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Don&#8217;t get screwed.</text><text x="58" y="258" font-family="Arial,Helvetica,sans-serif" font-size="30" font-weight="600" fill="#6b5b4d">Leases, TI, NNN &amp; buildouts — negotiated in your favor</text><g transform="translate(1010,86)" fill="none" stroke="#C0531F" stroke-width="9" stroke-linejoin="round"><rect x="20" y="40" width="150" height="130"/><line x1="20" y1="40" x2="95" y2="6"/><line x1="170" y1="40" x2="95" y2="6"/><rect x="50" y="80" width="36" height="36"/><rect x="104" y="80" width="36" height="36"/><rect x="74" y="128" width="42" height="42"/></g></svg>

How Do I Budget an Imaging Center (MRI/CT) Buildout?

Direct Answer

Budget a diagnostic imaging center buildout at $200–$450 per square foot, the most expensive medical fit-out per foot you are likely to undertake, driven by the shielding every modality demands. An MRI suite needs a radiofrequency (RF) shielded copper enclosure plus magnetic shielding, which runs $80,000–$250,000 for the cage alone depending on magnet strength, and the magnet room slab often must be reinforced for a 3,000–10,000 pound machine and a quench-vent pipe routed to the roof.

A CT suite needs lead radiation shielding — typically 1/16-inch to 1/4-inch lead-lined walls — costing $30,000–$120,000 depending on room size and barrier thickness set by a physicist's report. The single biggest money move is to lease ground-floor space with a clear path for magnet delivery and a structure that can carry the load, because a second-floor MRI requires structural steel reinforcement and a crane that can add $50,000–$200,000 you would avoid on grade.

For a typical 6,000–12,000 square foot multi-modality center, plan a hard-cost budget of $1,500,000–$5,000,000 plus equipment of $300,000–$3,000,000 depending on whether you buy new or refurbished. Do not let a landlord's $50–$75 per square foot TI allowance fool you into thinking it covers an imaging buildout — it covers a small slice.

And get a shielding physicist and a structural engineer to evaluate the space before you sign, because discovering after lease execution that the slab cannot hold the magnet or the magnetic field will fringe into a neighboring tenant is a catastrophe priced in hundreds of thousands.

Why Imaging Is the Priciest Medical Buildout

Imaging centers carry costs no other medical use does, and they all trace to physics. MRI generates a powerful magnetic field, so you need an RF shield (a welded or clipped copper or galvanized-steel enclosure that blocks radio interference) and often passive or active magnetic shielding to keep the field from spilling into adjacent spaces.

The magnet itself is enormous and heavy, so the slab may need reinforcement, and the cryogen quench vent — the emergency pipe that releases helium gas if the magnet quenches — must run to the exterior with code-compliant sizing. Floors, doors, and even the HVAC ductwork in the magnet room must be non-ferrous, which raises material cost across the board.

CT and X-ray swap magnetic concerns for ionizing radiation, so the cost mover is lead shielding. A medical physicist calculates the required barrier thickness based on workload and occupancy on the other side of each wall, and you line walls, doors, and view windows accordingly.

Lead-lined drywall, lead glass, and lead doors are expensive and heavy. Both modalities need robust electrical — an MRI magnet and a CT both pull serious power and often require dedicated transformers and conditioned power — plus precision HVAC with tight temperature and humidity control to protect the equipment, sized at roughly 300–400 square feet per ton because the machines reject heat continuously.

Add a chiller for MRI cooling at $40,000–$120,000, and the per-foot number climbs fast.

Build Your Number From the Ground Up

For a 2-modality (1 MRI + 1 CT) 8,000 square foot center on grade in second-generation medical space:

• General conditions/supervision: $100,000–$200,000 (7–10% of hard cost).
• Demolition and structural prep: $5–$12 per square foot = $40,000–$96,000.
• RF + magnetic shielding (MRI): $80,000–$250,000.
• Lead radiation shielding (CT/X-ray): $30,000–$120,000.
• Structural reinforcement (slab/steel): $0 on grade to $200,000 upper floor.
• Framing, drywall, finishes: $30–$55 per square foot = $240,000–$440,000.
• HVAC, precision cooling, chiller: $150,000–$400,000.
• Electrical, dedicated transformers, conditioned power: $150,000–$400,000.
• Quench vent, plumbing, finishes: $60,000–$150,000.
• Permits, physicist report, design, engineering: $80,000–$200,000.

That puts hard cost roughly $1,300,000–$3,000,000, or $160–$375 per square foot, before equipment. Imaging equipment is the giant separate line: a new 1.5T MRI runs $1,000,000–$1,500,000 and a new 64-slice CT runs $300,000–$700,000, while quality refurbished units cut that by 30–50%.

