You have a high-deductible plan, a knee that has been aching since August, and no idea what an office visit will cost. Or you are between jobs and uninsured for a few months. Either way the question is the same: if you are paying out of pocket, what does care in Colorado actually cost, and how do you find out before you are sitting in the exam room?
It is a fair question that is harder to answer than it should be. Here is a plain look at how cash pay works, what to ask, and where published prices actually exist.
What cash pay actually means
Cash pay, self pay, and direct pay all describe the same arrangement: you pay the practice directly for the service, and no insurance claim is filed. It does not mean you have to bring literal cash. Cards, HSA and FSA cards, and checks are typically fine.
The important part is not the payment method. It is that the price is set by the practice, agreed to up front, and does not depend on where you are in a deductible, which network you are in, or an explanation of benefits that arrives six weeks later.
Why paying directly is sometimes cheaper than using insurance
In insurance-based billing, the practice submits a charge, your plan applies a contracted rate, and your share depends on your deductible, coinsurance, and copay. Until that math runs, nobody in the building can tell you the final number with certainty.
A self-pay price skips most of that:
- Early in the plan year, before your deductible is met, you are often paying close to the full contracted rate anyway, just later and with less warning.
- No claim processing means no denials, resubmissions, or staff time spent chasing payment, and some practices price self-pay services lower as a result.
- One number, known in advance. You can decide whether to proceed based on the actual cost.
This does not mean cash pay is always the better math. If your deductible is already met, or the service is one your plan covers in full, running it through insurance is usually the cheaper route. It varies a great deal by plan, and your plan administrator is the right person to confirm what your specific coverage does.
What published cash prices look like
Prices for the same service vary widely between practices and facilities, so the only figures worth quoting are published ones. Ridgeview publishes its sports medicine prices in full, which gives a sense of the shape of self-pay pricing for musculoskeletal care. For patients who are not members, the posted prices include:
- New sports medicine consultation: $250
- Follow-up for an established problem: $100
- Sports physical or pre-participation exam: $150
- Musculoskeletal diagnostic ultrasound: $70
- Steroid injection: $150
Ridgeview members pay less for most of those, and several of the consultation fees are waived for members entirely. The complete list for both members and non-members is on the sports medicine pricing page. Worth knowing: you do not need a Ridgeview membership to be seen for a sports medicine problem. Standalone visits are open to anyone, even if your primary care is somewhere else.
Labs, imaging, and the costs that catch people out
The office visit is often the smaller line item. Bloodwork, X-rays, MRI, and specialist consultations are where self-pay bills get large, and those are billed by whoever performs them rather than by your doctor. A physician can tell you what they are ordering. They cannot always tell you what a third party will charge for it.
So ask, before anything is drawn or scanned:
- Use the words self-pay or cash price. It is often a different number from the one quoted to insurance, and you usually have to ask for it by name.
- Ask for the order code. With the CPT code your doctor is ordering, you can call a lab or imaging center and get a specific price rather than an estimate.
- Ask about facility fees. Some sites of service add a separate charge on top of the study itself.
- Ask whether a free-standing center is an option. Prices for the same imaging study at different facilities are frequently very different.
Ridgeview offers routine laboratory work at wholesale pricing for members, which is one of the reasons the membership math tends to work out for people who need labs more than once a year.
A membership is not the same thing as paying cash per visit
Direct primary care is a monthly membership rather than a charge per visit. At Ridgeview, founding membership rates are $99 a month for an individual and $179 a month for two adults. Standard rates are $129 and $199, and children up to age 26 are $39 a month each.
That covers the primary care relationship itself: appointments, unhurried visits, and direct access to Dr. Kroner. What it does not cover is everything else in the health system. A direct primary care membership is not health insurance. It does not pay for hospital stays, surgery, emergency care, specialist visits, or most prescriptions.
Most members keep a plan for the large and unpredictable things and let the membership handle the ordinary ones. We went through that pairing in more detail in how DPC and insurance work together, and the tax-account question in whether you can pay with an HSA or FSA. For anything specific to your own taxes or plan documents, check with a tax professional or your plan administrator.
Four questions worth asking before you book
- What is the self-pay price for this visit, and is it due at the time of service?
- If something is found today, what else might be ordered, and roughly what do those cost?
- Is a follow-up included, or billed separately?
- If I later want to submit this to my plan, will you give me an itemized receipt with codes?
A practice that prices openly should be able to answer all four without checking with anyone.
When cash pay is probably the wrong move
If you are managing a condition that needs frequent specialist care, expensive medication, or carries any realistic chance of a hospital admission, paying out of pocket for all of it is a risk rather than a strategy. That is what coverage is for, and going without it to save on monthly costs can end badly.
And cost should never be the reason an evaluation gets postponed. Chest pain, trouble breathing, sudden weakness or numbness, confusion, a sudden severe headache, a joint that cannot bear weight after an injury, or a visibly deformed limb all need urgent care or an emergency department now, not an afternoon of price research. Anything new, worsening, or simply worrying deserves an evaluation by a physician.
Where to start in Wheat Ridge
If you want to know what your care would cost here before committing to anything, the easiest way is to ask. Book a free 30-minute meet and greet with Dr. Kroner through the contact page, or call 720-807-9961. Bring your situation, your plan details if you have them, and your questions about price. Nothing is charged for the conversation.
Ridgeview Direct Care is at 4045 Wadsworth Blvd #300, Wheat Ridge, CO 80033, open Monday through Friday, serving Arvada, Lakewood, Golden, Edgewater, and west Denver. If you are weighing membership, the membership page lays out how enrollment works.
This article is for educational purposes only and is not medical, tax, or insurance advice. Please see our medical disclaimer.