Med Spa and Medical Aesthetic M&A Multiples Report 2026: Valuation Benchmarks by Size and Model

Prepared by CT Acquisitions research. Observed transaction ranges reported by third-party sources. Not an appraisal, not investment advice, not legal, tax, or financial advice. Read the compliance note in section 12 before quoting any figure.

Last updated: July 1, 2026. Vintage window covered: transactions closing between calendar Q1 2024 and Q2 2026, benchmarked against the 2019 baseline.

1. Executive summary

The med spa segment is the most fragmented, highest-growth, and most cash-pay-dependent sub-vertical inside healthcare services. It sits adjacent to dermatology on the CT Acquisitions healthcare cluster, but with a distinct axis: dermatology blends insurance, medical, and cosmetic revenue, while a pure med spa is 95 percent or more cash-pay, with roughly one third of top-line revenue tied to injectables and the balance to devices, memberships, skincare retail, and wellness add-ons. That mix produces a different valuation shape and a different buyer universe for med spa M&A multiples 2026.

Eight observations frame the 2026 market.

• Single-provider, owner-operated med spas with under 500 thousand dollars in seller discretionary earnings continue to change hands at 2.1x to 3.9x SDE on BizBuySell-tracked listings, per its Q2 2025 Insight Report cash-flow-multiple bands (source: BizBuySell health-and-beauty spa benchmark page).
• Mature single-provider or small multi-provider med spas with 500 thousand to 1.5 million dollars in SDE now transact in a 3.5x to 6.0x SDE window per Skytale Group‘s published sweet-spot range (source: Skytale Group med spa M&A commentary; americanmedspa.org 2025 look-back).
• Lower-middle-market multi-provider groups with 1 million to 3 million dollars in adjusted EBITDA cluster at 5.0x to 7.0x adjusted EBITDA per FOCUS Investment Banking’s 2026 Medspa Dashboard and consistent with the Scope Research and Breakwater 2026 tables.
• Regional platforms above 3 million dollars in adjusted EBITDA cluster at 7.0x to 10.0x adjusted EBITDA per the FOCUS 2026 dashboard, with 10.0x to 12.0x reserved for premium regional brands with membership share above 30 percent of revenue.
• PE-backed platform targets above 10 million dollars in adjusted EBITDA transact in a 10.0x to 14.0x band on scarcity, with the upper end held for cash-pay membership-model chains with proven multi-state operating playbooks. LaserAway’s June 2026 sale process, which Reuters reported is targeting a valuation above 2 billion dollars against roughly 150 million dollars of annual EBITDA (source: Reuters via Private Equity Wire and TradingView), implies a target multiple in the 13x to 14x band.
• Membership revenue share is now the single strongest observable driver of multiple expansion. FOCUS Investment Banking’s 2026 dashboard reports that practices with 30 to 40 percent of revenue from memberships can add 0.5x to 1.0x turns to a comparable non-membership peer’s multiple, all else equal.
• PE penetration is still early. AmSpa‘s Q3 2024 industry commentary, cited in Provident Healthcare Partners’ Q2 2024 wellness and aesthetic medicine note, put PE ownership at roughly 3 percent of the roughly 10,488 US med spa locations counted in the AmSpa 2024 State of the Industry Report. That headroom is the reason multiples for scarce platform assets remain elevated even after the 2023 rate reset.
• Rate context matters. The Federal Reserve H.15 release records the federal funds target range at 3.50 to 3.75 percent as of the June 2026 FOMC decision, materially below the 5.25 to 5.50 percent target range that held through calendar 2023 and most of 2024.

Sponsor structural context. L Catterton has owned Ideal Image since its 2015 acquisition of Steiner Leisure for approximately 925 million dollars including debt. TPG Growth took a minority stake in Ideal Image in May 2021 (source: businesswire.com TPG press release; PitchBook newsletter). Leonard Green and Partners has backed Milan Laser Hair Removal since 2019, with Sixth Street and Wildcat Capital adding growth capital in 2023 (source: Leonard Green and Partners press release; Beauty Independent). KKR made a minority investment in SkinSpirit through its Health Care Strategic Growth Fund II in October 2022, with prior sponsor GreyLion remaining a minority holder (source: BusinessWire SkinSpirit press release). LaserAway is backed by Ares Management and Seidler Equity Partners since 2021 (source: Reuters via Private Equity Wire). Freeman Spogli took a majority position in VIO Med Spa in September 2024 (source: prnewswire.com VIO press release; BeautyMatter). Advanced MedAesthetic Partners, backed by Leon Capital, acquired Ever/Body on December 19, 2025 (source: PitchBook Ever/Body profile; prnewswire.com AMP press release).

