You can get a heart scan at hospitals, outpatient imaging centers, and preventive cardiology clinics. The right choice depends on the type of scan you need, whether you have a doctor’s order, and how you plan to pay. Most people looking for a heart scan fall into one of two groups: those with symptoms whose doctor has ordered a diagnostic scan, and those without symptoms who want a screening scan to check their risk. Both groups have good options, but the path to getting scanned looks different for each.
Types of Heart Scans and What They Show
Before choosing where to go, it helps to know which scan you actually need. The two most common heart scans use CT technology but serve different purposes.
A coronary calcium score is a quick, low-cost CT scan that measures calcium buildup in the arteries supplying your heart. It takes about 10 minutes, requires no contrast dye, and produces a single number (your calcium score) that estimates your risk of a future heart attack. It’s primarily used for people without symptoms who want to understand their cardiovascular risk. A score of zero suggests low risk, though it’s worth noting that in studies of people with chest pain, about 17% of those with a zero calcium score still had significant blockages found on more detailed testing. So a calcium score is a risk-screening tool, not a definitive diagnostic one.
A CT angiography (CTA) is a more detailed scan that uses contrast dye injected through an IV to produce 3D images of your coronary arteries. It can directly visualize blockages and narrowing. In head-to-head comparisons, CTA correctly identifies coronary artery disease about 81% of the time, compared to roughly 69% for the calcium score alone. CTA is typically ordered when you’re already having symptoms like chest pain or shortness of breath, or when a screening test has raised concerns.
Hospitals and Outpatient Imaging Centers
Hospitals with cardiology departments are the most common location for both types of heart scans. If your doctor orders a diagnostic CTA because of symptoms, it will almost certainly be performed at a hospital outpatient department or a hospital-affiliated imaging center. These facilities have the specialized “cardiac-capable” CT scanners (equipment that can cost over $2 million) and the trained cardiac imaging specialists needed to interpret complex studies.
Independent, freestanding imaging centers also perform heart scans, though the landscape is shifting. Reimbursement pressures and health system consolidation have been moving cardiac imaging away from smaller private practices and toward hospital-outpatient settings. That said, independent centers still exist in many metro areas and can offer competitive pricing, particularly for out-of-pocket scans. The trade-off is that if your scan reveals something serious, a hospital-based center already has the infrastructure for follow-up procedures, while a standalone clinic would need to refer you elsewhere.
Preventive Screening Programs
If you don’t have symptoms and just want to check your heart health, several large medical systems run dedicated preventive cardiovascular screening programs. Northwestern Medicine’s Bluhm Cardiovascular Institute, for example, offers coronary calcium scans as a straightforward out-of-pocket expense through its Preventive Cardiovascular Care Program. Cedars-Sinai in Los Angeles runs a similar program where results are reviewed by an imaging cardiologist and sent to you and your doctor, typically within 72 hours.
These programs are designed to be simple. You schedule the appointment, pay a flat fee (often between $75 and $300 depending on the facility and region), and get your results within a few days. Some programs also include an abdominal ultrasound to check for aortic aneurysms as part of the screening package. Search for “preventive heart screening” or “coronary calcium score” along with your city name to find programs near you.
Do You Need a Doctor’s Referral?
This depends on the scan type and how you’re paying. For insurance-covered diagnostic scans like a CTA, you need a physician’s order. Medicare rules specifically require that diagnostic imaging be ordered by the treating physician who will use the results to manage your care. Private insurers follow similar requirements.
For out-of-pocket screening calcium scans, the rules are more relaxed. Many preventive screening programs will arrange a physician order as part of their intake process, even if you don’t have a referring doctor. Some states allow self-referral for certain imaging services when you’re paying out of pocket. If you’re unsure, call the imaging center directly. Most will walk you through what’s needed.
Insurance and Cost
Screening calcium scans are generally not covered by insurance, including Medicare. Insurers classify them as preventive rather than medically necessary, so you’ll pay out of pocket. The good news is that the price is relatively modest compared to most medical imaging. Many facilities advertise fixed pricing specifically because they know patients are paying directly.
Diagnostic CTAs ordered for symptoms or a known condition are a different story. These are typically covered when ordered by your physician and when medical necessity criteria are met. Coverage requires documentation that the test is being used to diagnose or manage a specific medical problem. Your doctor’s office usually handles the prior authorization process. If you’re getting a CTA at a hospital outpatient department versus a freestanding center, ask about the facility fee, as hospital-based scans historically cost more, though that pricing gap has been narrowing.
How to Find an Accredited Facility
Not all imaging centers maintain the same quality standards. The American College of Radiology (ACR) runs an accreditation program and maintains a searchable online database at acr.org where you can look up facilities by location and imaging type. Accredited facilities have been evaluated for their equipment, staff qualifications, and quality control practices.
Within the ACR system, some facilities earn additional recognition. A “Diagnostic Imaging Center of Excellence” designation means the facility has demonstrated strong infrastructure and consistent quality. Higher tiers, labeled “With Distinction” and “Pinnacle,” reflect progressively stronger performance. While any accredited facility should produce reliable results, these designations can help you compare options when you have several nearby choices.
What to Expect Before the Scan
A calcium score scan requires minimal preparation. You’ll lie still for about 10 minutes while the scanner takes images timed to your heartbeat. No IV, no fasting, no special instructions in most cases.
A CTA is more involved. Because image quality depends on a slow, steady heart rate (ideally below 65 beats per minute), you may be given a medication to temporarily lower your heart rate before the scan. You’ll need to avoid caffeine for at least 12 hours beforehand, since it can raise your heart rate and reduce image quality. Fasting for at least four hours before the scan is standard because contrast dye is injected through an IV. If you take metformin for diabetes, you’ll typically need to stop it for 48 hours after the scan. Your other regular heart medications should be continued as normal.
The scan itself takes 15 to 30 minutes. You’ll feel a warm flush when the contrast dye is injected, which is normal and fades quickly. Results from both types of scans are usually available within 72 hours, delivered to both you and your referring physician as a written report.
Choosing the Right Option for You
If you’re a person in your 40s, 50s, or 60s with risk factors like high cholesterol, high blood pressure, a family history of heart disease, or a long history of smoking, and you want a baseline check, a coronary calcium score at a preventive screening program is the most accessible starting point. It’s fast, inexpensive, and doesn’t require a lengthy referral process.
If you’re having chest pain, unexplained shortness of breath, or other cardiac symptoms, start with your primary care doctor or cardiologist. They’ll determine whether a CTA or another type of cardiac imaging is appropriate and order it through a hospital or accredited imaging center where your insurance can help cover the cost. Trying to self-order a screening scan when you have active symptoms can delay the more comprehensive evaluation you actually need.