Do I absolutely have to have a PCP referal?

I have Cigna HMO, and I called my PCP today to get an appointment for a referral, and there was no appointment that I could get into before my meeting with the surgeon on the 21st of January. The soonest they have was the 22nd? Can I pay for this visit out of my own pocket? Does it have to be referred? I really do not want to lose this date with the surgeon, because the next one they have available is the 14 of February. I don't want to wait that long for this process to begin. Does anyone have any suggestions?

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