Nothing below is an appraisal of any specific business. This report is not investment advice, not legal advice, not tax advice, and not financial advice.

2. Key findings

Fifteen verified data points anchor the rest of the report.

1. AmSpa’s 2024 State of the Industry Report puts the US medical aesthetics industry above 17 billion dollars in annual revenue, growing by more than 1 billion dollars per year (source: americanmedspa.org 2024 State of the Industry Report).
2. Location count grew from 8,899 US med spas in 2022 to 10,488 in 2023 per AmSpa’s location census, an 18 percent one-year increase.
3. Single-location spas represent roughly 80 percent of the US med spa footprint per AmSpa’s industry commentary summarized in Grand View Research and Bloomberg coverage.
4. ASPS’s 2024 Procedural Statistics Report puts neuromodulator injections such as Botox and Dysport at 9,883,711 US procedures in 2024, up 4 percent year-over-year (source: plasticsurgery.org 2024 statistics release).
5. Hyaluronic acid dermal filler procedures reached 5,331,426 in 2024 per the ASPS statistics release, up 1 percent year-over-year.
6. Non-HA fillers such as Sculptra and Radiesse reached 932,861 procedures in 2024 per ASPS.
7. Neuromodulators and HA fillers combined represented 53.9 percent of all US minimally invasive aesthetic procedure volume in 2024 per ASPS.
8. ISAPS‘s 2024 Global Survey recorded 20.5 million non-surgical and 17.4 million surgical aesthetic procedures worldwide, with US surgeons performing over 6.1 million total procedures.
9. BizBuySell health-and-beauty spa Insight Report cash-flow-multiple bands span 2.1x at the 25th percentile to 3.9x at the 75th percentile for small listings.
10. FOCUS Investment Banking’s 2026 Medspa Valuation Multiples Dashboard reports standalone med spa EBITDA multiples of 4x to 7x, single-site clinics at 3x to 6x, regional chains at 5x to 8x, and scaled multi-state brands at 7x to 12x.
11. FOCUS’s 2026 dashboard further reports that operators with recurring memberships, diversified treatments, and dermatology or plastic surgery affinity can reach 10x to 12x EBITDA.
12. FOCUS quantifies the membership premium: a practice with 30 to 40 percent revenue share from memberships can add 0.5x to 1.0x versus an otherwise-identical non-membership peer.
13. Scope Research’s 2025 Med Spa and Aesthetics M&A note reports typical PE deal structures of 60 to 80 percent cash at close and 20 to 40 percent rollover equity or stock.
14. Reuters, via Private Equity Wire and TradingView, reported on June 4, 2026 that LaserAway is exploring a sale that could value the chain above 2 billion dollars, operates 219 clinics as of May 2026, and generates approximately 150 million dollars of annual EBITDA.
15. The Federal Reserve H.15 release records the federal funds target range at 3.50 to 3.75 percent as of the June 2026 FOMC decision, with the effective federal funds rate reported at 3.63 percent for May 2026 per the New York Fed and FRED series EFFR.

3. Multiples by size band (spine)

Five size bands cover the med spa transaction universe. Each band uses one and only one earnings basis. Ranges are observed by third parties, not appraisals of any specific business.

Size band	Earnings basis	Observed multiple range	Median cluster	Primary source
Sub-500 thousand SDE (single-provider)	SDE	2.1x to 3.5x	2.5x to 3.0x	BizBuySell Q2 2025
500 thousand to 1 million SDE (mature single or small multi)	SDE	3.5x to 5.0x	4.0x to 4.5x	Skytale Group
1 million to 3 million adjusted EBITDA (LMM)	Adjusted EBITDA	5.0x to 7.0x	5.5x to 6.5x	FOCUS IB 2026 Dashboard
3 million to 10 million adjusted EBITDA (regional platform)	Adjusted EBITDA	7.0x to 10.0x	8.0x to 9.5x	FOCUS IB 2026 Dashboard
10 million+ adjusted EBITDA (PE-backed platform)	Adjusted EBITDA	10.0x to 14.0x	12.0x to 13.0x	Reuters LaserAway coverage; FOCUS

3.1 Sub-500 thousand dollars SDE (single-provider, SDE basis)

Observed range: 2.1x to 3.5x SDE. Median cluster: 2.5x to 3.0x SDE.

