Both Cardio Res-Q assessments include the same clinical evaluation with Dr. Varano, the same advanced labs and the same personalized heart protection plan. The Comprehensive Assessment costs $775. The Enhanced Assessment costs $999 and adds two imaging studies: a CIMT ultrasound of the neck arteries and a coronary artery calcium (CAC) score.
So the choice comes down to one question: do you want imaging now, and would the result change what you do? If you already have a recent calcium score, or you are young enough that a zero is the expected answer, Comprehensive is often enough. If you are over 40 with a family history or metabolic risk and have never had a scan, Enhanced gives the fuller baseline.
Key takeaways
- Both assessments include the same clinical evaluation, advanced labs and personalized plan.
- Enhanced costs $999 against $775 and adds a CIMT ultrasound and a coronary calcium score.
- The calcium scan is billed separately at an outside facility, typically $100 to $200.
- Comprehensive is often enough if you have a recent calcium score, are a younger adult, or the result would not change your plan.
- Both scans have limits, and CIMT should not decide your treatment by itself.
The two assessments side by side
| What is included | Comprehensive ($775) | Enhanced ($999) |
|---|---|---|
| Clinical evaluation with Dr. Varano | Yes | Yes |
| ApoB and Lp(a) | Yes | Yes |
| hs-CRP and homocysteine | Yes | Yes |
| Insulin, glucose and A1c | Yes | Yes |
| Cleveland Heart cardiac panel | Yes | Yes |
| Lifestyle and risk evaluation | Yes | Yes |
| Personalized heart protection plan | Yes | Yes |
| CIMT ultrasound | No | Yes |
| Coronary calcium (CAC) score | No | Yes, ordered by your provider and done at an outside imaging facility |
| Extra cost to expect | None listed | The CAC scan is a separate self-pay study, typically $100 to $200 |
Both are one-time, direct-pay assessments. They are not billed to insurance. You are welcome to try an HSA or FSA card, but the clinic cannot confirm it will be accepted and does not provide insurance reimbursement forms.
What the imaging adds
Blood tests describe the conditions inside your arteries: how many plaque-forming particles are circulating, how much inflammation is present, how well you handle sugar. Imaging looks at the artery itself.
A coronary calcium score is a quick CT scan of the heart with no injection and no contrast dye. It measures calcified plaque in the heart arteries. A CIMT ultrasound is a painless scan of the carotid arteries in the neck that measures wall thickness and can show early plaque. It uses no radiation.
The calcium score is the stronger of the two for decisions. Current US lipid guidance says a score of zero supports holding off on drug therapy and rescanning in three to seven years, unless you have diabetes, smoke, or have familial hypercholesterolemia or a strong family history.1
Two things to know before you pay for Enhanced
The CAC scan is billed separately. It is performed at an imaging facility outside our office. Your provider orders it, and you find and schedule a local imaging center yourself. It is typically a self-pay study of $100 to $200 on top of the $999. Plan on a realistic total of about $1,100 to $1,200.
CIMT has real evidence limits. The 2013 ACC/AHA risk assessment guideline does not recommend routine CIMT measurement for predicting a first heart event.2 A meta-analysis found that carotid plaque predicts coronary events more accurately than wall thickness does.3 In this program CIMT is used as a visual baseline and a way to follow the arteries over time. It should not be the test that decides your treatment on its own.
The calcium score has limits too. A calcium scan cannot see plaque that has not calcified yet.4 The scan uses a small dose of radiation, averaging about 1 to 1.5 millisieverts.5 And the US Preventive Services Task Force found the evidence insufficient to judge the balance of benefit and harm of adding a calcium score to traditional risk assessment in adults without symptoms.6
Who tends to choose Enhanced
At our clinic, most patients over 40, or those with a family history or metabolic risk factors, choose the Enhanced Assessment. It tends to fit if:
- You are over 40 and have never had a calcium score.
- A parent or sibling had early heart disease.
- You have diabetes, insulin resistance, high blood pressure or high cholesterol.
- You and your doctor are undecided about starting medication, and a scan result would tip the decision.
- You want a starting picture to compare against in later years.
When Comprehensive is enough
The $775 assessment is the better choice more often than people expect. Consider it if:
- You already have a recent calcium score. Bring the report. The clinic accepts calcium scores done elsewhere. Calcium changes slowly, and the scan is typically repeated about once every five years, so paying for it again soon adds little.
- You are a younger adult. A zero is the expected result at younger ages, so the scan is less likely to tell you something new. The labs, including inherited markers such as Lp(a), are where the useful information usually is.
- You already have known heart disease. After a stent, a heart attack or bypass surgery, the question of whether you have plaque is already answered. Your cardiologist leads your care, so ask them before paying for more imaging.
- The result would not change your plan. If you are already treated and would not do anything differently, imaging is optional.
You do not lose the imaging option by starting with Comprehensive. If your labs or history point toward a scan, ask our team how it can be arranged afterward.
How to book
You can book either one online: book the Comprehensive Assessment ($775) or book the Enhanced Assessment ($999). The full program details and a three-question risk screener are on the Cardio Res-Q program page.
Plan to fast for 10 to 12 hours before your labs. Ongoing care after the assessment is optional. If you have chest pain, shortness of breath or other symptoms now, do not book a screening assessment. See your doctor or a cardiologist, or call 911 for an emergency.
Are You a Candidate for Cardio Res-Q?
Three quick questions about the risk factors we screen for. Your answers stay between you and the clinic.
Frequently asked questions
Is the $999 price everything I will pay for the Enhanced Assessment?
No. The $999 covers the clinical evaluation, the labs, the Cleveland Heart panel, the CIMT ultrasound and your plan. The calcium score is done at an outside imaging facility and is typically a separate self-pay study of $100 to $200, paid to that facility.
Can I start with Comprehensive and add imaging later?
The Comprehensive Assessment is complete on its own. If your results suggest that imaging would help, ask our team how a calcium score or CIMT can be arranged afterward and what it would cost, since we do not publish separate prices for those.
I had a calcium score last year. Which one should I pick?
Usually Comprehensive. Bring your report so it can be reviewed alongside your labs. Calcium scans are typically repeated about every five years, so a recent result still counts.
Does the Enhanced Assessment involve radiation?
The CIMT ultrasound does not. The calcium score is a low-dose CT scan, so it involves a small amount of radiation. It takes less than 15 minutes and needs no injection or contrast dye.
Are both assessments paid out of pocket?
Yes. Both are direct-pay and are not billed to insurance. You are welcome to try an HSA or FSA card, but the clinic cannot confirm it will be accepted.
Related reading
This article is for general education and is not medical advice. Decisions about testing and medication should be made with your clinician. If you have chest pain or other symptoms of a heart attack, call 911.
