Self-pay means paying a private hospital directly for treatment, no insurance involved. Most providers offer fixed-price packages covering the procedure, hospital stay and routine aftercare. Typical costs: a private MRI £300–£500, cataract surgery £2,000–£4,000 per eye, a hip replacement £12,000–£15,500. You'll usually need a GP referral, and prices are quotable upfront.
- ✓Fixed-price self-pay packages bundle the procedure, stay and routine aftercare into one quote.
- ✓Typical prices: MRI £300–£500; cataract £2,000–£4,000/eye; hip replacement £12,000–£15,500.
- ✓CMA rules require private hospitals and consultants to be transparent about fees upfront.
How self-pay works
Every major private hospital group — Spire, Circle, Nuffield Health, HCA, Ramsay and others — treats self-pay patients alongside insured ones. The route is simple: a referral (usually from your GP, NHS or private), a consultation with a specialist (typically £150–£250), any diagnostics, then a quote for treatment. Most providers now publish guide prices online, and many offer fixed-price packages: one figure covering the operation, the hospital stay, the anaesthetist and routine aftercare, agreed before you're admitted.
The appeal is speed and certainty without an ongoing premium. The NHS is brilliant; the waiting isn't — the median wait is 12.4 weeks, 1 in 12 wait 38.6+ weeks, and around 1 in 4 diagnostics take six weeks or more. Self-pay converts that wait into a consultation within days and surgery typically within two to six weeks, priced in advance.
What self-pay treatment typically costs
Prices vary by hospital, city and consultant, but the ranges are fairly consistent nationally. London tends to sit at the top of each range.
| Treatment | Typical self-pay price |
|---|---|
| Initial consultation | £150–£250 |
| MRI scan (one area) | £300–£500 |
| Diagnostic colonoscopy | £1,500–£2,500 |
| Cataract surgery | £2,000–£4,000 per eye |
| Hernia repair | £2,500–£4,500 |
| Knee arthroscopy | £3,500–£6,000 |
| Hip replacement | £12,000–£15,500 |
| Knee replacement | £13,000–£16,500 |
Two cautions on comparing quotes. First, check what's excluded: pre-operative diagnostics, the first consultation and non-routine complications usually sit outside the package. Second, check the aftercare window — good packages include physiotherapy sessions and follow-up appointments; leaner ones don't. Our guides to private MRI scans and hip replacements break down the big-ticket items in detail.
Paying for it: upfront, financed, or staged
Most self-pay patients simply pay by card or transfer before admission. But for four- and five-figure procedures, hospitals have built out the options:
- Interest-free instalments. Many hospital groups offer 0% finance over 10–12 months through a lending partner, subject to credit checks; longer terms carry interest.
- Medical loans. Specialist lenders and ordinary personal loans both get used; compare APRs like any other borrowing, and be wary of terms that outlast your recovery.
- Staged payment. Consultation and diagnostics first (hundreds, not thousands) — you can then take the diagnosis back to the NHS for treatment if the quote is too steep. Paying for the diagnostic step alone is one of self-pay's most cost-effective uses.
- Employer or family help. Some employers contribute to one-off treatment rather than running a full insurance scheme.
- Shop between hospitals. Quotes for the same procedure can differ by thousands between providers in the same region — getting two or three package prices is an hour well spent.
Weigh self-pay against insurance
Self-pay vs insurance: the break-even logic
The honest comparison: insurance at the UK average of around £80/month costs roughly £960 a year, every year, whether you claim or not. Self-pay costs nothing until you need something — then potentially a lot. The break-even arithmetic is straightforward: a decade of average premiums (~£9,600) is comparable to one hip replacement, and materially less than one serious multi-treatment episode.
So the split tends to work like this. Self-pay suits one-off, quotable, affordable problems — a scan to end uncertainty, a cataract, a hernia — especially for people who'd otherwise be excluded from insurance benefits by pre-existing condition rules (insurance never covers the condition you already have; self-pay doesn't care). Insurance suits open-ended risk: the possibility of cancer care, repeat treatment or multiple family claims, where costs can dwarf any single package price. Our guide to whether health insurance is worth it works through the sums properly.
