Appian360 is engaged with an organization serving patients across 3 states with $2.4B in revenue, 82,000 annual discharges, over 1.26M outpatient registrations, over 285K ER visits and over 75K surgical visits. The focus of our work is within an integrated cancer service line network consisting of more than 20 patient care service sites and over 120 oncology specific physicians. The 24 month project established a system whereby approximately 50 cancer disease site leaders would develop 48 imaging pathways for the 12 highest volume cancer disease states. Appian360 conducted an analysis at 6 facilities to compare the financial impact of the pathways. Nine cancer sites were included in the study including Head and Neck, Breast, Lung, Lymphoma, Rectal, Esophogeal, Cervical, Endometrial, and Ovarian. Based on the newly agreed to imaging pathways the yearly cost savings were over $6M or nearly $3,000 per case. These results extrapolated to all cases is estimated at $12M savings for the entire population. These findings were further validated by the Acturial Office. Estimates for full implementation across all AHN facilities for the standardized imaging pathways are projected in the $50-75M range.