Buster knows this but I will post it for others that might not. Ivor Cummins is a big proponent of CAC testing and has lots of information about it and why it could be important.

https://www.youtube.com/results?search_query=ivor+cummins+CAC

The cost of the test can vary widely. If just going to an ordinary hospital and asking for it the cost could be 300 or even 500 dollars. But there are hospitals and places that have the machines that use the test as kind of a "loss leader" kind of service (like the grocery stores sell a few items below cost and advertise the loss leaders to get you into the store). It basically gets "new customers".

Wife and I made an appointment (though we found out we could have just walked in) to a hospital in KC that normally charges a hundred bucks but was on a promotion for $50 each. I just did a google search for CAC facilities and it was one of several hospitals that popped up. Funny thing is, I had been to the emergency room a few weeks before for chest pains (not heart related it turned out and I found out later). The chest pains got me an appointment with a local cardiologist to do follow up. I ask about CAC and he foo-fooed it. I looked up a location (other than my home hospital) that was cheap and a couple hours away and did it anyway. Cardiologist had me going in for an ultrasound at local hospital (which I did and turned out perfect) and chemical stress test (which I canceled the appointment for that because I had figured out myself where the chest pain had come from and already knew the ultrasound was good).

When I went back for the follow up appointment he said the ultra sound was perfect. Ask me why I didn't do the stress test, which I told him why I had the chest pains and he said something like "yes that can happen". Tried to put me on a statin (which I would not have any part of). Then I handed him a copy of the CAC test. He kind of flippantly said "well you are good then" and pretty quickly left the office. I was not impressed with the guy and if I ever need a cardiologist will go to someone else.

But again, I digress. I had been watching what Ivor Cummins had said for months before my imagined "heart attack" that turned out to not be my heart at all (fortunately for me). So finding a place and going to get a CAC was on my short list and we did it. For a large part many hospitals/cardiologists take a two prong approach to the CAC. They either encourage it as a loss leader to get you into the facility and as a customer. Or they hate it and discourage people doing it because it gives real time information that if you don't have a problem, then you don't need continuing appointments and more expensive tests. That sounds jaded on my part towards the medical community, but most hospitals now are for profit centers, so yes they do think about income streams. Regular customers make them money. Healthy ones that don't need services do not. A CAC test will let you know if at least one aspect of your heart health is healthy (doesn't say anything about the electrical component). The hospital where I did the CAC wanted me to schedule a follow up appointment with one of their cardiologists (because I DID have some calcium) about going on a statin. Same message for wife. I did not oblige. I had gotten the information we had went after with the CAC test.

For the low cost wife and I were always planning on going back and get it done again to see if our scores increased or stayed the same (hers I think was in the 40's and mine in single digits, maybe 9). But covid came along and since we have just not got around to it. I seriously doubt we have problems though. I being diabetic for years should have had a problem if I was going to have one. Diabetics (or anyone with insulin resistance) is at much higher risk for calcium buildup. I did have some (which is not good) but with our current lifestyle change (low carb/keto) our risk should be much lower than in the past because of much better blood sugar regulation (fewer and lower spikes in blood glucose).