Coronary Calcium Score Test: Cost and What Your Score Means
Quick answer: a coronary calcium score is a quick CT scan of the heart, with no injection, that measures hardened (calcified) plaque in the arteries that feed the heart. A score of 0 means no calcified plaque was seen; 1 to 10 is minimal, 11 to 100 mild, 101 to 400 moderate and over 400 extensive. It takes under 20 minutes and usually costs about $100 to $400 out of pocket, because many insurance plans do not cover it. It is most useful for adults whose heart risk is borderline or intermediate, to help decide about cholesterol-lowering medication.
It is one of the simplest scans I do: a few stickers on the chest, a short breath-hold and you are done. The result, a single number, can change how you and your doctor approach your heart health.
What is a coronary calcium score?
Plaque, a build-up of fat and other substances in the artery wall, can harden with calcium over time. That calcium is a marker of coronary artery disease, which raises the risk of heart attack. A cardiac CT scan detects this calcium and reports it as a number: the calcium score (also called a coronary artery calcium or CAC score, or simply a «heart scan»).
Who should consider it?
Your doctor first estimates your 10-year risk of heart attack or stroke with a risk calculator that uses your age, blood pressure, cholesterol and other information. The calcium score is most useful when that estimate falls in the middle and it is not clear whether you would benefit from cholesterol-lowering medicine. Current national guidelines suggest considering the test for men aged 40 and older and women aged 45 and older whose estimated risk is borderline or intermediate.
The major risk factors it helps put in context include high cholesterol, family history of heart attacks, diabetes, high blood pressure, smoking, excess weight and physical inactivity.
It is a test for people without symptoms. If you have chest pain or shortness of breath, see a doctor promptly; other tests are used to evaluate symptoms.
What your score means
| Calcium score | What it suggests |
|---|---|
| 0 | No evidence of coronary artery disease |
| 1 to 10 | Minimal evidence |
| 11 to 100 | Mild evidence |
| 101 to 400 | Moderate evidence |
| Over 400 | Extensive evidence |
A score of 0 means no calcified plaque was seen. The chance of a heart attack in the next two to five years is very low, and a zero may support delaying cholesterol-lowering medicine in some people.
Any score above 0 means coronary artery disease is present, even without symptoms. Under current guidelines, finding any calcium generally supports treating cholesterol to a lower target, and an even lower target when there is more calcium. A high score may support starting medication.
Your score is one part of your overall risk picture. Your doctor will interpret it together with your other risk factors; do not start or stop any medication based on the number alone.
From the scanner room: [TU EXPERIENCIA: qué preguntan los pacientes al salir de la prueba, cómo reaccionan cuando ven «puntuación 0» o un número alto, y qué les dices (sin interpretar su caso).]
How to prepare
- Do not eat or drink, and avoid caffeine and smoking, for four hours before the exam.
- Wear loose clothing without metal; you may change into a gown.
- Tell the team if you might be pregnant.
A high heart rate can affect the image quality, which is one reason to avoid caffeine.
What the test is like
- Small sticky electrodes are placed on your chest so the scanner can time the images to your heartbeat.
- You lie on your back on the CT table.
- You hold your breath for a few seconds while the scan is taken.
- No injection or contrast is needed.
The exam takes less than 20 minutes, and you can return to your normal activities immediately. For the general CT walkthrough, see [link: What to Expect During a CT Scan].
How much does a calcium score test cost?
Paying out of pocket, a coronary calcium scan typically costs about $100 to $400, depending on the location and facility, and many people find prices around $100 to $150 after comparing. Many insurance plans do not cover it, often because the U.S. Preventive Services Task Force has found the evidence insufficient to recommend it as a routine screening test.
States with coverage laws. A handful of states require some insurance coverage, for example:
- Texas: covered plans must pay up to $200 for one heart screening test (a calcium score CT or carotid ultrasound) every 5 years, with exceptions by plan type.
- New Mexico: large health plans must cover the test for most adults aged 45 to 65.
- Oregon: plans issued or renewed from January 1, 2026, must cover the scan for people aged 40 and older when ordered by a licensed provider.
- Connecticut: a 2025 law requires insurers to cover coronary calcium scans.
Employer self-funded plans may not have to follow state mandates, so always ask your plan. A calcium score is usually an eligible expense for a Health Savings Account (HSA). More on costs in [link: How to Get a Cheaper MRI: 9 Ways to Lower the Bill], many of which also apply to CT.
Limitations and risks
- Soft plaque is not measured. The score only counts calcified plaque. Especially in people under 50, plaque without calcium can be present and missed. A score also does not show whether an artery is narrowed.
- Radiation: it uses a small dose of x-rays. See [link: How Much Radiation Is in a CT Scan?].
- Follow-up tests: a high score may lead to further heart tests, which may or may not be useful and can have side effects.
- Not in pregnancy unless medically necessary.
Tips from the technologist
[TU EXPERIENCIA: 2-3 consejos propios. Ideas: nada de café esa mañana, ropa sin metal en el pecho, respirar tranquilo para bajar el pulso antes del escáner.]
Frequently asked questions
What does a calcium score of 0 mean?
No calcified plaque was detected. The short-term risk of a heart attack is very low, but it does not rule out soft plaque, and your doctor will consider your other risk factors.
Is a calcium score of 100 bad?
A score between 11 and 100 is graded as mild evidence of coronary artery disease, and 101 to 400 as moderate. What it means for you depends on your age and other risk factors; your doctor will explain.
Does Medicare cover a calcium score test?
Generally not when it is done purely as a screening test for risk assessment. Check with your plan.
Do I need a doctor’s referral?
Many imaging centers let you book and pay for the scan yourself, but it is best done with a doctor who can interpret the result in context.
How often should I repeat the test?
There is no single rule. Your doctor may suggest repeating it after several years in some cases, especially if your first score was 0.
This article is for general information and does not replace advice from your doctor. Do not start or stop medication without medical advice.
Sources
- RadiologyInfo.org (ACR and RSNA): Cardiac CT for Calcium Scoring
- Healthline: Coronary calcium scan cost
- Mito Health: Calcium score test cost and the Texas coverage law (October 2026)
- Legal Clarity: Why insurance doesn’t cover coronary calcium scans
- UNM Health Sciences: New Mexico coverage for coronary artery calcium screening
- Oregon Legislature: SB 56 measure analysis
- Connecticut House Democrats: coronary calcium scan coverage