A lot of places apparently think 800mg of ibuprofen is sufficient pain medication to have metal tools shoved not too gently into your uterus. Even more so if your uterus is oddly positioned and the nurse has to press on your gut to move your uterus down so they can push -harder- with the tools to make it fit in there. Most OB/gyn will only do them in office, without pain medication/numbing. Also too, insurance cost is part of it. It's 100% covered.. if you do it without sedation. I paid 1300$ and got my rear knocked out with ketamine and that was the best experience I've had with IUD placements.