Before you pay for preventive heart screening anywhere, ask nine questions: which tests, what evidence, how much radiation, who reads the results, what happens if something is abnormal, the full cost, whether your doctor gets the results, how false alarms are handled, and what follow-up is included.
A good provider answers all nine without hedging. Below, each question comes with the reason it matters. At the end we answer them for Cardio Res-Q, whose Comprehensive Assessment is $775 and Enhanced Assessment is $999.
Key takeaways
- Ask any heart screening provider nine questions before you pay, and expect clear answers.
- Find out which tests are included, what evidence supports each and what decision each could change.
- Ask about radiation, who interprets the results and what happens if something is abnormal.
- Get one total cost that includes outside studies, and check whether a membership is required.
- Ask how false alarms and incidental findings are handled, and remember a calcium score of zero does not rule out soft plaque.
1. Which tests are included, and why each one?
Ask for the full list in writing. For each test, ask what decision it could change for someone like you. A test that cannot change anything is cost without benefit. Be wary of a package that is the same for everyone regardless of age or risk.
2. What is the evidence behind each test?
Some tests are backed by guidelines and others are not. The US Preventive Services Task Force found in 2018 that the evidence was insufficient to judge the benefits and harms of adding a calcium score, an ankle-brachial index or hs-CRP to standard risk assessment in adults without symptoms.1 That does not make these tests useless. It means a provider should explain who they help.
3. Does any test involve radiation?
Blood tests and ultrasound involve none. CT scans do. A coronary calcium scan delivers about 1 to 1.5 mSv, which is a low dose.2 Ask how often the provider suggests repeating any CT, because the dose adds up with each scan.
4. Who interprets the results?
Ask who reads each scan and who explains the full picture to you: a physician, another clinician, or a printed report. Ask how long that conversation lasts and whether you can ask questions afterward.
5. What happens if a result is abnormal?
This is the question people forget. Ask whether the provider treats, refers, or simply hands you the report. Ask who arranges a cardiology referral if one is needed, and how quickly.
6. What is the total cost, including outside studies?
Ask for one number that includes lab fees, imaging done elsewhere, the results visit and any required follow-up. Ask whether insurance is billed, and whether a membership is required to get your results or your plan.
7. Will the results be shared with my own doctor?
Screening works best when your regular doctor or cardiologist can see it. Ask whether you get copies of every result, and whether the provider will send them on and talk to your doctor if needed.
8. How are false alarms and incidental findings handled?
Every screening test produces some false alarms. CT scans also show parts of the lungs and chest, so they can turn up findings unrelated to the heart. In one older study of 1,356 people screened with a heart calcium scan, about one in five had at least one finding outside the heart, and about 4 percent were advised to have a follow-up CT.3 Such findings range from harmless to serious, and the follow-up costs money and can cause worry. Ask who reviews the non-heart parts of the scan and who manages anything they find.
Ask about false reassurance too. A calcium score sees only calcified plaque, so a score of zero does not rule out soft plaque.4
9. What follow-up is included in the price?
Ask whether the price covers a results review, a written plan, and questions afterward. Ask what repeat testing is suggested, how often, and what it costs. Ask whether ongoing care is optional.
How Cardio Res-Q answers the nine questions
These answers come from the published Cardio Res-Q program page. Where it is silent, we say so.
- 1. Tests. The $775 Comprehensive Assessment includes Dr. Varano's clinical evaluation, ApoB, Lp(a), hs-CRP, homocysteine, insulin, glucose, A1c, the Cleveland Heart cardiac panel, a lifestyle and risk evaluation, and a personalized heart protection plan. The $999 Enhanced Assessment adds a CIMT ultrasound and a coronary artery calcium score. The Cleveland HeartLab panel reports Lp(a), ApoB, hs-CRP, oxidized LDL and small dense LDL, plus other proprietary markers.
- 2. Evidence. It varies by test, and you should know that. The 2013 ACC/AHA risk guideline does not recommend routine CIMT measurement for predicting a first heart event.5 Our guides to CIMT and the calcium score set out the evidence and limits of each.
- 3. Radiation. The labs and the CIMT ultrasound involve none. The calcium score is a low-dose CT. The clinic treats a calcium score as a baseline that keeps its value for several years, and it accepts scores done elsewhere.
- 4. Interpretation. Dr. Varano, a D.O. and integrative physician, not a cardiologist, reviews all lab and imaging findings with you at a 1-hour consult and explains your risk profile. The CIMT is performed by Jessica Brown in the Conshohocken office. Ask the imaging facility you choose who reads the calcium scan.
- 5. Abnormal results. You receive a personalized plan. Cardio Res-Q is not emergency care and not a replacement for a cardiologist. If you need medication for prevention, the clinic prescribes statins and non-statin medicines case by case and does not refer you elsewhere for it. Ask our team how a result that needs a specialist is handled.
- 6. Total cost. $775 or $999, direct-pay and not billed to insurance. With the Enhanced Assessment, the calcium scan is a separate self-pay study at an outside imaging facility, typically $100 to $200. Patients are welcome to try an HSA or FSA card, but the clinic cannot confirm it will be accepted, and it does not provide insurance reimbursement forms. See cost, insurance and HSA/FSA.
- 7. Sharing. Yes. The clinic is happy to share results and work with your cardiologist or primary care doctor.
- 8. Incidental findings. The program page does not say how findings outside the heart on the calcium scan are handled. Ask our team.
- 9. Follow-up. The assessment is complete and standalone. Ongoing care is optional: membership is $279 per month and the Specialty Treatment Plan is $125 per month. Follow-ups can be by telehealth, in Pennsylvania only, when no CIMT or EndoPAT follow-up testing is recommended. Ask our team whether questions after your consult are included.
Next step: how to book
Take these nine questions to any provider you are considering, including us. To book a Cardio Res-Q assessment, go to the program page and choose the Comprehensive or Enhanced option, or contact our team with your questions first.
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 preventive heart screening worth paying for?
It depends on your risk and on whether the result would change what you or your doctor do. For a low-risk adult with no family history, a routine checkup may be enough. For someone at borderline or intermediate risk, a test such as a calcium score can help with a decision about treatment.
What is an incidental finding?
It is something a scan shows that has nothing to do with the reason for the scan, such as a small spot in the lung on a heart CT. Most need no further imaging, but some do. Ask in advance who will review and manage them.
Should I tell my regular doctor before I book?
It helps. Your doctor may already have recent results that make some tests unnecessary, and will be the one acting on many of the findings. Ask any screening provider to send your results on.
What if I have symptoms?
Screening is for people without symptoms. If you have chest pain, shortness of breath or other symptoms of a heart attack, call 911. For symptoms that come and go, see your doctor or a cardiologist promptly.
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.
