Based on a detailed review of more than 30,000 auto injury claims closed with payment in 2012, this report documents substantial differences across states in the utilization of key medical diagnostic and treatment services. The study examined utilization patterns for MRIs and CT scans, as well as for treatment provided by chiropractors and physical therapists. Documenting extreme variation in utilization patterns for similar types of claims suggests opportunities for improving the quality of care provided to auto injury claimants and reducing the cost of auto injury claims.