Plainfield Surgery Center
Services
Patients and Median Charge
This section shows the number of patients visiting this facility for certain conditions or procedures. IDPH used data provided by the facilities to calculate the charges. Your billable amount may vary greatly; always consult your physician or patient advocate.
All measures below are calculated for all patients unless otherwise specified.
| Major Diagnosis | Patients | Median Charge | |
|---|---|---|---|
| Arthroscopy 
                    
                    -
                    
                 
 | Too few cases | ||
| DescriptionThe number of patients who received an Arthroscopy (CCS 149). Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | 8 | $18,006.50 | |
| 
                    
                    -
                    
                 
 | 16 | $18,950.00 | |
| 
                    
                    -
                    
                 
 | 25 | $16,640.00 | |
| 
                    
                    -
                    
                 
 | 15 | $16,640.00 | |
| 
                    
                    -
                    
                 
 | 12 | $18,653.75 | |
| 
                    
                    -
                    
                 
 | 14 | $16,497.50 | |
| 
                    
                    -
                    
                 
 | 13 | $16,947.50 | |
| 
                    
                    -
                    
                 
 | 23 | $21,260.00 | |
| 
                    
                    -
                    
                 
 | 49 | $13,422.00 | |
| 
                    
                    -
                    
                 
 | 40 | $12,964.00 | |
| 
                    
                    -
                    
                 
 | 28 | $18,000.00 | |
| 
                    
                    -
                    
                 
 | 28 | $20,000.00 | |
| 
                    
                    -
                    
                 
 | 32 | $20,000.00 | |
| 
                    
                    -
                    
                 
 | 33 | $20,000.00 | |
| 
                    
                    -
                    
                 
 | 30 | $18,012.50 | |
| 
                    
                    -
                    
                 
 | 30 | $20,000.00 | |
| 
                    
                    -
                    
                 
 | 10 | $24,000.00 | |
| 
                    
                    -
                    
                 
 | 16 | $16,000.00 | |
| 
                    
                    -
                    
                 
 | 23 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 24 | $16,000.00 | |
| 
                    
                    -
                    
                 
 | 11 | $16,000.00 | |
| Bunionectomy 
                    
                    -
                    
                 
 | Too few cases | ||
| DescriptionThe number of patients who received a Bunionectomy (CCS 143). Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| Colonoscopy 
                    
                    -
                    
                 
 | 869 | $2,933.00 | |
| DescriptionThe number of patients who received a Colonoscopy with Biopsy (CCS 76). Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | 1,274 | $3,176.00 | |
| 
                    
                    -
                    
                 
 | 1,183 | $3,176.00 | |
| 
                    
                    -
                    
                 
 | 2,060 | $3,176.00 | |
| 
                    
                    -
                    
                 
 | 1,859 | $3,176.00 | |
| 
                    
                    -
                    
                 
 | 1,531 | $3,176.00 | |
| 
                    
                    -
                    
                 
 | 1,544 | $3,176.00 | |
| 
                    
                    -
                    
                 
 | 1,286 | $2,933.00 | |
| 
                    
                    -
                    
                 
 | 1,083 | $2,933.00 | |
| 
                    
                    -
                    
                 
 | 653 | $2,933.00 | |
| 
                    
                    -
                    
                 
 | 607 | $2,820.00 | |
| 
                    
                    -
                    
                 
 | 374 | $2,820.00 | |
| 
                    
                    -
                    
                 
 | 297 | $2,820.00 | |
| 
                    
                    -
                    
                 
 | 531 | $2,820.00 | |
| 
                    
                    -
                    
                 
 | 547 | $2,820.00 | |
| 
                    
                    -
                    
                 
 | 325 | $2,820.00 | |
| 
                    
                    -
                    
                 
 | 329 | $2,820.00 | |
| 
                    
                    -
                    
                 
 | 268 | $2,820.00 | |
| 
                    
                    -
                    
                 
 | 215 | $2,820.00 | |
| 
                    
                    -
                    
                 
 | 196 | $2,820.00 | |
| 
                    
                    -
                    
                 
 | 125 | $2,820.00 | |
| 
                    
                    -
                    
                 
 | 63 | $2,820.00 | |
| Tonsillectomy 
                    
                    -
                    
                 
 | 242 | $4,160.00 | |
| DescriptionThe number of patients who received a Tonsillectomy and/or Adenoidectomy (CCS 30). Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | 209 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 373 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 454 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 401 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 318 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 280 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 167 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 128 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 73 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 58 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 46 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 61 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 110 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 111 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 115 | $3,757.00 | |
| 
                    