Finance equipment apart from construction. Hold a 15–20% contingency because shielding rework and physics re-tests are common.

How To Not Get Screwed

Imaging is where a bad lease or a wrong space turns into a seven-figure mistake. Guard these.

The structural and access trap. Before you sign, confirm two things in writing: the floor can carry the magnet (a structural engineer's letter) and there is a delivery path for it — wide enough doors or a knock-out wall, and either grade access or a route a crane can reach.

A landlord who delivers you an upper-floor suite with no magnet path is handing you a $50,000–$200,000 problem. Make slab capacity and delivery access lease conditions with the landlord responsible for any base-building structural shortfall.

The fringe-field and quench-vent fights. An MRI's magnetic field extends beyond its room, and the 5-gauss line cannot cross into uncontrolled space or another tenant's suite. If your site cannot contain the fringe field, you need more shielding — more money — or a different room.

Likewise the quench vent must penetrate the roof, which is the landlord's roof. Get written landlord consent for roof penetration and exterior venting in the lease, or you will be renegotiating mid-construction from a weak position.

The TI allowance mismatch and the financing dressed as a concession. A $60 per square foot allowance against a $200–$450 per square foot job is a rounding error. Negotiate up to $80–$150 per square foot on a long term (10–15 years), paid as reimbursement against invoices, and refuse to silently amortize the balance into rent at the landlord's 8–10% without pricing it.

Vet the GC hard: RF shielding, lead shielding, and quench venting are specialty subs — bid three GCs with imaging-center experience, demand a fixed-price (stipulated sum) contract, cap change-order markup at 10–15%, hold 10% retainage until the physicist's post-construction survey passes, and never pay for shielding work the physicist has not signed off on.

Timeline, Physics, and Cash Flow

An imaging center buildout runs 20–36 weeks of construction after permits — the longest of the medical fit-outs — because shielding, structural work, magnet delivery and ramp-up, and the physicist's pre- and post-construction surveys all sit in the critical path. Add a possible Certificate of Need in regulated states (2–12 months up front) and equipment lead times that can stretch 12–24 weeks for a new MRI.

Every empty week is costly: an 8,000 square foot suite at $36 per square foot annual burns about $5,500 per week dark. Negotiate a 6–10 month rent-free buildout window, sequence the magnet delivery before the RF enclosure is sealed (you cannot get the magnet in once the cage is closed), and keep 15–20% liquid contingency outside the construction loan for shielding re-tests and the physics punch list.

Finance the imaging equipment on its own term so you are not paying construction-loan interest on a million-dollar MRI.

FAQ

How much does an MRI/CT imaging center buildout cost per square foot? Plan $200–$450 per square foot, the highest of any medical use. RF and magnetic shielding for MRI ($80,000–$250,000), lead shielding for CT ($30,000–$120,000), precision HVAC, dedicated power, and possible structural reinforcement are what drive the premium.

Why does MRI cost more to build than CT? MRI requires both an RF-shielded copper enclosure and magnetic shielding, plus a reinforced slab for a multi-ton magnet and a cryogen quench vent to the roof, with non-ferrous materials throughout. CT's main cost is lead radiation shielding sized by a physicist, which is significant but typically less than the full MRI enclosure package.

Can I put an imaging center on an upper floor? You can, but it is expensive. An upper-floor MRI usually needs structural steel reinforcement and crane delivery, adding $50,000–$200,000. Ground-floor space with grade-level magnet access and adequate slab capacity is almost always the cheaper, faster choice.

Will the landlord's allowance cover it? No. A typical $50–$75 per square foot TI allowance covers a fraction of a $200–$450 per square foot imaging job. Negotiate up to $80–$150 per square foot on a 10–15 year term, paid as invoice reimbursement, and require the landlord to fund base-building structural and roof-penetration work.

Sources

• CBRE, "U.S. Healthcare Real Estate: Imaging and Diagnostic Facility Cost Trends" (2025).
• JLL, "Healthcare and Life Sciences Fit-Out Cost Guide" (2025).
• Cushman & Wakefield, "Specialty Medical and Outpatient Imaging Outlook" (2025).
• RSMeans / Gordian, "Building Construction Costs With RSMeans Data — Healthcare Occupancy" (2025).
• American College of Radiology (ACR), "Facility Design and Equipment Siting Guidance."
• Facility Guidelines Institute (FGI), "Guidelines for Design and Construction of Outpatient Facilities" (2022 edition).
• NCRP Report No. 147, "Structural Shielding Design for Medical X-Ray Imaging Facilities."
• NAIOP, "Specialty Medical Tenant Improvement Allowance Benchmarks" (2025).