Explore next steps to improve your mental health. 
We all know therapy can change lives. Perhaps couples therapy saved your sister’s marriage or a friend learned to manage their anxiety after working with a therapist. Yet when it’s your turn to book a session, you freeze, wondering if you can actually afford therapy.
Realizing you have no idea what therapy will actually cost is all too common, but “don’t let uncertainty with your insurance benefits or coverage get in the way of seeking support,” says Kim Rippy, MA, LPC, a trauma and anxiety therapist in Virginia. Learning about payment options and true costs gives someone “the best opportunity to receive the high-quality care they need and deserve,” she says.
In this guide, we’ll walk you through everything you need to know about therapy costs, from national averages and state-by-state breakdowns to the specific factors that influence pricing and how to make therapy more affordable.
What’s the Average Cost of Therapy?
Therapy costs an average of $143.26 per session without insurance, according to a comprehensive 2024 study that analyzed data from more than 175,000 private practice therapists.
What about with insurance? Most Medicaid plans cover therapy with minimal or no copays, and Medicare covers 80 percent of a session cost. The cost with private insurance is harder to predict, with some people paying $0 per session and others paying the entire cost until they’ve met their deductible.
| Insurance Type | Average Price Per Session |
|---|---|
| Self-pay | $143.26 |
| Medicaid | Minimal or no copay |
| Medicare | $28.65 |
| Private insurance | Depends on plan |
While these averages give you a starting point, your actual costs will depend on several important factors. Let’s break down what influences therapy pricing so you can get a clearer picture of what to expect.
Factors That Influence Therapy Costs
Insurance coverage is just one piece of the puzzle. What you’ll actually pay depends on many factors, from the provider and service type, your state, session length, and more.
Type of Provider
You may have noticed that mental health providers can have many different titles: therapists, counselors, psychologists, psychiatrists, and psychiatric nurse practitioners. These titles may influence what you’ll be charged.
“A medical doctor or a psychiatrist is usually the most expensive,” says Amy Pearlman, MSW, LICSW, senior vice president of clinical strategy at Thriveworks. On the other end of the affordability range are therapists or counselors with a master’s degree, not a doctorate. These providers tend to be the most affordable for those paying completely out-of-pocket as well as those with a coinsurance.
“If you have a coinsurance, you are paying a percentage of your visit,” Pearlman explains. “Therefore you would pay more to see a doctorate-level therapist than you would to see a master’s-level therapist.”
Specialized Services
The previously mentioned $143 average cost per session only applies to standard talk therapy, such as cognitive behavioral therapy or psychotherapy. But there are many different types of specialized mental healthcare treatments, and some come with a higher price point than others.
Specialized approaches such as EMDR, dialectical behavior therapy (DBT), and family therapy often come at higher rates due to the extra training and certification required. These treatments typically cost more because therapists need additional specialized education and credentials beyond basic therapy training.
Size of Provider
Larger therapy practices and platforms often offer more financial flexibility than solo practitioners. If a therapist works independently and sees 100 patients per month, they’re more likely to feel the financial burden of offering payment plans or sliding scale fees than a therapy group that sees more than 10,000 people per month.
Larger providers also tend to be in-network with more insurance companies, meaning there’s a higher likelihood they accept your specific insurance plan. “Mental health care is almost always covered. It’s just a matter of whether the provider is in-network with your plan,” says Charity Minerva, vice president of strategy at Thriveworks. For example, Thriveworks is in-network with more than 360 insurance plans nationwide.
Your State
Location doesn’t just matter in real estate; it impacts the cost of everything, including therapy. That’s because therapists in states with higher costs of living also face significantly higher overhead expenses for office space and basic living costs.
But it’s not just about cost of living: Provider availability is often the bigger factor. States with fewer mental health professionals per capita tend to have higher rates, creating “therapy deserts” where care exists, but only at premium prices.
