From the Guidelines
The average out-of-pocket cost for a CT Coronary Artery Calcium (CAC) test is approximately $75 to $250. This cost range is based on the most recent guidelines from 2023, as reported in the Journal of the American College of Cardiology: Cardiovascular Imaging 1.
Key Points to Consider
- The cost of a CAC test can vary significantly depending on the location and type of facility.
- Some insurance carriers, such as Anthem, UnitedHealthcare, and Aetna, have favorable coverage decisions for CAC tests, while others may not cover it or may require patients to meet their deductible first 1.
- Medicare pays for CAC tests in certain states, and Texas covers CAC scanning by state law.
- For patients without insurance coverage, the cash price for a CAC test can range from $75 to $250, as stated in the 2023 guidelines 1.
Factors Affecting Cost
- Location: Costs can vary depending on the region and type of facility.
- Insurance coverage: The extent of coverage can significantly impact out-of-pocket costs.
- Facility type: Different facilities, such as hospitals or outpatient imaging centers, may charge differently for the same test.
Recommendation
It is essential to contact local imaging centers directly and check with your insurance provider about coverage options before scheduling a CAC test to get an accurate estimate of the out-of-pocket cost. This will help you make an informed decision and plan accordingly. The test itself is quick, non-invasive, and requires minimal preparation, making it a relatively convenient option for assessing heart disease risk 1.
From the Research
Average Out-of-Pocket Cost of a CT CAC Test
The average out-of-pocket cost of a Computed Tomography (CT) Coronary Artery Calcium (CAC) test can vary depending on several factors, including location, insurance coverage, and healthcare provider.
- According to a study published in 2015 2, the average cost of a CTCA (Computed Tomography Coronary Angiography) was estimated to be 180 euros (approximately $200 USD), based on the use of a 64-slice CT scanner active for 10 hours per day.
- Another study published in 2010 3 found that the cost of a coronary CT angiography-only strategy was the least expensive, with an incremental cost-effectiveness ratio (ICER) of $17,516 per correct diagnosis.
- However, it's worth noting that these costs may not reflect the out-of-pocket cost for an individual patient, as they may be influenced by insurance coverage, deductibles, and other factors.
Factors Affecting Out-of-Pocket Cost
Several factors can affect the out-of-pocket cost of a CT CAC test, including:
- Insurance coverage: Patients with insurance coverage may have a lower out-of-pocket cost compared to those without insurance.
- Location: The cost of a CT CAC test can vary depending on the location, with urban areas tend to have higher costs compared to rural areas.
- Healthcare provider: The cost of a CT CAC test can also vary depending on the healthcare provider, with some providers charging more than others.
Cost-Effectiveness of CT CAC Test
The cost-effectiveness of a CT CAC test has been evaluated in several studies, including one published in 2018 4, which found that CAC testing in asymptomatic populations is cost-effective across a broad range of baseline risk.
- Another study published in 2010 3 found that a coronary CT angiography-only strategy demonstrated a favorable ICER of $20,429 per quality-adjusted life-year (QALY) relative to the least expensive coronary CT angiography-first strategy.