Buy the assets that age slowly. Lease the ones that obsolete fast.
MRI magnets have long service lives: 15 to 20 years is normal, which makes ownership through a loan or a $1 buyout lease the usual answer. CT and PET/CT turn over faster on slice count and detector technology, so fair market value operating leases are common there. Ultrasound and X-ray are cheap enough that ownership almost always wins.
The decision that gets missed: only ownership structures qualify for Section 179 and bonus depreciation. An FMV operating lease is deducted as an operating expense instead. That is not automatically worse. But it changes the math, and it should be a decision rather than a surprise.
Five West writes equipment finance, capital leases, FMV leases, leaseback, and SBA, so we can model both sides on your numbers rather than recommending the one product we sell.
The three structures
Published market ranges as of August 2026. Confirm tax treatment with your CPA.
The question that decides it: how long will you keep this?
Everything else follows from that, so run it modality by modality.
MRI: usually buy. A magnet is a 15- to 20-year asset. Software and coils get upgraded; the magnet stays. Financing a 15-year asset on a 60-month operating lease and handing it back means paying for the depreciation of a machine that had most of its life left. Loans dominate here, and the long service life supports 84-month terms comfortably.
CT and PET/CT: leasing has a real case. Slice count and detector technology move, and clinical expectations move with them. A 64-slice that was competitive six years ago reads as dated to a referring physician today. If you expect to upgrade in five years, an FMV lease lets you hand the risk of that residual value to the lessor, which is exactly what a lessor is for.
Ultrasound, X-ray, mammography: usually buy. Ticket sizes are small enough that lease overhead is disproportionate, and the equipment earns for a decade. Buy them.
Where an FMV lease genuinely wins
- You intend to upgrade on a known cycle. If the plan is a new system in five years, you are buying five years of use, and a lease prices exactly that.
- You want the residual risk off your balance sheet. Predicting what a scanner is worth in 2031 is the lessor's business, not yours.
- Cash flow during a ramp. Lease payments are frequently lower than loan payments on the same equipment, because you are not amortizing the residual.
- You are already at the Section 179 cap. If a buildout has consumed the $2,560,000 allowance and pushed you into the $4,090,000 phase-out band, the tax advantage of owning one more asset is diminished, and operating-expense treatment on the marginal system may suit better.
- The technology is genuinely unsettled in that modality right now.
Where ownership wins
- Long-lived assets. Magnets, X-ray rooms, ultrasound.
- You want the Section 179 or bonus deduction. This is the big one. A $600,000 refurbished CT bought and placed in service in October can generate roughly $192,000 of tax reduction at a 32% marginal rate in year one, against about $37,365 of payments made. An FMV lease produces no such year-one event.
- You will keep it past the lease term anyway. FMV buyouts at term end are priced at fair value, and paying rent for five years and then market price is the most expensive path to ownership.
- You want a clean exit. Owned equipment can be sold, traded, or refinanced. Leased equipment must be returned in specified condition, and de-installation and rigging at term end are on you.
- Total cost matters more than monthly. Across a full ownership horizon, loans are usually cheaper.
The service contract usually matters more than the structure
This is the part most lease-versus-buy articles skip, and in imaging it frequently dominates the comparison.
Annual service runs 8% to 12% of purchase price. On MRI specifically: GE $66,000 to $134,000, Siemens $69,000 to $113,000, Philips $80,000 to $110,000, Hitachi $42,000 to $60,000. Over a seven-year hold that is $300,000 to $900,000, which on many deals is larger than the total interest.
Leases and captive financing frequently bundle service into the payment, which makes the payment look like one number and hides two. Ask for the payment with and without service, and ask for the service contract priced independently. A structure that looks 1.5 points more expensive can be cheaper once you compete the service line.
Comparing an offer honestly
Payment factors and APRs are not comparable, but total cost of contract is. For each option, add up:
- Every payment across the full term
- Down payment, documentation, and origination fees
- Any buyout: $1, a stated percentage, or fair market value
- End-of-term obligations: return condition, de-installation, rigging, freight
- Service contract, if bundled, priced separately for comparison
- The year-one tax effect, which differs by structure
Then compare the totals over the same number of years and the same assumption about what you do at the end. If one option assumes you hand the scanner back and the other assumes you own it outright, they are not the same comparison. Add the cost of replacing the returned system to make them one.
A worked comparison
A $750,000 CT, five-year horizon, illustrative figures:
Illustrative. Lease factors vary widely with credit, term, and residual assumption; a lower factor changes this comparison materially.
On these numbers the loan is cheaper and delivers a large year-one deduction, and you hold an asset with remaining life. The lease is defensible if you are certain you will replace the system in five years and you value handing back the residual risk. What is not defensible is choosing the lease because the monthly payment looked close and nobody added up the totals.
A note on sale-leaseback
If you own a scanner outright and need capital, a sale-leaseback converts it to cash while you keep operating it. It is a legitimate tool for funding an expansion or a second modality without new debt on the balance sheet in the same form. It also means you no longer own the asset, and there are tax consequences to the sale, including potential depreciation recapture if you previously expensed it. Worth exploring, worth modeling with your CPA first.
