeners clinics use, scored the same way, and private. And if a culturally matched clinician matters to you, Black Health keeps a verified directory of Black therapists, searchable by state, specialty and insurance.
Frequently asked questions
How much does online therapy cost without insurance?
The posted numbers as of August 2026: BetterHelp $70 to $100 per week; per-visit marketplaces like Sesame from about $34 for a telehealth visit, with therapy visits priced by the clinician. Promotions frequently lower the first weeks or months.
Is online therapy as effective as in-person?
For common conditions like depression and anxiety, trials of therapist-delivered video treatment have generally found comparable outcomes to in-person care. Fit with the individual therapist predicts more than the medium; both models let you switch.
Does insurance cover BetterHelp?
BetterHelp has an insurance-eligible tier that its FAQ prices at an average $23 per session copay; whether your plan qualifies shows during signup. Note the format difference: insurance-based users may not get the live chat and audio session formats included in cash memberships.