                    -
                    
                 
 | 128 | $3,493.00 | |
| 
                    
                    -
                    
                 
 | 21 | $3,757.00 | |
| 
                    
                    -
                    
                 
 | 14 | $3,757.00 | |
| 
                    
                    -
                    
                 
 | 115 | $3,493.00 | |
| 
                    
                    -
                    
                 
 | 86 | $3,493.00 | |
| 
                    
                    -
                    
                 
 | 50 | $3,493.00 | |
| Knee Cartilage Excision 
                    
                    -
                    
                 
 | 52 | $8,320.00 | |
| DescriptionThe number of patients who received an Excision of Semilunar Knee Cartilage (CCS 151). Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | 76 | $8,320.00 | |
| 
                    
                    -
                    
                 
 | 88 | $8,320.00 | |
| 
                    
                    -
                    
                 
 | 112 | $8,320.00 | |
| 
                    
                    -
                    
                 
 | 126 | $8,320.00 | |
| 
                    
                    -
                    
                 
 | 267 | $8,320.00 | |
| 
                    
                    -
                    
                 
 | 272 | $8,320.00 | |
| 
                    
                    -
                    
                 
 | 277 | $8,320.00 | |
| 
                    
                    -
                    
                 
 | 276 | $8,320.00 | |
| 
                    
                    -
                    
                 
 | 250 | $8,138.00 | |
| 
                    
                    -
                    
                 
 | 223 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 177 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 183 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 219 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 203 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 143 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 121 | $16,000.00 | |
| 
                    
                    -
                    
                 
 | 75 | $16,000.00 | |
| 
                    
                    -
                    
                 
 | 109 | $16,000.00 | |
| 
                    
                    -
                    
                 
 | 123 | $16,000.00 | |
| 
                    
                    -
                    
                 
 | 129 | $16,000.00 | |
| 
                    
                    -
                    
                 
 | 76 | $16,000.00 | |
| Lesion Excision 
                    
                    -
                    
                 
 | 34 | $4,999.00 | |
| DescriptionThe number of patients who received an Excision of Skin Lesion (CCS 170). Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | 89 | $5,610.00 | |
| 
                    
                    -
                    
                 
 | 83 | $5,610.00 | |
| 
                    
                    -
                    
                 
 | 122 | $4,903.00 | |
| 
                    
                    -
                    
                 
 | 127 | $4,960.00 | |
| 
                    
                    -
                    
                 
 | 112 | $5,528.50 | |
| 
                    
                    -
                    
                 
 | 122 | $5,610.00 | |
| 
                    
                    -
                    
                 
 | 140 | $5,610.00 | |
| 
                    
                    -
                    
                 
 | 148 | $5,756.00 | |
| 
                    
                    -
                    
                 
 | 142 | $5,477.00 | |
| 
                    
                    -
                    
                 
 | 134 | $5,266.00 | |
| 
                    
                    -
                    
                 
 | 134 | $5,393.00 | |
| 
                    
                    -
                    
                 
 | 119 | $5,393.00 | |
| 
                    
                    -
                    
                 
 | 144 | $5,393.00 | |
| 
                    
                    -
                    
                 
 | 159 | $5,393.00 | |
| 
                    
                    -
                    
                 
 | 126 | $5,534.00 | |
| 
                    
                    -
                    
                 
 | 151 | $5,393.00 | |
| 
                    
                    -
                    
                 
 | 123 | $5,393.00 | |
| 
                    
                    -
                    
                 
 | 73 | $5,534.00 | |
| 
                    
                    -
                    
                 
 | 77 | $5,512.00 | |
| 
                    
                    -
                    
                 
 | 43 | $4,425.50 | |
| 
                    
                    -
                    
                 
 | 17 | $6,173.50 | |
| Inguinal Hernia Repair 
                    
                    -
                    
                 
 | Too few cases | ||
| DescriptionThe number of patients who received an Inguinal and Femoral Hernia Repair (CCS 85). Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | 10 | $8,860.50 | |
| 
                    