The bottom line
Match the structure to the asset's life and your intention. Buy magnets, X-ray rooms, and ultrasound. Consider an FMV lease on CT and PET/CT if you genuinely plan to upgrade on a cycle and want the residual risk elsewhere. Remember that Section 179 and bonus depreciation go only to ownership structures: loans and $1 buyout leases. And whichever way you go, unbundle the service contract before you compare anything, because on imaging equipment it is frequently the largest number in the deal. Give us the modality and your hold period and we will run both structures side by side.
On rates: Any range on this page is illustrative rather than a quote. Your actual rate can come in higher or lower, and it depends on personal and business credit, time in business, the equipment itself, the term you choose, and the size of the transaction. Two files for the same machine can price differently. It is also worth checking the date on anything you read elsewhere. A good deal of the equipment-finance content still circulating was written when prime was 3.25%, and prime is 6.75% today, so if you happen to come across rates like 5% or 6%, it is worth confirming whether the page is current before you plan around it. The surest way to know your number is to let us price your file.
Five West programs at a glance
The right structure depends on the asset, and a lender that writes only one product will recommend that product. We write the full line, so the recommendation follows your hold period rather than our shelf.
- Rates
- Priced to your credit profile, term, and equipment; competitive with a bank on rate, not on speed
- Terms
- 24 to 84 months, with 10 years on select programs
- Amounts
- $20,000 to $5 million+
- Application only
- Up to $500,000 with no tax returns or financial statements
- Credit
- Established businesses from 600+, startups from 700+
- Equipment
- New, used, refurbished, dealer, and private-party purchases
- Speed
- Same-day options on qualified files, with approvals in as little as a few hours
- Coverage
- Nationwide, U.S. territories, and cross-border
Give us the modality and how long you plan to keep it and we will model loan against FMV lease on your numbers, side by side.
Free consultation, no obligation. All financing is subject to credit approval and underwriting; rates and terms depend on the complete business and credit profile.
Related imaging center financing guides
More on financing equipment for a diagnostic imaging center.
Lease versus buy: your questions answered
Should you lease or buy an MRI?
Usually buy. An MRI magnet has a 15- to 20-year service life, so financing it on a 60-month operating lease and returning it means paying for the depreciation of an asset with most of its life remaining. Equipment loans and $1 buyout leases dominate MRI, and the long service life supports 84-month terms comfortably. FMV leases make more sense on CT and PET/CT, where technology cycles are shorter.
Does leasing imaging equipment qualify for Section 179?
It depends on the structure. A capital lease with a $1 buyout is treated as ownership and generally qualifies for Section 179 and 100% bonus depreciation. A fair market value operating lease does not, because the lessor owns the asset. You deduct the lease payments as an operating expense instead. Confirm treatment with your CPA before signing.
What is the difference between a capital lease and an operating lease?
A capital lease, typically with a $1 buyout, is ownership in substance: you take the depreciation deductions and own the equipment at term end, typically at 7% to 12% APR over 36 to 60 months. An FMV operating lease leaves ownership with the lessor, is quoted as a monthly payment factor of roughly 0.018 to 0.028 over 24 to 60 months, and ends with return, renewal, or purchase at fair market value.
Is leasing a CT scanner cheaper than buying?
The monthly payment is often lower, but total cost usually is not. On a $750,000 CT over five years, a loan at 8% runs about $15,207 monthly and $912,438 total, leaving you owning the scanner. An FMV lease at a 0.022 factor runs about $16,500 monthly and $990,000 total, ending in return or a fair-market buyout. Leasing wins when you are certain you will upgrade and want the residual risk with the lessor.
How much does an imaging service contract cost, and should it be bundled?
Annual service runs roughly 8% to 12% of purchase price. On MRI, OEM contracts run $66,000 to $134,000 for GE, $69,000 to $113,000 for Siemens, $80,000 to $110,000 for Philips, and $42,000 to $60,000 for Hitachi. Leases and captive financing often bundle it into one payment, which hides the cost. Ask for the payment with and without service, and price the service contract independently.
How do I compare a lease payment factor to a loan APR?
You cannot compare them directly, because part of a lease payment covers the lessor's residual assumption rather than interest. Compare total cost of contract instead: every payment across the term, plus fees, plus any buyout, plus end-of-term return, de-installation, and rigging obligations, plus the service contract if bundled. Then account for the year-one tax difference between ownership and operating-lease treatment.
What is a sale-leaseback on imaging equipment?
Selling a scanner you own outright to a lessor and leasing it back, converting the asset to cash while continuing to operate it. It can fund an expansion or a second modality without adding conventional debt. The tradeoffs are that you no longer own the asset and the sale has tax consequences, including potential depreciation recapture if you previously expensed it under Section 179.
Not sure which structure fits?
Tell us the modality and how long you plan to keep it. We will model both and show you the totals side by side.
This article is general information about commercial equipment financing and is not a commitment to finance. All financing is subject to credit approval and underwriting. Rates, terms, and approval depend on the complete business and credit profile. Figures shown are illustrative market ranges gathered from published sources as of August 2026 and are not an offer. Five West Financial is not a tax advisor or an accounting firm; confirm any tax treatment with your CPA before relying on it.