What Do Mirena and Paragard IUDs Cost in 2026?

Mirena and Paragard are the two most widely prescribed intrauterine devices in the United States, together covering the hormonal and non-hormonal ends of the long-acting reversible contraceptive market. Mirena, made by Bayer, releases levonorgestrel and is FDA-approved for up to eight years of pregnancy prevention plus treatment of heavy menstrual bleeding. Paragard, made by CooperSurgical, is a copper intrauterine device with no hormones, approved for up to 10 years. Bayer also sells two lower-dose hormonal IUDs, Kyleena and Skyla, and the nonprofit Medicines360 sells Liletta, a lower-cost hormonal alternative to Mirena distributed mainly through public health clinics.

Insurance coverage drives the real 2026 price far more than the device itself does. Under the Affordable Care Act's preventive services mandate, most non-grandfathered private health plans and every state Medicaid program must cover FDA-approved contraceptives, including all five IUD brands, at $0 copay with no deductible. Patients without ACA-compliant coverage face the full cash price of the device plus a separate clinic fee for insertion. This guide breaks down the 2026 cash price, the Bayer manufacturer patient assistance program, Medicaid family planning rules, and what to do if an insurer bills a patient for a device that should be free.

Federal Title X family planning clinics add a third path that most drug-cost guides skip. Clinics receiving Title X funding provide IUDs free to patients at or below the federal poverty level and on a sliding scale up to 250 percent of the federal poverty level, regardless of insurance status. Patients comparing costs should also check their state's Medicaid income limits and confirm whether their plan classifies the device under the medical benefit, billed with a HCPCS J-code, or the pharmacy benefit, billed like a prescription with a formulary tier, because that classification changes which cost-sharing rules apply.

What IUD Costs by Point of Pay (2026)

The price you pay depends almost entirely on WHERE you pay. The same iud can cost many times more at a hospital than at your local pharmacy:

Why Hospitals Charge So Much

Outpatient hospital and hospital-owned clinic bills for IUD insertion routinely separate three line items: the device itself, a facility fee for the procedure room, and a physician or advanced-practice clinician fee for the insertion under CPT code 58300. A patient who looks only at the total can mistake a $2,500 combined bill for the device price, when the device itself runs $900 to $1,350 and the remainder is facility overhead. Hospital-owned clinics generally charge higher facility fees than independent physician offices or community health centers performing the identical procedure, sometimes two to three times more for the same device and the same 15-minute insertion visit.

Bayer, CooperSurgical, and Medicines360 sell the physical device to the clinic or pharmacy at a wholesale price, then the clinic or pharmacy marks up the device line item and adds its own procedure charges on top. Patients who receive a bill above $1,500 for the device alone, separate from any facility fee, should request an itemized statement listing the HCPCS code (J7298 for Mirena, J7300 for Paragard, J7296 for Kyleena, J7297 for Liletta, or J7301 for Skyla) and compare it against the wholesale acquisition cost, which ran near $1,270 for Mirena and $1,190 for Paragard as of 2026.

HCPCS J-Codes: What Appears on Your Bill

Insurers and clinics bill IUDs under HCPCS Level II J-codes when the device is processed through the medical benefit rather than the pharmacy benefit. Each brand carries its own code.

Patient Assistance Programs

Bayer, the manufacturer of Mirena, Kyleena, and Skyla, runs an income-based patient assistance program for uninsured and underinsured patients. Paragard's dedicated manufacturer program ended in 2014; CooperSurgical now directs self-pay patients to an installment payment plan instead. Liletta, sold by the nonprofit Medicines360, is not distributed through a traditional PAP but is priced near cost for safety-net clinics.

Medicare Part D

Traditional Medicare rarely covers IUDs, because Medicare Part B does not pay for contraception used solely to prevent pregnancy. Medicare Part B will cover Mirena, Kyleena, Skyla, or Paragard on a case-by-case basis when a prescriber documents a non-contraceptive medical reason, such as treating endometrial hyperplasia or heavy menstrual bleeding with Mirena, and standard cost-sharing (the 2026 Part B deductible of $283 plus 20 percent coinsurance) still applies to that claim.

Medicare Advantage plans occasionally add contraceptive coverage as a supplemental benefit beyond what Original Medicare covers, so beneficiaries under 65 who qualify for Medicare through disability should check their plan's evidence of coverage directly. Dual-eligible beneficiaries who also have Medicaid get the device through the Medicaid family planning benefit at $0 to $3, regardless of what Original Medicare pays. Because IUDs are billed through the medical benefit rather than the Medicare Part D pharmacy benefit, the 2026 Part D annual out-of-pocket cap of $2,100 generally does not apply to this device.

Common IUD Billing Errors

Patients who receive an IUD bill above $200 with ACA-compliant insurance, or any bill at all with Medicaid, should check for these issues before paying:

• An ACA-compliant plan charges a copay or deductible for the device or insertion despite the federal preventive services mandate requiring $0 cost-sharing; ask the plan for a written explanation citing the specific exception (grandfathered status or a religious exemption) before paying.
• A plan wrongly requires prior authorization before approving the IUD; ACA-compliant plans generally cannot require prior authorization for a preventive contraceptive service, though some plans still impose it in error and delay the insertion appointment as a result.
• An insertion visit billed at a hospital-owned clinic facility rate when the same visit at an independent OB-GYN office or community health center would carry a lower facility charge; ask whether the clinic is hospital-owned before scheduling.
• The wrong HCPCS code used, for example Kyleena or Skyla billed under Mirena's J7298, which can trigger a higher patient responsibility or a claim denial for a coverage mismatch.
• The device and insertion billed as two separate claims processed under different benefit types, medical versus pharmacy, causing the deductible to apply to one claim even though the ACA mandate should zero out both.
• Removal and same-visit reinsertion of a new IUD billed as two full separate procedures instead of the correct combined coding, doubling the facility fee unnecessarily.

Frequently Asked Questions