The article considers directions of development of market of commercial medical services exemplified by St. Petersburg. The regional market of commercial medicine plays important role in health care of the Russian Federation. The commercial medicine permits to reduce deficiency of state financing of medicine in Russia at the expense of increasing of solvency of population making demand for commercial medical services. Among regional markets of commercial medicine, the most developed are markets of Moscow and St. Petersburg. The subjective and objective factors affecting formation of barriers for entering market of commercial medical services in region are identified. The prospects of development of regional market of commercial medicine are presented on the basis of construction dynamic series and estimates based on ratings obtained by reducing verbal assessments into numerical form. The study results can be useful and of interest for both business and regional health care authorities. The presented trends and prospects of development of market of commercial medical services in St. Petersburg reflect strategic directions of modernization of health care through prism of replication of best practices of increasing satisfaction of patients with quality of medical services.