A coronary artery calcium (CAC) scan, billed as CPT 75571 and marketed almost everywhere as a “heart scan,” is an unusual item in American healthcare: a test that insurance generally refuses to pay for, which has therefore developed an honest, published cash price. Health systems advertise it on billboards for $49.
That is not a discount you have to negotiate. It is the actual retail market for the scan, and it exists because the alternative is nobody buying it. This guide covers what a calcium score test costs in 2026 across hospital heart-scan programs, imaging centers, and prepaid marketplaces, why the same CT can also generate a $392 charge, and what to check before you book.
What Does a Calcium Score Test Cost Without Insurance?
Figures below are published cash prices as of August 2026 alongside average submitted charges from the CMS Medicare Physician & Other Practitioners file (2024 claims, released May 2026). The scan itself takes 10 to 15 minutes and uses no contrast dye, which is why programs can price it flat.
| Service | Low | Average | High |
|---|---|---|---|
| Heart-scan program flat self-pay price (health system) | $49 | n/a | $140 |
| Freestanding imaging center self-pay scan | n/a | $199 | n/a |
| Cardiac CT calcium scoring, prepaid cash | $48 | $163 | $397 |
| Calcium score test, average cash price by state | $92 | n/a | $130 |
| MDsave estimated national average (before prepaid discount) | n/a | $336 | n/a |
| CPT 75571 in an office setting (average billed charge) | n/a | $392.62 | n/a |
| CPT 75571 in a facility setting (average billed charge) | n/a | $149.66 | n/a |
| CPT 75571, amount Medicare allows in an office setting | n/a | $89.43 | n/a |
Sources: the $49 flat price is published by Advocate Health and by Columbus Regional Health; $140 is Houston Methodist’s heart scan package price; $199 is American Health Imaging’s self-pay rate; prepaid and estimated national figures come from MDsave’s cardiac CT calcium scoring listing; state-level cash prices come from Sidecar Health’s calcium score data, which runs from $92 in Iowa to $130 in Alaska; billed-charge and Medicare-allowed figures are national averages in the CMS 2024 physician file.
Those sources disagree by roughly eightfold, and the disagreement is real rather than a data error. A marketed heart-scan promotion and a diagnostically ordered cardiac CT are two different transactions using the same CPT code. The practical range for someone shopping deliberately is $49 to $199. The practical range for someone who does not shop is $150 to $400.
What Drives the Price
Whether it is sold as a screening promotion
This is the dominant factor. Health systems run calcium scoring as a marketed preventive product with a single advertised number and no add-ons. Advocate Health’s page is explicit that the $49 covers everything and that there are no other fees. Columbus Regional Health prices the same scan at $49 and collects it at the time of service. Houston Methodist bundles the scan and its reading at $140. Bought outside that framing, the same code carries an average submitted charge of $392.62 in office settings according to 2026-released CMS data.
Where you get it
A freestanding imaging center generally lands between the promotional hospitals and the diagnostic price. American Health Imaging charges $199 and describes it as typically less than hospital-based pricing. The prepaid marketplace picture is wider still: MDsave lists $48 to $397 nationally, with an MDsave national average of $163 against an estimated national average of $336 for the same scan bought conventionally.
Whether a referral is required
Programs differ, and the requirement changes your path more than your price. American Health Imaging requires a physician referral. Columbus Regional Health’s $49 scan is open to patients aged 40 to 79 with at least one risk factor and is repeatable once every five years unless a physician orders it sooner. Advocate’s is self-pay only with no insurance billed. Ask which model the program uses before you assume you need an appointment with a doctor first.
Region
Regional variation is modest for this test, which is a sign it has a real market price. Sidecar Health’s cash-price data ranges from $92 in Iowa to $130 in Alaska, a spread of about 40 percent. Compare that to the eightfold spread between settings and it is clear that where you go matters far more than what state you live in.
What else gets attached
Some heart-scan programs upsell into bundles. Houston Methodist’s Heart Scan Plus is $205 and adds vascular screening, its standalone vascular screening is $120, and its CIMT vascular age screening is $120. None of that is the calcium score. If a quoted price is above $200, ask exactly which line items are included.
Cash Price vs. Insurance
For most tests, the advice is to compare the cash price against your plan’s negotiated rate. For a calcium score, that comparison usually does not exist, because there is no covered rate to compare against.
Medicare’s Local Coverage Determination for coronary CT angiography (L35121) states plainly that quantitative calcium scoring is not a covered service and will be denied as not medically necessary, and that a calcium score reported in isolation is considered a screening service. Commercial plans generally track Medicare’s position on this. That is why hospitals sell the scan for cash: Advocate Health tells patients directly that the $49 scan is self-pay only and that the insurance company will not be billed.
The consumer takeaway is unusual and mostly good news. You are not leaving money on the table by paying cash, and you do not need to worry about whether an in-network facility was used. What you should do is confirm before booking that the quoted price is all-in and that nobody will submit a claim on your behalf, because a denied claim can turn a clean $49 transaction into a billing dispute.
One caveat worth knowing: because insurance is not paying, the amount also does not count toward your deductible or out-of-pocket maximum. If you are close to meeting either, that changes the math on other tests but not on this one.
How to Pay Less
- Search for a local heart-scan promotion first. Advocate Health and Columbus Regional Health both publish $49, and similar programs run at health systems nationwide. That is the floor. Check any quote you are handed against our fair price checker before agreeing to it.
- Ask for the flat, all-in self-pay price by name. The phrase that works is “what is your self-pay price for CPT 75571, all in.” Programs that have one will quote it immediately. If the answer involves a facility fee and a separate reading fee, you are being priced as a diagnostic study rather than a screening.
- Compare the imaging center against the hospital. American Health Imaging’s $199 self-pay rate is roughly half the $392.62 average office-setting submitted charge in 2024 CMS data, and it is a single number with no reading fee behind it.
- Buy it prepaid if there is no local promotion. MDsave’s cardiac CT calcium scoring national average is $163 against a $336 estimated national average for the same scan bought the usual way.
- Make sure no claim gets filed. Insurance almost certainly will not pay, and a denied claim can leave you with the full diagnostic charge instead of the promotional price. Say up front that you are paying cash.
- If a hospital bill shows up anyway, work the bill. Pull the hospital’s posted cash rate using our hospital price transparency guide, request an itemized hospital bill, and use our medical bill negotiation guide to get it down to the published self-pay number. For larger balances, check our hospital charity care guide and the charity care checker.
How It Compares to Other Cardiac Tests
At cash prices, the calcium score is one of the cheapest things in cardiology, which is part of why it is marketed so aggressively. A $49 to $199 scan sits below a prepaid Holter monitor at a $215 national average, and well below an echocardiogram or a stress test.
The test it most often accompanies is a standard 12-lead EKG, which runs $20 to $145 as a cash price. Our EKG cost guide covers that one, including why the interpretation frequently arrives as a separate bill. The calcium score does not usually have that problem, precisely because it is sold as a package.
This is a cost guide and not medical guidance. Whether a calcium score is useful for you is a conversation for a clinician. What it should cost, and the fact that you will almost certainly be paying for it yourself, is what this page is for.
Bottom Line
A calcium score test is a $49 to $199 cash purchase if you look for a heart-scan program or an imaging center that publishes a flat rate, and a $150 to $400 charge if you let it be billed as an ordinary diagnostic CT. Insurance is not part of the equation: Medicare’s own coverage policy calls quantitative calcium scoring a non-covered screening service, and most plans follow. Treat it like any other retail purchase, get the all-in price in writing, confirm no claim will be filed, and the transaction stays as simple as the scan itself.