| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
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Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
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