                    -
                    
                 
 | 10 | $8,856.00 | |
| 
                    
                    -
                    
                 
 | 15 | $9,068.00 | |
| 
                    
                    -
                    
                 
 | 23 | $9,068.00 | |
| 
                    
                    -
                    
                 
 | 30 | $9,068.00 | |
| 
                    
                    -
                    
                 
 | 33 | $9,068.00 | |
| 
                    
                    -
                    
                 
 | 63 | $8,748.00 | |
| 
                    
                    -
                    
                 
 | 74 | $8,748.00 | |
| 
                    
                    -
                    
                 
 | 65 | $8,467.62 | |
| 
                    
                    -
                    
                 
 | 57 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 79 | $14,978.00 | |
| 
                    
                    -
                    
                 
 | 94 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 78 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 82 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 51 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 30 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 31 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 26 | $8,000.00 | |
| 
                    
                    -
                    
                 
 | 14 | $8,000.00 | |
| Insertion of catheter or spinal stimulator and injection into spinal canal 
                    
                    -
                    
                 
 | 14 | $4,173.00 | |
| DescriptionThe number of patients who received an insertion of catheter or spinal stimulator and injection (CCS 5) Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | 33 | $4,082.00 | |
| 
                    
                    -
                    
                 
 | 82 | $3,925.00 | |
| 
                    
                    -
                    
                 
 | 79 | $3,925.00 | |
| 
                    
                    -
                    
                 
 | 33 | $2,450.00 | |
| 
                    
                    -
                    
                 
 | 25 | $1,675.00 | |
| 
                    
                    -
                    
                 
 | 46 | $2,450.00 | |
| 
                    
                    -
                    
                 
 | 48 | $3,325.00 | |
| 
                    
                    -
                    
                 
 | 35 | $3,325.00 | |
| 
                    
                    -
                    
                 
 | 31 | $3,300.00 | |
| 
                    
                    -
                    
                 
 | 46 | $2,062.50 | |
| 
                    
                    -
                    
                 
 | 49 | $1,675.00 | |
| 
                    
                    -
                    
                 
 | 45 | $1,830.00 | |
| 
                    
                    -
                    
                 
 | 44 | $2,004.50 | |
| 
                    
                    -
                    
                 
 | 34 | $1,830.00 | |
| Lumpectomy 
                    
                    -
                    
                 
 | Too few cases | ||
| DescriptionThe number of patients who received a Lumpectomy, Breast Quadrantectomy (CCS 166) Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | 5 | $7,205.00 | |
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | 11 | $7,205.00 | |
| 
                    
                    -
                    
                 
 | 18 | $7,066.00 | |
| 
                    
                    -
                    
                 
 | 15 | $6,927.00 | |
| 
                    
                    -
                    
                 
 | 15 | $6,927.00 | |
| 
                    
                    -
                    
                 
 | 14 | $6,927.00 | |
| 
                    
                    -
                    
                 
 | 14 | $6,927.00 | |
| 
                    
                    -
                    
                 
 | 16 | $6,927.00 | |
| 
                    
                    -
                    
                 
 | 15 | $6,927.00 | |
| 
                    
                    -
                    
                 
 | 17 | $6,927.00 | |
| 
                    
                    -
                    
                 
 | 15 | $6,927.00 | |
| 
                    
                    -
                    
                 
 | 10 | $6,927.00 | |
| 
                    
                    -
                    
                 
 | 11 | $6,927.00 | |
| 
                    
                    -
                    
                 
 | 12 | $6,927.00 | |
| 
                    
                    -
                    
                 
 | 7 | $6,927.00 | |
| Other non-OR therapeutic procedures, male genital 
                    
                    -
                    
                 
 | Too few cases | ||
| DescriptionThe number of patients other non-OR therapeutic procedures, male genital (CCS 117) Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | 6 | $10,845.00 | |
| 
                    
