CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
Mar. 31, 2021	Mar. 31, 2020
CASH FLOWS FROM OPERATING ACTIVITIES
Net income (loss)	$ 13,775	$ (13,998)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	22,656	21,934
Amortization of operating lease right-of-use assets	17,863	17,259
Equity in earnings of joint ventures	(2,285)	(1,955)
Amortization of deferred financing costs and loan discount	1,147	1,081
(Gain) loss on sale and disposal of equipment and other	(1,307)	771
Amortization of cash flow hedge	925	0
Non-cash change in fair value of interest rate hedge	(11,245)	0
Stock-based compensation	8,248	6,622
Change in fair value of contingent consideration	200	0
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:
Accounts receivable	(17,493)	10,504
Other current assets	(4,308)	5,164
Other assets	(3,507)	677
Deferred taxes	3,133	(11,413)
Operating lease liability	(18,291)	(17,345)
Deferred revenue	1,416	28
Accounts payable, accrued expenses and other	17,157	21,584
Net cash provided by operating activities	28,084	40,913
CASH FLOWS FROM INVESTING ACTIVITIES
Purchase of imaging facilities and other acquisitions	(57,075)	(4,300)
Purchase of property and equipment	(30,424)	(51,538)
Proceeds from sale of equipment	151	779
Net cash used in investing activities	(87,348)	(55,059)
CASH FLOWS FROM FINANCING ACTIVITIES
Principal payments on notes and leases payable	(827)	(914)
Payments on term loan debt	(10,824)	(10,824)
Proceeds from revolving credit facility	87,100	215,900
Payments on revolving credit facility	(87,100)	(135,900)
Net cash (used in) provided by financing activities	(11,651)	68,262
EFFECT OF EXCHANGE RATE CHANGES ON CASH	(12)	1
NET INCREASE IN CASH AND CASH EQUIVALENTS	(70,927)	54,117
CASH AND CASH EQUIVALENTS, beginning of period	102,018	40,165
CASH AND CASH EQUIVALENTS, end of period	31,091	94,282
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid during the period for interest	8,267	9,934
Equipment acquired and leasehold improvements	28,800	$ 30,800
Investment in joint ventures	36,813
Investment in joint ventures	$ 36,813

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