Calcium Score Test (CAC): Cost and Results

Quick answer

A coronary artery calcium (CAC) scan is a quick CT scan, with no IV or dye, that measures calcified plaque in the heart's arteries. The score shows how much plaque has built up and helps decide whether you need a statin. The 2026 ACC/AHA guideline recommends it for men 40 and older and women 45 and older at borderline or intermediate risk when the result would change treatment.

What is a calcium score test?

You lie on a CT table with small ECG stickers on your chest, and the scan itself takes seconds. There's no IV, no dye and no preparation beyond avoiding caffeine if the imaging center asks. Radiation is low, under 1 mSv with modern scanners.

A radiologist adds up the calcium in your coronary arteries into an Agatston score and compares it with people of the same age and sex (your percentile). It's not the same as a CT angiogram, which uses IV dye to look for narrowing and is used when you have symptoms.

Who should get a calcium score?

The 2026 ACC/AHA dyslipidemia guideline upgraded CAC scoring to its strongest level of recommendation for refining risk. It's recommended for men 40 and older and women 45 and older whose 10-year risk is borderline (3% to under 5%) or intermediate (5% to under 10%) when knowing the score would help decide whether to take a statin.

It's generally not useful if you've already had a heart attack or stroke, or if you're at high risk and clearly need treatment anyway. If you have chest pain or shortness of breath, this screening scan isn't the right test; see a clinician, and call 911 for chest pain.

What your calcium score means

Score	What it means and what's usually recommended
0	No detectable calcified plaque and a low 10-year risk. Holding off on a statin is reasonable unless you have a higher-risk condition such as diabetes, smoking or a strong family history of early heart disease.
1 to 99, below the 75th percentile	Mild plaque. A moderate-intensity statin is recommended.
100 or higher, or at or above the 75th percentile	Significant plaque for your age. Cholesterol-lowering treatment should be started.
300 to 999	Extensive plaque. Stronger treatment is considered.
1,000 or higher	Very extensive plaque. The most intensive treatment, with an LDL goal under 55 mg/dL.

A good calcium score is zero. The percentile matters because the same score means more at 45 than at 70.

What is the treatment for a high calcium score?

Calcium can't be removed, and a high score without symptoms doesn't by itself mean you need a stress test or a stent. Treatment lowers your chance of a heart attack: a statin (often high-intensity) to reach an LDL goal, blood pressure and blood sugar control, no smoking, and regular activity. Some people with high scores and a low bleeding risk are offered low-dose aspirin; that's a case-by-case decision with your clinician.

Can you lower your calcium score? Usually not, and that's okay. Statins stabilize plaque and can make it denser, so the score may rise even as your risk falls. We track your LDL, ApoB and blood pressure rather than the score.

How often should you repeat a calcium score?

If your score is zero, a repeat scan is usually considered after 3 to 7 years depending on your age, sex and risk, toward the shorter end if you have diabetes. If your score is above zero and you're already being treated, repeat scans rarely change the plan.

Calcium score test cost in Texas

Self-pay. A CAC scan in the U.S. usually costs $100 to $400, and the average out-of-pocket cost is about $100 to $150. For self-pay patients, we give you a written all-in price, including the radiologist's read, before you book. Passion Direct Online members get about 20% off self-pay imaging.

With insurance in Texas. Texas law requires many state-regulated health plans to cover up to $200 for either a CAC scan or a carotid ultrasound every five years for men ages 46 to 75 and women ages 56 to 75 who have diabetes or at least intermediate heart risk. Employer self-funded plans aren't required to follow that law, and Original Medicare generally doesn't cover a CAC scan as a screening test. We check your plan before you book.

How it works at Passion Health

Check your risk first. Your labs and a PREVENT risk estimate, usually with the Blood Work + Visit.
Order only when it helps. A Texas-licensed clinician orders the scan if it would change your treatment, and you get the price in writing.
Get scanned nearby. At a partner imaging center in Texas. The report comes back to your clinician.
Get a plan. A results visit by video or in person, with treatment and a recheck date.

Calcium score questions

What is a good calcium score?

Zero. It means no detectable calcified plaque, and holding off on a statin is reasonable unless you have diabetes, smoke or have a strong family history of early heart disease.

Does insurance cover a calcium score test in Texas?

Often, up to $200. Texas law requires many state-regulated plans to cover a CAC scan or carotid ultrasound every five years for men 46 to 75 and women 56 to 75 with diabetes or at least intermediate risk. Self-funded employer plans aren't required to follow that law, and Original Medicare generally doesn't cover it as a screening test.

How is a calcium score test done?

You lie on a CT table with ECG stickers on your chest. The scan takes seconds, needs no IV or dye, and uses a low radiation dose, under 1 mSv.

Is a calcium score the same as a CT angiogram?

No. A calcium score is a quick scan without dye that measures calcified plaque in people without symptoms. A CT angiogram uses IV dye to look for narrowing and is used to evaluate symptoms.

How often should I repeat a calcium score?

If it's zero, usually after 3 to 7 years, toward the shorter end with diabetes. If it's above zero and you're treated, repeat scans rarely change the plan.

Sources

About this guide. Written for Passion Health Primary Care patients in Texas and checked against the sources above. It is education, not a diagnosis; a Texas-licensed clinician interprets your results with your history. Medically reviewed by Anantha Chentha, MD, Co-Founder and Chief Quality Medical Officer, October 30, 2026.

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