The birth control implant (e.g., Nexplanon or Implanon) is a long-acting reversible contraceptive device inserted beneath the skin of the upper arm. Although the implant offers pregnancy prevention for up to five years, circumstances often require its removal sooner, which is a common procedure performed in a healthcare provider’s office. The cost to have this small, flexible rod removed varies dramatically depending on your insurance status and the type of facility performing the minor surgery.
Average Costs Based on Provider Type
The out-of-pocket cost for implant removal, if uninsured or paying cash, is influenced by the setting where the procedure takes place. Specialized family planning clinics and community health centers typically offer the lowest prices, often ranging from no cost up to approximately $300. These facilities often use grants to provide affordable reproductive healthcare, keeping cash prices low.
A private obstetrician-gynecologist (OB/GYN) office or an urgent care center charges a higher cash price, which varies based on the complexity of the removal. For a routine removal, the fee is typically between $300 and $500, covering the provider’s time, local anesthetic, and supplies. If the implant has migrated or is difficult to locate, requiring additional time or imaging, the cost may increase.
The most expensive option is generally a hospital outpatient setting, which charges a separate facility fee in addition to the physician’s professional fee. These administrative charges can push the total self-pay price well beyond $500, sometimes approaching $1,000. Geographic location also contributes to price differences, with urban areas often seeing higher average costs.
Understanding Insurance Coverage and Deductibles
For individuals with private health insurance, the Affordable Care Act (ACA) requires most plans to cover all FDA-approved contraception, including the implant and its removal, without cost-sharing. For compliant plans, you should not be charged a co-payment, co-insurance, or have the cost applied to your deductible for a routine removal. The removal is classified as a preventative service when performed in-network.
Several factors can lead to unexpected charges. Plans “grandfathered” in before the ACA mandate, or those with religious exemptions, may not cover the removal at no cost. Seeing an out-of-network provider is another common reason for an unexpected bill, as the preventative mandate only guarantees no-cost sharing with in-network providers.
Patients might also face charges if the removal is complicated, such as if the implant is deeply embedded or requires an ultrasound for localization. The facility may bill separately for the complication or use a different billing code not fully covered under the preventative mandate. This can lead to a bill against your deductible or a co-pay, even if the main procedure is covered.
Strategies for Reducing Out-of-Pocket Expenses
For those who are uninsured or facing high out-of-pocket costs, several strategies exist to minimize the final bill. The most effective approach is to seek care at community health centers, county health departments, or reproductive health clinics like Planned Parenthood. These organizations often offer services on a sliding fee scale, adjusting the price based on household income and family size.
You can also reduce expenses by taking the following steps:
- Inquire about state and local family planning programs, which may use federal funding (such as Title X grants) to provide free or low-cost removal services to eligible residents. Eligibility is typically based on income.
- Contact the provider’s billing department before your appointment and request an itemized cost estimate using the specific billing codes.
- If paying cash, negotiate a significant discount off the sticker price by asking for a cash payment rate.
- Look into patient assistance programs offered by pharmaceutical companies or non-profit organizations, which may cover or reduce the cost for those who qualify financially.