                    -
                    
                 
 | 5 | $4,145.00 | |
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | 5 | $4,145.00 | |
| 
                    
                    -
                    
                 
 | Too few cases | ||
| 
                    
                    -
                    
                 
 | Too few cases | ||
| Upper GI Endoscopy 
                    
                    -
                    
                 
 | 126 | $6,223.00 | |
| DescriptionThe number of patients who received an Upper Gastrointestinal Endoscopy with Biopsy (CCS 70). Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | 253 | $6,223.00 | |
| 
                    
                    -
                    
                 
 | 354 | $6,223.00 | |
| 
                    
                    -
                    
                 
 | 736 | $6,223.00 | |
| 
                    
                    -
                    
                 
 | 560 | $6,223.00 | |
| 
                    
                    -
                    
                 
 | 468 | $6,223.00 | |
| 
                    
                    -
                    
                 
 | 522 | $6,223.00 | |
| 
                    
                    -
                    
                 
 | 482 | $6,223.00 | |
| 
                    
                    -
                    
                 
 | 382 | $6,223.00 | |
| 
                    
                    -
                    
                 
 | 207 | $5,983.00 | |
| 
                    
                    -
                    
                 
 | 188 | $5,983.00 | |
| 
                    
                    -
                    
                 
 | 71 | $5,983.00 | |
| 
                    
                    -
                    
                 
 | 52 | $3,163.00 | |
| 
                    
                    -
                    
                 
 | 150 | $5,852.00 | |
| 
                    
                    -
                    
                 
 | 174 | $5,852.00 | |
| 
                    
                    -
                    
                 
 | 75 | $5,852.00 | |
| 
                    
                    -
                    
                 
 | 77 | $3,163.00 | |
| 
                    
                    -
                    
                 
 | 70 | $3,163.00 | |
| 
                    
                    -
                    
                 
 | 50 | $4,932.50 | |
| 
                    
                    -
                    
                 
 | 40 | $3,163.00 | |
| 
                    
                    -
                    
                 
 | 19 | $5,852.00 | |
| 
                    
                    -
                    
                 
 | 13 | $4,507.50 | |
| Decompression Peripheral Nerve 
                    
                    -
                    
                 
 | 5 | $12,480.00 | |
| DescriptionThe number of patients who received treatment for a Decompression Peripheral Nerve (CCS 6). Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | 15 | $6,240.00 | |
| 
                    
                    -
                    
                 
 | 23 | $6,240.00 | |
| 
                    
                    -
                    
                 
 | 51 | $6,240.00 | |
| 
                    
                    -
                    
                 
 | 67 | $6,240.00 | |
| 
                    
                    -
                    
                 
 | 62 | $6,240.00 | |
| 
                    
                    -
                    
                 
 | 62 | $6,240.00 | |
| 
                    
                    -
                    
                 
 | 56 | $6,240.00 | |
| 
                    
                    -
                    
                 
 | 64 | $6,240.00 | |
| 
                    
                    -
                    
                 
 | 69 | $6,240.00 | |
| 
                    
                    -
                    
                 
 | 51 | $6,000.00 | |
| 
                    
                    -
                    
                 
 | 41 | $6,000.00 | |
| 
                    
                    -
                    
                 
 | 47 | $6,000.00 | |
| 
                    
                    -
                    
                 
 | 52 | $6,000.00 | |
| 
                    
                    -
                    
                 
 | 49 | $6,000.00 | |
| 
                    
                    -
                    
                 
 | 27 | $6,000.00 | |
| 
                    
                    -
                    
                 
 | 21 | $5,170.00 | |
| 
                    
                    -
                    
                 
 | 18 | $5,170.00 | |
| 
                    
                    -
                    
                 
 | 21 | $3,877.00 | |
| 
                    
                    -
                    
                 
 | 18 | $4,523.50 | |
| 
                    
                    -
                    
                 
 | 9 | $5,170.00 | |
| Other Therapeutic Procedures on Muscles and Tendons 
                    
                    -
                    
                 
 | 27 | $8,320.00 | |
| DescriptionThe number of patients who received treatment for Other Therapeutic Procedures on Muscles and Tendons (CCS 160). Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | 54 | $10,020.00 | |
| 
                    
