Bad news for cost-conscious health care consumers: Maine now tops the list of states with the highest cash prices for COVID telescreenings.

The $55 average cost of an online COVID screening in Maine compared to a national average of $42.10 in September, according to the U.S. Health Care Price Index, compiled by Sesame, a New York-based telemedicine website.

The company said its monthly survey includes thousands of health care providers across the U.S., and found the lowest cash prices in Arizona, where a video-based screening for COVID averaged $36.

The screenings consist of a remote visit with a health care professional to discuss a patient’s symptoms and determine whether the patient should get a COVID test. The cash price is what a doctor or health care provider charges a consumer when insurance or government coverage is not involved in the transaction. That could be because a patient does not have insurance, is underinsured or chooses to pay the provider directly, without involving a middleman.

The average national price for a remote COVID screening fell from $42.36 in August, according to Sesame. For September, Sesame’s website quotes prices for a COVID screening of $16 to $75, depending on the health care professional and the time.

In Maine, local urgent care providers charged prices such as $139 at ClearChoice in Scarborough and $150 at ConvenientMD in Portland.

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Remote, video-based screenings for COVID were highly popular in the early days of the pandemic, when health care providers were flooded with inquiries from worried patients, but in-person diagnosis was difficult.

Since then, remote screenings have remained a popular option for some patients who may have been exposed to the coronavirus. At the same time, marketplace dynamics are driving many health care prices, said Dr. Michael Botta, the co-founder of Sesame.

“By virtue of these marketplace dynamics, where individual clinicians are competing for business, we see price fluctuations on a week-by-week, month-by-month and season-by-season basis – and in Maine, we saw higher-than-average COVID screening pricing last month,” Botta said.

Similar dynamics were also in place at the beginning of the summer, when Maine’s COVID screening prices were the second-highest in the country at an average $82.50, Botta said.

In June, Washington, D.C., had the highest COVID screening prices at $116, while the national average was $43.90, he said.

Maine is a relatively small state in population and also has relatively few clinicians, Botta said. Those factors make the market less competitive, and prices tend to be higher.

The Sesame survey found most prices for health care were actually down slightly, despite the high rate of inflation over the summer.

For instance, the average national price for a primary care telehealth visit dropped 6.1 percent from July to September, according to Sesame. The cost of filling prescriptions and skin consultation appointments also fell.

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