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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
CASH FLOWS FROM OPERATING ACTIVITIES    
Net income (loss) $ 5,410 $ (14,283)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:    
Depreciation and amortization 32,368 31,315
Amortization of operating lease right-of-use assets 14,711 15,699
Equity in earnings of joint ventures, net of dividends (4,324) (1,835)
Amortization of deferred financing costs and loan discount 748 746
Loss on sale and disposal of equipment and other 186 579
Amortization of cash flow hedge, net of taxes 739 922
Non-cash change in fair value of interest rate hedge (1,216) 4,093
Stock-based compensation 11,897 12,185
Change in fair value of contingent consideration 1,974 2,335
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in purchase transactions:    
Accounts receivable (25,865) (9,997)
Other current assets (6,277) (1,691)
Other assets (5,892) (2,726)
Deferred taxes (1,158) 942
Operating lease liability (12,883) (15,080)
Deferred revenue (172) 335
Accounts payable, accrued expenses and other 6,839 9,077
Net cash provided by operating activities 17,085 32,616
CASH FLOWS FROM INVESTING ACTIVITIES    
Purchase of imaging centers and other acquisitions (3,530) (9,644)
Purchase of property and equipment (57,409) (55,915)
Proceeds from sale of equipment 2 3
Net cash used in investing activities (60,937) (65,556)
CASH FLOWS FROM FINANCING ACTIVITIES    
Principal payments on notes payable (1,102) (184)
Payments on term loan debt (1,875) (3,688)
Contributions from noncontrolling interests 4,169 0
Proceeds from sale of economic interest in majority owned subsidiary, net of taxes 8,713 0
Proceeds from issuance of common stock, net of issuance costs 218,385 0
Proceeds from issuance of common stock upon exercise of options 8 51
Net cash provided by (used in) financing activities 228,298 (3,821)
EFFECT OF EXCHANGE RATE CHANGES ON CASH (36) (229)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS 184,410 (36,990)
CASH AND CASH EQUIVALENTS, beginning of period 342,570 127,834
CASH AND CASH EQUIVALENTS, end of period 526,980 90,844
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION    
Cash paid during the period for interest 18,285 21,471
Cash paid during the period for income taxes $ 1 $ 40