States with Highest Therapy Costs:
| State | Average Cost Per Session |
|---|---|
| North Dakota | $227 |
| Alaska | $212 |
| South Dakota | $192 |
| Washington D.C. | $189 |
| Arkansas | $184 |
| Oregon | $182 |
| Nebraska | $180 |
| Mississippi | $179 |
| Minnesota | $176 |
| New York | $176 |
States with Lowest Therapy Costs:
| State | Average Cost Per Session |
|---|---|
| Missouri | $122 |
| Louisiana | $123 |
| South Carolina | $123 |
| Vermont | $126 |
| Tennessee | $126 |
| Oklahoma | $129 |
| Texas | $131 |
| Indiana | $132 |
| Nevada | $134 |
| Florida | $135 |
Surprisingly, the highest costs aren’t always in expensive metropolitan areas. States like North Dakota and South Dakota top the list primarily due to provider scarcity. North Dakota has only one psychologist per 4,900 citizens compared to New York’s one per 2,690 citizens. When mental health professionals are scarce, session rates climb substantially.
Session Length and Frequency
Shorter and/or less frequent sessions are often more affordable, but there’s an important tradeoff to consider. Just like learning any new skill, developing coping strategies and processing difficult emotions takes time and practice. Consistent sessions with enough time to explore your thoughts and feelings typically lead to more meaningful progress.
The good news? There is a middle ground. Pearlman recommends clients who opt for shorter and/or less frequent meetings ask for homework between sessions. If someone is struggling with anger issues, for example, their therapist may recommend a deep breathing exercise between sessions or an exercise to set better boundaries.
Your Employer
We all know some employers offer better health insurance than others. Your brother may rave about $20 copays with his employer-sponsored insurance plan, while you’re stuck paying $80 per session. But your job may also offer free therapy sessions, separate from insurance, through an employee assistance program (EAP).
An EAP is a confidential benefit that many employers provide to help employees deal with personal problems that might impact their work performance, health, and well-being. These programs typically offer a limited number of free counseling sessions per year—often three to eight sessions—at no cost to you.
To find out if your employer offers an EAP, check your employee handbook, benefits materials, or ask your human resources department directly, Minerva says. Some companies also include EAP information on employee ID cards or benefits portals.
When using an EAP, make sure to let the therapist know so they don’t bill your insurance provider by mistake.
Therapy Costs With Insurance vs Without Insurance
Without insurance: You’ll pay the full session cost upfront. Some therapists offer sliding scale fees based on income, and some accept payment plans to make sessions more manageable.
With insurance: Your costs depend on your plan’s structure:
- Copay plans: Fixed amount per session (typically $0 to $55)
- Deductible plans: Full cost until deductible is met, then reduced rates
- Coinsurance plans: You pay a percentage after deductible (typically 20 to 40 percent)
To find out exactly what your plan covers, call the number on your insurance card and ask these questions:
- What’s my copay for mental health visits?
- Do I need to meet my deductible first?
- Is my preferred therapist in-network or out-of-network?
- How many sessions are covered per year?
- Do I need a referral from my primary care doctor?
Many mental health clinics and platforms can help you figure out your out-of-pocket costs upfront. At Thriveworks, for example, we offer a pricing calculator that provides estimates based on your payment method and insurance plan. “Our team is also available to help verify your coverage and find a provider who accepts your insurance,” Minerva says. “For those without insurance or who choose not to use it, we offer transparent self-pay rates so you’ll know exactly what you’ll be responsible for.”
Is Therapy Worth the Cost?
Whether therapy is worth the cost is deeply personal and depends on your specific situation and goals. However the outcomes are encouraging: Thriveworks data shows that nearly nine out of 10 people (87 percent) experience meaningful improvements from therapy. Maybe that means you feel more confident in your daily interactions, experience greater emotional stability, or you and your partner can navigate difficult conversations with more understanding and less conflict.
Over time those small improvements add up, changing how we view and react to the world around us. “Therapy teaches us how to take care of ourselves,” Pearlman says. “It doesn’t change the things that come up in our lives, but it changes the way we respond.”
Frequently Asked Questions
Is online therapy cheaper than in-person therapy?
Online and in-person therapy are usually the same price. That said, online therapy opens up the chance to work with all therapists licensed in your state, not just ones within your geographical area, which may help you find more affordable providers.
How do I find out if therapy is covered by my plan?
Check your insurance plan’s summary of benefits or call the number on the back of your insurance card. Most individual and small group plans must cover mental health services under the Affordable Care Act. How much you’ll pay depends on your specific plan’s copays, deductibles, and whether your therapist is in-network.