                    -
                    
                 
 | 105 | $16,640.00 | |
| 
                    
                    -
                    
                 
 | 146 | $8,320.00 | |
| 
                    
                    -
                    
                 
 | 148 | $8,320.00 | |
| 
                    
                    -
                    
                 
 | 128 | $8,320.00 | |
| 
                    
                    -
                    
                 
 | 119 | $9,970.00 | |
| 
                    
                    -
                    
                 
 | 97 | $13,620.00 | |
| 
                    
                    -
                    
                 
 | 118 | $14,560.00 | |
| 
                    
                    -
                    
                 
 | 200 | $16,000.00 | |
| 
                    
                    -
                    
                 
 | 188 | $16,320.00 | |
| 
                    
                    -
                    
                 
 | 147 | $27,986.00 | |
| 
                    
                    -
                    
                 
 | 151 | $27,986.00 | |
| 
                    
                    -
                    
                 
 | 190 | $20,000.00 | |
| 
                    
                    -
                    
                 
 | 184 | $20,000.00 | |
| 
                    
                    -
                    
                 
 | 115 | $24,000.00 | |
| 
                    
                    -
                    
                 
 | 117 | $24,000.00 | |
| 
                    
                    -
                    
                 
 | 71 | $17,658.00 | |
| 
                    
                    -
                    
                 
 | 65 | $16,000.00 | |
| 
                    
                    -
                    
                 
 | 75 | $23,986.00 | |
| 
                    
                    -
                    
                 
 | 81 | $23,986.00 | |
| Myringotomy (Pediatric) 
                    
                    -
                    
                 
 | 118 | $9,144.50 | |
| DescriptionThis measure counts the number of patients classified into this APR DRG Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | 49 | $9,144.50 | |
| 
                    
                    -
                    
                 
 | 179 | $9,144.50 | |
| 
                    
                    -
                    
                 
 | 242 | $9,144.50 | |
| 
                    
                    -
                    
                 
 | 206 | $9,144.50 | |
| 
                    
                    -
                    
                 
 | 229 | $9,144.50 | |
| 
                    
                    -
                    
                 
 | 219 | $9,144.50 | |
| 
                    
                    -
                    
                 
 | 158 | $9,144.50 | |
| 
                    
                    -
                    
                 
 | 124 | $9,144.50 | |
| 
                    
                    -
                    
                 
 | 53 | $8,844.00 | |
| 
                    
                    -
                    
                 
 | 69 | $8,796.50 | |
| 
                    
                    -
                    
                 
 | 65 | $8,350.00 | |
| 
                    
                    -
                    
                 
 | 57 | $4,350.00 | |
| 
                    
                    -
                    
                 
 | 113 | $4,350.00 | |
| 
                    
                    -
                    
                 
 | 111 | $4,350.00 | |
| 
                    
                    -
                    
                 
 | 100 | $4,350.00 | |
| 
                    
                    -
                    
                 
 | 104 | $4,350.00 | |
| 
                    
                    -
                    
                 
 | 71 | $4,350.00 | |
| 
                    
                    -
                    
                 
 | 104 | $4,053.00 | |
| Tonsillectomy (Pediatric) 
                    
                    -
                    
                 
 | 156 | $4,160.00 | |
| DescriptionThe number of patients who received a Tonsillectomy and/or Adenoidectomy (Pediatric) (CCS 30). Historical Data | |||
| Measure | Result | ||
| 
                    
                    -
                    
                 
 | 98 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 257 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 362 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 311 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 241 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 210 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 132 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 110 | $4,160.00 | |
| 
                    
                    -
                    
                 
 | 65 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 50 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 37 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 52 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 92 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 94 | $4,000.00 | |
| 
                    
                    -
                    
                 
 | 97 | $3,757.00 | |
| 
                    
                    -
                    
                 
 | 104 | $3,493.00 | |
| 
                    
                    -
                    
                 
 | 126 | $3,493.00 | |
| 
                    
                    -
                    
                 
 | 126 | $3,493.00 | |