The subscription model, priced
BetterHelp, the largest online-therapy subscription, states its cost as $70 to $100 per week without insurance, billed every four weeks, 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 30% off the first six months, 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.
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.
Frequently asked questions
How much does online therapy cost without insurance?
The posted numbers as of August 2026: BetterHelp $70 to $100 per week billed every four weeks; 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.