Age changes the arithmetic too. Younger buyers pay low premiums against low risk, so either route defends itself; from the mid-50s onwards, premiums climb just as the likelihood of needing the expensive procedures does — which is exactly when a single self-pay bill starts looking less like an alternative to insurance and more like a warning about not having it.
Questions to ask, and your consumer rights
Since the Competition and Markets Authority's private healthcare investigation, hospitals and consultants are required to be transparent about pricing: consultants must set out their fees before treatment, and the Private Healthcare Information Network (PHIN) publishes performance and fee data. You're a consumer buying a service — act like one.
- Is this a fixed-price package, and exactly what does it include? Get the inclusions — anaesthetist, implant/prosthesis, nights in hospital, physio, follow-ups — in writing.
- What happens if there are complications? Ask what's covered, for how long after discharge, and where you'd be treated.
- What are the surgeon's numbers? Volumes and outcomes for this procedure — check the consultant on PHIN.
- What would this cost if I need more than expected? Extra nights, revision, additional diagnostics — know the rates before, not after.
- Can I see the full quote before committing? Under CMA rules, yes — a provider reluctant to put prices in writing is telling you something.
Frequently asked questions
How much does self-pay private treatment cost in the UK?
It depends on the procedure: a private MRI runs £300–£500, cataract surgery £2,000–£4,000 per eye, hernia repair £2,500–£4,500, and a hip replacement £12,000–£15,500. Consultations are typically £150–£250. Most hospitals publish guide prices and will confirm a fixed-price package quote before you commit.
Do I need a GP referral for self-pay private treatment?
Usually, yes — most consultants and hospitals ask for a GP referral (NHS or private GP both work) before a specialist consultation, and scans generally need a clinician's request. Some services, like certain health checks and physiotherapy, are directly bookable without one. Your NHS GP can refer you privately free of charge.
What does a fixed-price self-pay package include?
Typically the procedure itself, hospital accommodation, theatre and anaesthetist fees, and routine aftercare such as follow-up appointments — with many providers also covering treatment of routine complications within a set window. Initial consultations and pre-operative diagnostics are usually excluded, so confirm the full inclusion list in writing.
Is self-pay cheaper than health insurance?
For a single known problem, often yes: one £350 MRI or a £3,000 cataract costs less than years of premiums at the ~£80/month UK average. For open-ended risk — cancer, repeat treatment, a family's worth of claims — insurance wins, because one serious episode can exceed a decade of premiums.
Can I self-pay for private treatment if I have a pre-existing condition?
Yes — this is one of self-pay's biggest advantages. Hospitals don't underwrite you; they treat anyone clinically suitable, regardless of medical history. Insurance generally excludes pre-existing conditions, so for people whose main health issue is already diagnosed, self-pay is often the only realistic private route for that condition.
Can I pay for private treatment in instalments?
Usually. Most large hospital groups offer finance through lending partners — commonly interest-free over 10–12 months, with longer interest-bearing terms available, all subject to credit checks. Ordinary personal loans are an alternative worth comparing on APR. Treat finance as convenience: borrowing doesn't make a £13,000 operation cost less.
How quickly can I get self-pay treatment compared with the NHS?
Typically a consultation within days, diagnostics within one to two weeks and routine surgery within two to six weeks. The NHS median wait is currently 12.4 weeks, with 1 in 12 waiting 38.6+ weeks and about 1 in 4 diagnostics taking six-plus weeks — the gap self-pay exists to close.
Can I self-pay for diagnosis and then go back to the NHS for treatment?
Yes, and it's one of the smartest uses of self-pay. Pay a few hundred pounds for a private consultation and scan, then take the results to your GP and join the NHS pathway for treatment. You'll wait for the operation, but with a diagnosis in hand rather than in limbo.
What are my consumer rights when self-paying for private treatment?
Following the CMA's private healthcare market investigation, consultants must disclose their fees before treatment and hospitals must be transparent on pricing; the Private Healthcare Information Network (PHIN) publishes consultant fees and outcomes. Get the full quote in writing — a provider unwilling to do so is a red flag.
What questions should I ask a hospital before self-pay surgery?
Five essentials: is the quote a fixed-price package and what exactly does it include; how are complications handled and for how long; what are the surgeon's volumes and outcomes for this procedure (check PHIN); what would extras cost; and can everything be confirmed in writing before you commit.