CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
CASH FLOWS FROM OPERATING ACTIVITIES
Net Income	$ 12,355	$ 275
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	66,843	63,495
Noncash operating lease expense	30,006	31,601
Equity in earnings of joint ventures	(6,713)	6,096
Amortization of deferred financing costs and loan discount	1,541	1,494
Loss on sale and disposal of equipment	587	656
Loss on extinguishment of debt	2,080	0
Amortization of cash flow hedge, net of taxes	7,256	1,844
Non-cash change in fair value of interest rate hedge	674	(66)
Stock-based compensation	16,645	17,055
Change in fair value of contingent consideration	1,974	3,098
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:
Accounts receivable	(31,581)	(8,124)
Other current assets	5,242	4,703
Other assets	(5,553)	(6,590)
Deferred taxes	1,791	(2,249)
Operating leases	(27,707)	(28,582)
Deferred revenue	(185)	1,033
Accounts payable, accrued expenses and other	57,835	14,952
Net cash provided by operating activities	133,090	100,691
CASH FLOWS FROM INVESTING ACTIVITIES
Purchase of imaging facilities and other acquisitions	(32,771)	(10,315)
Purchase of property and equipment and other	(104,095)	(95,380)
Proceeds from sale of equipment	9	73
Equity contributions in existing and purchase of interest in joint ventures	(1,421)	(288)
Net cash used in investing activities	(138,278)	(105,910)
CASH FLOWS FROM FINANCING ACTIVITIES
Principal payments on notes and leases payable	(2,624)	(1,052)
Payments on Term Loan Debt	(682,438)	(7,376)
Proceeds from debt refinancing, net of issuing costs	863,869	0
Contribution from noncontrolling partners	4,169	0
Payments on contingent consideration	(3,614)	0
Distributions paid to noncontrolling interests	(2,423)	(3,523)
Proceeds from sale of economic interests in majority owned subsidiary, net of taxes	8,713	0
Proceeds from issuance of common stock	218,385	246,202
Proceeds from issuance of common stock upon exercise of options	367	51
Net cash provided by financing activities	404,404	234,302
EFFECT OF EXCHANGE RATE CHANGES ON CASH	(107)	(266)
NET INCREASE IN CASH AND CASH EQUIVALENTS	399,109	228,817
CASH AND CASH EQUIVALENTS, beginning of period	342,570	127,834
CASH AND CASH EQUIVALENTS, end of period	741,679	356,651
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid during the period for interest	34,203	39,301
Cash paid during the period for income taxes	$ 705	$ 201