MedStar St Mary's Hospital — price list
← Hospital overviewVerified from MedStar St Mary's Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
179 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| 3c admin stepdown bed Inpatient | 10071009 CDM | $357 | $350 | $350 – $357 | — | |
| Admission charge Inpatient | 22100010 CDM | $455 | $446 | $446 – $455 | — | |
| Alloderm cont prf 230 sqcm Outpatient | Q4116 HCPCS | $18,568 | $18,197 | $18,197 – $18,568 | — | |
| Alloderm cont prf md 185 sqcm Outpatient | Q4116 HCPCS | $14,944 | $14,645 | $14,645 – $14,944 | — | |
| Alloderm tiss thk md 48 sqcm Outpatient | Q4116 HCPCS | $6,262 | $6,137 | $6,137 – $6,262 | — | |
| Allogft cryo n/mesh 232 sqcm Outpatient | Q4433 HCPCS | $2,189 | $2,146 | $2,146 – $2,189 | — | |
| Allogft mesh 12 sqcm Outpatient | Q4186 HCPCS | $4,614 | $4,522 | $4,522 – $4,614 | — | |
| Allograft derma ace 28 sqcm Outpatient | Q4126 HCPCS | $6,553 | $6,422 | $6,422 – $6,553 | — | |
| Allograft men withbridge m/rt Outpatient | C1762 HCPCS | $14,161 | $13,878 | $13,878 – $14,161 | — | |
| Bh admin stepdown bed Inpatient | 10071017 CDM | $357 | $350 | $350 – $357 | — | |
| Drsg matrix bil 1/each 26 sqcm Outpatient | Q4104 HCPCS | $9,399 | $9,211 | $9,211 – $9,399 | — | |
| Drsg matrix bil 1/each 129 sqcm Outpatient | Q4104 HCPCS | $14,602 | $14,310 | $14,310 – $14,602 | — | |
| Drsg matrix bil 5/pk 26 sqcm Outpatient | Q4104 HCPCS | $9,397 | $9,209 | $9,209 – $9,397 | — | |
| Drsg matrix bil 5/pk 129 sqcm Outpatient | Q4104 HCPCS | $12,666 | $12,413 | $12,413 – $12,666 | — | |
| Drsg wnd bilayr 516.128 sqcm Outpatient | Q4104 HCPCS | $35,751 | $35,036 | $35,036 – $35,751 | — | |
| Drsg wnd matrix mesh 25 sqcm Outpatient | Q4104 HCPCS | $8,173 | $8,010 | $8,010 – $8,173 | — | |
| Drsg wnd matrix mesh 125 sqcm Outpatient | Q4104 HCPCS | $14,255 | $13,970 | $13,970 – $14,255 | — | |
| Drsg wnd matrix sgl 26 sqcm Outpatient | Q4108 HCPCS | $8,054 | $7,893 | $7,893 – $8,054 | — | |
| Drsg wnd matrix sgl 129 sqcm Outpatient | Q4108 HCPCS | $11,014 | $10,794 | $10,794 – $11,014 | — | |
| Drsg wnd mesh 516.12 sqcm Outpatient | Q4104 HCPCS | $31,087 | $30,466 | $30,466 – $31,087 | — | |
| Epifix tiss matrix 49 sqcm Outpatient | Q4186 HCPCS | $25,633 | $25,121 | $25,121 – $25,633 | — | |
| Fen cytal 12.25 sqcm Outpatient | Q4166 HCPCS | $251 | $246 | $246 – $251 | — | |
| Gft allo md perf cont 132 sqcm Outpatient | Q4116 HCPCS | $14,944 | $14,645 | $14,645 – $14,944 | — | |
| Gft allo perf duo 132 sqcm Outpatient | Q4116 HCPCS | $23,064 | $22,603 | $22,603 – $23,064 | — | |
| Gft decel thk 12.25 sqcm Outpatient | Q4125 HCPCS | $9,339 | $9,152 | $9,152 – $9,339 | — | |
| Gft dermis mesh 320 sqcm Outpatient | Q4122 HCPCS | $25,935 | $25,417 | $25,417 – $25,935 | — | |
| Gft dermis sft 128 sqcm Outpatient | Q4122 HCPCS | $10,213 | $10,009 | $10,009 – $10,213 | — | |
| Gft dermis sft 160 sqcm Outpatient | Q4122 HCPCS | $12,765 | $12,509 | $12,509 – $12,765 | — | |
| Gft hmn tiss amnioband 80mg Outpatient | Q4168 HCPCS | $4,667 | $4,573 | $4,573 – $4,667 | — | |
| Gft hmn tiss amnioband 24 sqcm Outpatient | Q4151 HCPCS | $8,846 | $8,669 | $8,669 – $8,846 | — |