There is no single best teleradiology company. There are four vendor types, and the right one differs for a hospital emergency department and for an outpatient imaging center: national networks such as vRad, which joined Radiology Partners in December 2020, win on raw overnight scale; independent groups such as StatRad win on roster continuity; full service groups such as ONRAD, which acquired Direct Radiology from Royal Philips in January 2025, win when a hospital wants reading plus on-site radiology management in one contract; and subspecialty final-read practices such as AstraRad win when the read has to be right the first time and no in-house overread exists. The uncomfortable finding behind this page: across vRad, StatRad, ONRAD and Radiology Partners, not one publishes a price, a pricing model, a definition of how turnaround is measured, an SLA compliance percentage, or a named list of subspecialties. All of that is verifiable on their own sites, and it is why buyers cannot compare vendors before signing.
The four vendor archetypes, and which facility each one fits
| Archetype | Examples | Wins when | Loses when |
|---|---|---|---|
| National overnight network | vRad, Radiology Partners | Volume must be absorbed at 3 a.m. across many sites | You need a named subspecialty section and roster continuity |
| Independent or radiologist-owned group | StatRad | You want a stable roster and platform control | You need published performance numbers before signing |
| Full service radiology partner | ONRAD, Direct Radiology | You want reading plus on-site radiology management in one contract | You are buying reads only |
| Subspecialty final-read practice | AstraRad | The read must be right the first time, with no in-house overread | You are buying lowest unit price on bulk plain film |
On one scorecard the market looks undifferentiated. It is segmented by failure mode, not by size.
Hospital ED versus outpatient imaging center: two different scoring weights
Hospital ED and inpatient. Weight overnight STAT turnaround with a stated measurement method, critical results callback, final versus preliminary status, the credentialing path, and escalation to a radiologist you can reach. vRad publishes more emergent turnaround material than anyone here; ONRAD sells hospital radiology management alongside reading. Our nighthawk page covers overnight on our side.
Outpatient imaging center and multi-site groups. Weight subspecialty match to an elective mix, mammography and prior comparison handling, unit economics at volume with no minimum, and weekend and overflow absorption. Nobody writes for this segment. vRad publishes a breast program headline; StatRad and ONRAD publish no subspecialty names at all.
Company by company: what each vendor publishes, and what it does not
vRad (Virtual Radiologic). Publishes protocol specific averages: stroke under 7 minutes, trauma under 12 minutes, with undated PDFs hosted on info.vrad.com stating emergent averages under 20 minutes. Finals are stated as over 80% of study volume. Does not publish how turnaround is measured, a routine tier, a compliance percentage, a client-facing subspecialty list, or a price. Its careers page states no fellowship is required for general diagnostic radiology. Joined Radiology Partners in December 2020.
StatRad. Publishes no numeric turnaround and no tiered SLA; the position is that every exam is treated as a STAT exam, with performance disclosed privately in a client portal. Publishes real credentials: Joint Commission accreditation, FDA 510(k) clearance as a registered medical device manufacturer, ISO certification, an in-house built PACS. Names no subspecialty and no price. Its About page still describes the company as privately owned by radiologists, while I-MED published its acquisition and StatRad's advisor published a completion date of July 1, 2024.
ONRAD and Direct Radiology. Publishes zero numeric turnaround figures; turnaround appears as the adjective superior, customizable per customer. Publishes a four step peer review process, a Quality Assurance Committee, and Joint Commission accreditation with OPPE and FPPE adherence. Names zero subspecialties, only modalities, alongside 145+ board-certified radiologists. No price. Acquired Direct Radiology from Royal Philips in January 2025.
Radiology Partners. Publishes no turnaround number, no measurement definition and no price. Its remote division, Matrix at RP, publishes 100% final reads and describes itself as the internal remote practice of Radiology Partners rather than a service marketed to outside clients. Self-describes as physician-led and physician-owned; its own dated releases disclose institutional investors with board seats and multi-billion dollar debt.
AstraRad. Publishes a median STAT turnaround of 28 minutes, tiers of STAT under 1 hour, Urgent under 4 hours and Routine under 24 hours, and 99.4% SLA compliance over the trailing 12 months on the SLA page. Final signed reads by 240 fellowship-trained subspecialists across ten named subspecialties, 600,000 reads a year. QA: 1 in 20 independently double-read, major discrepancy rate under 0.3%.
The cost per read problem
Four of the five providers here publish no price at all. That is normal: rates move with modality mix, volume and turnaround tier. It also means any listicle ranking vendors "by value" is ranking on nothing.
What you can compare before a quote is the model. Per report with no minimums transfers volume risk to the vendor; a monthly minimum transfers it to you; subscription plus per report means paying for a floor you may not use. Platform, integration, after-hours and priority surcharges are where a low headline rate is recovered.
AstraRad publishes its model: per report, no minimums, no subscriptions, no platform fees, rate card within one business day of a case mix being shared. We do not publish a dollar rate either, so on a published cost per read the honest answer for us is also no. Our cost guide explains what drives the number.
The five verifiable comparison axes
- Published turnaround with a stated method. A number without a measurement definition is marketing. Ask for the clock start event, the percentile, the trailing compliance rate.
- Report status. Final signed reads versus preliminary reads that need an in-house overread the next morning. That changes staffing cost, not just your invoice.
