This is an updated version of our IUD cost article originally posted in March 2014.
How much does an IUD cost? Like anything else in the health-care marketplace, the answer is: it depends. Birth control. So many choices! There are so many birth control methods out there, it can be hard to keep them all straight — and choose one that’s right for you. Also, what’s covered under the Affordable Care Act?
Many women choose birth-control pills. Increasingly though, women are opting for an IUD or intrauterine device, which is inserted directly into the uterus.
IUD’s have had a complicated history in this country. They have come in many different shapes and sizes, and some have been relatively unsafe, including the Dalkon Shield, which was the subject of an enormous class-action lawsuit for the damages it caused to women who used them.
For a period, they were FDA-approved only for women who had undergone childbirth due to the threat of side effects, including pelvic inflammatory disease. But in July, 2011, the American College of Obstetrics and Gynecology officially endorsed IUDs, commonly small T-shaped plastic devices laced with either copper or hormones to quell pregnancy, for healthy women and teenagers.
O.K., so how much does an IUD cost?
The prices vary dramatically.
First and foremost, know what you’re buying. Back in 2014, clinics offered two different types of IUDs: ParaGard and Mirena. Today there are three more: Kyleena, Liletta and Skyla.
ParaGard, which lasts for up to 10 years, is wrapped with tiny coils that release small amounts of copper, which is an irritant, creating a reaction that is toxic to sperm.
Mirena, which lasts up to five years, releases small amounts of the progestin hormone Levonorgestrel, which impairs sperm motility and viability, so it can prevent fertilization.
Skyla, Liletta, and Kyleena all release Levonorgestrel. Mirena and Liletta release the most, with Kyleena next and Skyla with the smallest amount. Here’s a chart from Oregon Health & Science University with the details on the different kinds of IUD’s.
There are two parts to IUD insertion: The device and the insertion. The insertion fee is sometimes included in the cost of the device, and sometimes extra. Under some insurance plans, the IUD is covered under the prescription part of the plan, not the procedure part. In some plans, the individual is asked to buy the IUD and then take it to the doctor to have it inserted.
In all cases, you are likely to have to pay for a pregnancy test first.
It also bears mentioning that sometimes doctors will tell you the insertion involves some pain, but usually it’s not that bad. Recently, the Centers for Disease Control and Prevention updated its guidance to say that IUD insertion pain can often be excruciating, and offering several options to reduce pain. Don’t be shy about asking in advance.
Excellent resource: Here’s a list of the upsides and the downsides, from our friend Carey Goldberg over at Commonhealth, the health-care blog at WBUR public radio in Boston.
At one Manhattan women’s health clinic, ParaGard costs $700, and Mirena costs $800, insertion fee included; at one Brooklyn clinic, ParaGard runs just $550 and Mirena $650, insertion fee also included. And at one Waterbury, Ct., clinic, ParaGard costs $680 and Mirena between $7-800, plus an additional $300 insertion charge.
Many places have a sliding scale depending on your income and size of family, plus other factors.
So is the same Mirena IUD going to cost you $650, or $2,600? It all depends on where you go.
Here at ClearHealthCosts.com, we do pricing surveys for the self-pay prices for common procedures. What we have found nationwide is a range from $55 to $2,600 for an IUD if you ask in advance and pay cash. Here’s our price list for IUD insertion in New York and here’s an IUD price list for the San Francisco area.
Here’s a list of IUD prices in the Philadelphia area. Here’s a list of IUD prices in the Dallas-Fort Worth area.
Pro tip: Check out the notes field: the notes will tell you if it’s Mirena or Paragard, and the charge for each, if the provider offers both.
Are IUDs covered under the Affordable Care Act?
That depends. Gretchen Borchelt of the National Women’s Law Center wrote this piece in 2013, which we saw on Bedsider:
“Plans must cover all FDA-approved birth control methods with no out-of-pocket expense. That includes implants, IUDs, the shot, the pill, the patch, the ring, diaphragms, cervical caps, and sterilization procedures.” (Birth control you can buy without a prescription are not yet required to be covered under this law.)
“Unfortunately some insurance plans are not following the law yet. At the National Women’s Law Center, we hear from women whose plans are only covering the pill, but not the ring or the patch. Other women have been told that only generic brands are covered…. Health plans have been given some leeway to determine what is covered, but they should not be able to stop you from getting the birth control that is right for you.
“The bottom line is that you have to call your insurance plan to find out whether your particular birth control is covered without out-of-pocket expenses. Here’s a guide to what to ask the human you eventually get on the phone, and what their answers mean for you.”
How much does Depo-Provera cost? Most clinics also offer Depo Provera contraceptive injection, a shot of progestin that prevents the ovaries from releasing eggs. We’re covering this in another piece.
Not sure which one is right for you? Birth control is a personal decision. Money also matters, and other issues — protection from STD’s, side effects and so on. Here’s a handy chart from Bedsider, giving you the lay of the land.
The takeaway: Questions to ask
As we always say, know before you go.
Questions to ask:
-
- Paragard or Mirena? Or Skyla, Liletta, Kyleena? And why?
- Will I have to bring the device or do you supply it?
- If I have to bring it, where would I find it? Is there anything I need to know about how to buy it?
- Is this covered by insurance without a copay? If not, why not?
- How much will it cost? How much will it cost ME?
- Do you have a sliding scale based on income, family size and other factors? How does that work?
- Are there insertion fees? Other fees or charges?
- Is there a separate charge for the doctor’s visit, or is it all included in the price you just named?
- What kind of pain mitigation do you use?
Call before you go. Ask how much you will be charged. Take notes. Take names. Take numbers.
