Actually, you pay more than you were with the $20 therapist. If you see your therapist 50 weeks a year (2 off for "vacation" :-) then the one charging you $20 got $1,000 of your money ($20 x 50 weeks). But if you are paying $750 deductible; at $65 that is gone in 12 weeks, leaving you to pay 38 more weeks at $13 which comes to $494 so your total is $1244 under that plan ($750 + $494). And, you did not mention your premium price, what comes out of your paycheck each month; you have to add that in too.

Generally, a "middleman" cannot be cheaper than one-on-one. Insurance is "in case", so a constant use will always cost more; that's why it is rarely cost effective to buy dental, eye, or other "extra" insurance (which mental health is often too, which is why many companies don't have it or limit it) because not everyone needs it so there is not a big enough group of people paying but not using to cover those using. When we use insurance at companies, especially small companies, the next time the company goes to renegotiate their contract, the price is higher because the cost average was higher. I worked for a company with 30 or so people and the premium would often rise, per employee, a couple hundred dollars a year because someone had had a major emergency costing the "fund" a lot of money. It's based on the statistics and actual use patterns for whatever group you are in. They have to pay the employees, the paper pushers and that adds to the "actual" cost.