Treatment Cost Calculator: Is Cash Pay or Copay Cheaper?

Where your out-of-pocket telehealth costs come from

Telehealth pricing varies widely across providers and facilities based on service type and payment method, and a rough calculator like this one can show likely out-of-pocket costs before care starts. It does not connect to your insurer or to any provider's price list; it multiplies a typical per-visit range for the payment type you choose by the number of visits you expect. Here are some general patterns observed in the industry, and combining them with a broader online therapy decision guide to choose the right route first can make it easier to compare options before you sign up:

Online Therapy

Subscription-based platforms list roughly $57-$120 per week at regular price as of October 22, 2026, for messaging plus scheduled live sessions: BetterHelp $70-$100, Talkspace $69-$109, Calmerry $57-$90, and Online-Therapy.com $60-$120, with messaging-only tiers at the low end. Traditional per-session therapy through telehealth usually falls in the $80-$200 range without insurance, though in-network providers may have copays of $20-$50.

Online Psychiatry

Without insurance, an initial psychiatric evaluation runs about $225-$500 and a follow-up medication management visit about $100-$300, and prices vary by provider and state. Published first-visit and follow-up prices (checked October 24, 2026): Rula $225 and $175, Talkspace $299 and $175, Doctor On Demand $299 and $129, MDLIVE up to $299 and $159, and Blossom Health $300 and $250. Talkiatry's psychiatry cost guide puts an uninsured evaluation at $300-$500 and follow-ups at $100-$300. Some platforms offer membership models that include visits and medication coordination, and many people also compare BetterHelp vs Talkspace costs and features when deciding how subscription pricing stacks up across services.

Insurance Considerations

Coverage for telehealth services has expanded significantly. Many insurers now cover online mental health services similarly to in-person care, but in-network providers accept lower rates under your health plan while out-of-network care can increase out of pocket costs. The allowed amount for specific services is often lower than a provider's standard price. However, coverage varies by plan, and not all platforms accept insurance. Always verify coverage before starting services, ask about available discounts, and find your insurer's cost estimator on the member site for personalized estimates.

Financial Assistance

Many providers and platforms offer sliding scale fees, payment plans, or financial assistance programs for people who have no insurance, or whose plan pays too little of the cost of care. Community mental health centers often provide services on an income-based sliding scale. Clinics usually check household income and family size before they apply a sliding-scale discount, often by asking for a pay stub or tax return, though some accept your own written statement. Federally funded health centers must give a full discount to patients with incomes at or below 100% of the federal poverty level (they may charge a small nominal fee instead) and partial discounts to patients up to 200%, per the HRSA Health Center Program Compliance Manual. Employee Assistance Programs (EAPs) frequently include free short-term counseling sessions and other workplace mental health benefits. Contact the provider to ask what assistance is available.

How to Use This Cost Estimator Tool

This tool gives you a realistic range, not a quote. It does not read your deductible status, coinsurance or out-of-pocket maximum. It asks for four things only: the type of care, how you plan to pay, visits per month and number of months, and it shows a low and a high figure per visit, per month and for the whole period. It is built on the price patterns we track across the telehealth market, but your actual bill depends on your specific plan, the platform's contracts, and the service codes used for each visit. Treat the output as a planning number you can take into a benefits call, not a promise.

1. Pick the right service type first. The first menu offers four kinds of care: online therapy, online psychiatry, life or wellness coaching, and a general telehealth (primary care) visit. Therapy, psychiatry and general telehealth each have a self-pay range per visit, and the ranges overlap: about $80–$200 for therapy, $100–$300 for a psychiatry follow-up, and $50–$150 for a general telehealth visit. Coaching has no range: published coaching prices differ too much by format, from about $33 a text session at Headspace to $249 for a monthly video session at Wholist, so for coaching the tool shows those examples instead of an estimate. There is no combined option, so if you want therapy and medication management together, run the estimate once for therapy and once for psychiatry and add the two totals. If you are unsure, start with therapy-only and add a psychiatry estimate if a clinician later recommends it.
2. Be honest about session frequency. Most ongoing therapy works at weekly or biweekly visits. Medication management often settles at monthly once a regimen is stable. Overestimating frequency inflates the number; underestimating it hides a real cost.
3. Check the range against your own plan. The tool has no field for your copay or coinsurance, so it uses a typical range for each payment type. If you already know your copay, multiply it by your visits per month and compare that figure with the range shown. Your plan's summary of benefits, or the cost estimator on your insurer's member site, is the better source for your own numbers. “Average” coverage numbers are useful for order-of-magnitude thinking but can be off by hundreds of dollars for an individual plan.
4. Compare scenarios, not only one. Run it more than once with different inputs (insurance versus cash pay, four visits a month versus two, therapy alone versus therapy plus a separate psychiatry estimate) and compare the totals side by side.

How to Interpret Your Cost Estimator Result

The number at the top of the result shows estimated out of pocket costs, not a guaranteed price, and final charges can vary from the estimate. Three things cause most of the variation between the low and high end:

• Session length and CPT code. A 45-minute therapy session (CPT 90834) and a 60-minute session (CPT 90837) bill differently and are often reimbursed differently.
• Intake vs. follow-up visits. First visits typically cost more than later ones. The estimator uses one per-visit range for every visit, so add the higher first-visit fee yourself; for psychiatry, the range reflects follow-up visits, and an initial evaluation runs about $225–$500 without insurance, depending on provider and state.
• Platform fees outside the session. Some subscription platforms bundle messaging and live visits; some charge separately. Bundled amounts may include some related services, but separate bills from different providers can still arise. Read the fee schedule before signing up.

Some specific services may not appear, so if you cannot find them in the estimator, verify the details directly.

If the estimated monthly cost is within reach, the next step is usually a short benefits-verification call to the number on your insurance card to confirm coverage for the specific platform and service you are considering. Our telehealth costs and insurance guide has the exact questions to ask.

Common mistakes this tool helps you avoid

• Assuming advertised subscription prices cover psychiatry visits; most subscriptions exclude medication management.
• Forgetting the first-visit premium, which can add 20–50% to month one.
• Counting only the session fee and missing labs, pharmacy charges, or platform service fees.
• Treating your deductible as if it were an annual copay; for high-deductible plans, early-year costs are often much higher than later in the year.
• Comparing in-network and out-of-network plans with the same inputs, even though prices vary across hospitals and different providers based on staffing, technology, equipment, service mix, and care intensity.

Under the federal hospital price transparency rule, a hospital must post prices for at least 300 “shoppable” services in a consumer-friendly format, or offer an online price estimator instead (45 CFR 180.60). That mainly helps when your therapy or psychiatry is billed through a hospital clinic; most app-based telehealth is not.

Some states publish tools built on insurance claims data. Georgia’s Health Cost Transparency and Comparison Tool shows median costs by facility for common procedures, and the Florida Health Price Finder, run by Florida’s Agency for Health Care Administration, shows typical prices for “care bundles,” the set of services usually given for a condition. Neither shows your personal out-of-pocket cost.