Coronary Calcium Scan (CAC) Cost (2026)
Coronary Calcium Scan (CAC) costs $99 - $400 nationally in 2026, with a median of $175. Pricing varies significantly by metro market, provider credentials, and case complexity.
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About Coronary Calcium Scan (CAC)
A coronary artery calcium (CAC) scan is a low-dose computed tomography scan of the heart that measures the amount of calcified atherosclerotic plaque in the coronary arteries. The Agatston score quantifies this calcium, providing one of the strongest individual predictors of future cardiovascular events. CAC scans take 10-15 minutes, expose patients to approximately 1-2 mSv of radiation (similar to a mammogram), and cost $100 to $400 cash-pay. The 2018 ACC/AHA cholesterol guidelines specifically recommend CAC scans for intermediate-risk adults to refine treatment decisions, and major medical centers offer them as cash-pay preventive imaging.
What it is
CAC is a non-invasive CT scan that uses X-rays to detect and quantify calcified plaque in the three main coronary arteries (left anterior descending, left circumflex, and right coronary artery). The result is reported as an Agatston score, ranging from 0 (no detectable calcium) to over 1,000 (very high calcium burden). Higher scores indicate more advanced atherosclerosis and substantially higher future cardiovascular event risk.
Who it is for
CAC scans are most useful for adults at intermediate cardiovascular risk where the decision to start statin therapy is unclear. Best candidates: adults age 40-75 with intermediate risk on traditional calculators (Framingham, ASCVD), individuals with family history of early coronary disease, patients hesitant to start statins, and patients seeking comprehensive cardiovascular preventive screening. Less useful for low-risk young adults (often score 0 without changing management) and very high-risk patients (would be treated regardless of score).
What is typically included
- Pre-scan intake and consent
- Low-dose CT scan (10-15 minutes)
- Radiologist or cardiologist interpretation
- Agatston score report
- Risk percentile comparison to age/sex peers
- Some providers include consultation to discuss results
Procedure snapshot
- Category
- Diagnostics
- Timeline
- 1 day
- Typical recovery
- 0 days
- Financing common
- No
- Evidence level
- FDA-Approved
Cost factors
Hospital vs outpatient imaging center
Outpatient imaging chains often charge $99-$199 cash-pay. Hospital-based imaging can run $300-$600 cash-pay.
Bundled wellness packages
CAC scans are commonly bundled with executive physicals, full-body MRI, or longevity clinic memberships. Bundled pricing typically ranges $500-$2,500.
Geographic market
Major metros run 25-50 percent above mid-tier markets.
Insurance coverage when ordered by physician
Some Medicare Advantage plans and select commercial plans cover CAC when ordered by a physician with documented intermediate risk.
Coronary Calcium Scan (CAC) Cost by City
Median coronary calcium scan (cac) pricing across top US metros.
Frequently asked questions
How much does a coronary calcium scan cost in 2026? +
A cash-pay coronary calcium scan costs $99 to $400 per scan in the United States in 2026, with most outpatient imaging centers priced at $125-$200. Bundled wellness packages including CAC plus other diagnostics run $500-$2,500.
Does insurance cover a coronary calcium scan? +
Some Medicare Advantage plans and select commercial plans cover CAC scans when ordered by a physician with documented intermediate cardiovascular risk. Original Medicare does not cover CAC as routine screening. Most patients pay cash-pay due to broad availability at $100-$200 and the simplicity of bypassing insurance authorization.
What does a coronary calcium score mean? +
The Agatston score quantifies calcified plaque in the coronary arteries. 0 = no detectable calcium (very low cardiovascular risk). 1-99 = mild calcium burden (increased risk). 100-399 = moderate burden (significantly increased risk). 400+ = high burden (substantially increased risk and typically prompts aggressive treatment).
How long does a CAC scan take? +
The actual scan takes 10-15 seconds of imaging time. The full appointment, including intake, positioning, and brief monitoring, takes approximately 15-30 minutes. Results are typically delivered within 1-7 days.
Is a coronary calcium scan worth it? +
For adults age 40-75 at intermediate cardiovascular risk, CAC scans are well-supported by evidence and clinical guidelines to refine statin treatment decisions. For very low-risk young adults or known high-risk patients already on aggressive treatment, the test provides less value. Discuss with your physician whether your risk profile makes CAC appropriate.
What is the radiation dose of a CAC scan? +
Approximately 1-2 mSv per scan. For comparison, a mammogram is approximately 0.4 mSv, a chest X-ray 0.1 mSv, and 6 months of natural background radiation is approximately 1.5 mSv. The radiation dose is considered very low.
Can I have a CAC scan if I have a pacemaker or stent? +
Pacemakers do not interfere with CAC scoring. Existing stents may complicate scoring near the stented area. Discuss with the imaging provider during scheduling.
Should I get a CAC scan every year? +
No. CAC progression over time is slow. Repeat scans are typically considered every 5-10 years, or earlier if a CAC of 0 in someone with strong risk factors warrants reassessment in 3-5 years. Annual repeat scanning is not recommended.
What should I do if my CAC score is high? +
Discuss results with your physician or a cardiologist. Treatment typically involves intensive lifestyle modification, high-intensity statin therapy, and consideration of additional medications (PCSK9 inhibitors, ezetimibe) based on full lipid profile and overall risk.
Can a CAC scan miss heart disease? +
Yes. CAC measures only calcified plaque. Soft (non-calcified) plaque, which is associated with acute heart attacks, is not detected. Symptomatic patients with chest pain, exertional shortness of breath, or other cardiac symptoms should be evaluated separately regardless of CAC score.
Sources
- Detrano R, et al. "Coronary Calcium as a Predictor of Coronary Events in Four Racial or Ethnic Groups." New England Journal of Medicine, 2008. (MESA trial - validation of CAC for risk prediction)
- Grundy SM, et al. "2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol." Circulation, 2018. (Clinical guidelines recommending CAC for intermediate risk)
- SCOT-HEART Investigators. "Coronary CT Angiography and 5-Year Risk of Myocardial Infarction." New England Journal of Medicine, 2018. (Clinical outcomes data)
- Greenland P, et al. "ACCF/AHA 2007 Clinical Expert Consensus Document on Coronary Artery Calcium Scoring." Circulation, 2007. (Foundational ACCF/AHA position)