- Named subspecialties matched to your case mix. Not "subspecialty trained," a list. Then ask which section reads your coronary CTA and which reads your pediatric MRI.
- QA methodology with a stated discrepancy definition. Sampling rate, who performs the second read, how discrepancies are classified and adjudicated.
- Complete pricing structure and ownership stability. Every fee, and who owns the company today, with a change of control termination right.
Vanity metrics to ignore: roster headcount, years in business claims predating current ownership, media logos, country counts.
Contradictions you can check in ten minutes
This costs an hour and no RFP. Open each vendor's site, its press releases and any PDFs still hosted on its domain, then look for the same fact stated twice.
Checkable as of July 2026: vRad's radiologist count appears as 688 and as 500+ inside the same November 2025 press release, and as 550+ on its blog. Its site states the QA committee overreads 2% of final interpretations while a QA PDF live on its domain states 1%. Its boilerplate states 1,600 facilities while a hosted PDF states 2,100+. ONRAD publishes 7,500+ reads per day on its homepage and over 7,500 studies per year on its About page, most likely a typo, but it is on their site. Radiology Partners publishes "nearly 200 radiologists" and "185 Radiologists" on the same Matrix page.
None of these are disqualifying alone. They tell you how carefully a vendor governs its published numbers, a fair proxy for how it will govern the numbers in your monthly SLA report.
Where AstraRad is the wrong choice
- You are buying lowest unit price on high volume routine plain film and ultrasound. Price-led reading shops beat a fellowship-trained subspecialist roster on that number every time, and they should. Our overflow page is honest about where we fit on that work.
- You need a radiologist physically in the building: fluoroscopy supervision, image guided procedures, interventional coverage, in-person tumor board. We read remotely. A full service group such as ONRAD, or a local practice, is the right call.
- You want the vendor to bill payers directly so your organization never touches the interpretation fee. vRad publishes a Payer Direct billing program that does exactly that. AstraRad does not.
- You are shopping for an AI-first workflow, meaning algorithmic triage or an AI pre-read that flags studies before a radiologist opens them. AstraRad does not perform AI pre-reads or AI triage. Our turnaround comes from 240 subspecialists across 12 time zones, 24/7/365. Vendors marketing AI platforms should be evaluated on their own claims, not ours.
How to build a two-vendor shortlist in one week
Day 1. Pull 30 days of studies by modality, body part and priority. That file is your scoring weight.
Day 2. Segment yourself: ED and inpatient, or outpatient imaging center. Keep the axes that map to your real failure mode.
Day 3. Run the contradiction check on every vendor on the list.
Day 4. Send four vendors the same written request: turnaround tiers with a measurement definition and trailing compliance rate, subspecialty sections mapped to your case mix, complete fee schedule, QA sampling rate and discrepancy definition, and confirmation that radiologists are licensed in the state where your patients are located. Our licensing hub documents ours.
Day 5. Cut to two on written answers only. The 25 question version is in our buyer's guide.
Scorecard
Turnaround and report status, checked July 2026:
| Provider | Published turnaround | Stated methodology | Report status |
|---|---|---|---|
| AstraRad | Median STAT 28 min; STAT <1h, Urgent <4h, Routine <24h (SLA) | Tiers plus 99.4% SLA compliance, trailing 12 months | Final signed reads |
| vRad | Stroke under 7 min, trauma under 12 min (source) | Does not publish; no percentile, no routine tier | Preliminary and final; finals over 80% of volume |
| StatRad | Does not publish (source) | Does not publish | Preliminary and final |
| ONRAD / Direct Radiology | Does not publish (source) | Does not publish; a 2010 article still live argues comparisons are not apples to apples | Final reads the majority; preliminary available |
| Radiology Partners | Does not publish (source) | Does not publish | Matrix at RP publishes 100% final reads |
Pricing, subspecialties, QA, ownership:
| Provider | Cost per read and pricing model | Named subspecialties | QA disclosure | Ownership |
|---|---|---|---|---|
| AstraRad | Model published: per report, no minimums, no subscriptions, no platform fees, rate card within one business day (pricing). No dollar rate | Ten named, 240 fellowship-trained (roster) | 1 in 20 independently double-read; major discrepancy under 0.3% | Not published on the site |
| vRad | Does not publish a price, rate card or model (source); publishes a Payer Direct billing program | Does not publish a list or count | Three level discrepancy scheme, 2% internal overread, SOC 2 Type II, Joint Commission. No double-read program published | Joined Radiology Partners, December 2020 (source) |
| StatRad | Does not publish (source); setup free unless HL7 is added | Does not publish | Methodology only: third party reviewers, spot checks, monthly miss rate review, Joint Commission, FDA 510(k), ISO | Site states privately owned by radiologists (source); I-MED deal completed July 1, 2024 |
| ONRAD / Direct Radiology | Does not publish (source) | Does not publish; modalities only (source) | Methodology only: four step peer review, QA Committee, Joint Commission with OPPE and FPPE | Acquired Direct Radiology, January 2025; self-describes as largest independent |
| Radiology Partners | Does not publish (source) | Does not publish | Guideline adherence across six incidental findings since 2015, not a discrepancy measurement | Physician-led and physician-owned per its site; releases disclose institutional investors with board seats |
Every "does not publish" cell means exactly that, checked against the linked page. If a vendor will put the missing number in a contract, that counts. Ask us for ours at contact.