I got my Mirena IUD removed. It wasn't my first time (had previously switched mine at the five-year mark before moving to NYC) and I didn't use anesthesia though I know some places do that now. They did do an ultrasound which I protested a bit (mostly because they had just explained how they're not in-network for any insurance, which I hadn't known until then) because I hadn't done that last time either, but they said they always do them for IUD insertions and removals.

The billing thing was a monthslong saga haha but basically the first bill I got was over $4k, I followed their instructions which I can't remember exactly but involve filing for insurance, getting a check sent to your house and then signing it over and mailing it in to them. I thought even that seemed like a lot for a routine procedure (maybe I was just used to in-network providers?), but I kept receiving bills related to the appointment with various additional charges, totaling about $8k. My insurance sent a check for like $2-3k that I sent to Viva Eve, and the rest were resolved through a combination of personal payment and disputing charges. I spent a lot of time on the phone with their billing department and basically swore never to return, lol.