CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
CASH FLOWS FROM OPERATING ACTIVITIES
Net Income	$ 24,611	$ 24,341
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	101,822	95,705
Noncash operating lease expense	45,516	47,542
Equity in earnings of joint ventures, net of dividends	(10,308)	5,012
Amortization of deferred financing costs and loan discount	2,336	2,240
Loss on sale and disposal of equipment	735	1,183
Loss on extinguishment of debt	2,080	0
Gain on contribution of imaging centers into joint venture	0	(16,808)
Amortization of cash flow hedge, net of taxes	8,242	2,765
Non-cash change in fair value of interest rate hedge	7,429	949
Stock-based compensation	21,368	21,380
Loss on impairment	1,200	3,949
Change in fair value of contingent consideration	1,974	(4,112)
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:
Accounts receivable	(35,369)	(1,379)
Other current assets	4,738	5,754
Other assets	(7,388)	(16,641)
Deferred taxes	4,834	7,389
Operating leases	(40,497)	(43,390)
Deferred revenue	(255)	1,155
Accounts payable, accrued expenses and other	57,426	(5,091)
Net cash provided by operating activities	190,494	131,943
CASH FLOWS FROM INVESTING ACTIVITIES
Purchase of imaging facilities and other acquisitions	(37,748)	(10,915)
Purchase of property and equipment and other	(145,164)	(136,537)
Proceeds from sale of equipment	151	82
Equity contributions in existing and purchase of interest in joint ventures	(1,496)	(5,453)
Net cash used in investing activities	(184,257)	(152,823)
CASH FLOWS FROM FINANCING ACTIVITIES
Principal payments on notes and leases payable	(4,296)	(1,929)
Payments on Term Loan Debt	(688,375)	(11,062)
Proceeds from debt refinancing, net of issuing costs	863,815	0
Contribution from noncontrolling partners	7,569	0
Payments on contingent consideration	(3,614)	(3,390)
Distributions paid to noncontrolling interests	(2,423)	(3,523)
Proceeds from sale of economic interests in majority owned subsidiary, net of taxes	8,641	5,102
Proceeds from issuance of common stock	218,385	245,831
Proceeds from issuance of common stock upon exercise of options	367	72
Net cash provided by financing activities	400,069	231,101
EFFECT OF EXCHANGE RATE CHANGES ON CASH	40	(171)
NET INCREASE IN CASH AND CASH EQUIVALENTS	406,346	210,050
CASH AND CASH EQUIVALENTS, beginning of period	342,570	127,834
CASH AND CASH EQUIVALENTS, end of period	748,916	337,884
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid during the period for interest	51,520	59,421
Cash paid during the period for income taxes	$ 2,202	$ 225