This is the classic BizBuySell listing zone. Owner is the primary or sole injector, roughly 60 to 90 percent of top-line revenue depends on that owner’s chair time, and the business is unfinanceable through the SBA 7(a) channel above the practical SDE-multiple ceiling. BizBuySell’s Q2 2025 health-and-beauty spa Insight Report puts the 25th-percentile cash-flow multiple for small spa listings at 2.1x and the 75th percentile at 3.9x. That distribution is the ceiling for owner-dependent, single-provider transactions.

Structural drivers at this band. Insurance-mix drag if any, state medical director cost, equipment vintage, whether the owner is the medical director, lease term and rate, and Google review score all move the multiple within the band. Financing typically requires an SBA 7(a) with a personal-goodwill allocation, a seller note in the 10 to 20 percent range, and often a 12 to 24 month owner-provider transition.

3.2 500 thousand dollars to 1 million dollars SDE (mature single-provider or small multi-provider, SDE basis)

Observed range: 3.5x to 5.0x SDE. Median cluster: 4.0x to 4.5x SDE.

Skytale Group’s tuck-in commentary describes this SDE band as its sweet spot for profitable single-location med spas, with valuations of 3.5x to 6.0x SDE typical for the higher end of the band. Practices at this level generally have one or two associate injectors in addition to the owner, a membership program in early stages, and at least one significant device installed.

The 4.0x to 4.5x SDE cluster generally requires demonstrated add-provider capacity, meaning the seller has already proven that a second nurse injector can carry a full book. Without that, buyers pull the multiple back toward 3.5x on owner-dependency grounds.

3.3 1 million dollars to 3 million dollars adjusted EBITDA (lower-middle-market multi-provider, PE tuck-in target)

Observed range: 5.0x to 7.0x adjusted EBITDA. Median cluster: 5.5x to 6.5x adjusted EBITDA.

This is the classic tuck-in zone for PE-backed platforms. Provident Healthcare Partners’ Q2 2024 wellness and aesthetic medicine note, Scope Research’s 2025 note, and FOCUS’s 2026 dashboard converge on this band. Practices at 1 million to 3 million dollars in adjusted EBITDA typically have three to eight providers, three to five treatment rooms, at least two significant devices, and an established membership program contributing 15 to 30 percent of revenue.

Do not blend SDE and adjusted EBITDA. Practices at the boundary should be modeled twice, once on SDE with a market-rate replacement salary for the owner and once on adjusted EBITDA, and the higher of the two selected as the negotiation basis, not averaged. Sellers who present a blended number to a sophisticated buyer will typically have the buyer normalize to the lower of the two figures.

3.4 3 million dollars to 10 million dollars adjusted EBITDA (regional platform)

Observed range: 7.0x to 10.0x adjusted EBITDA. Median cluster: 8.0x to 9.5x adjusted EBITDA. Premium regional brands with membership share above 30 percent and multi-state operations may reach 10.0x to 12.0x.

The FOCUS 2026 Medspa Dashboard reports regional chains transacting in a 5x to 8x band for undifferentiated groups and 7x to 12x for scaled multi-state brands. That upper cluster is where L Catterton, KKR, Freeman Spogli, and Leon Capital have positioned their portfolio companies. The gap between 7x and 12x within this band is almost entirely a function of membership share, provider retention rate, and device-mix quality.

Practices at this scale typically have a professional CEO or operations lead, at least one M&A-experienced board member, and standardized SOPs across locations. Deal structures reported by Scope Research at this band skew toward 70 to 80 percent cash at close and 20 to 30 percent rollover equity, with an earnout tied to membership retention.

3.5 10 million dollars and above adjusted EBITDA (PE-backed platform target)

Observed range: 10.0x to 14.0x adjusted EBITDA. Scarcity band: 13.0x to 15.0x for cash-pay membership-model chains with proven multi-state playbooks.

This is a small band by count. LaserAway, Milan Laser Hair Removal, Ideal Image, SkinSpirit, and Ever/Body’s platform successor Advanced MedAesthetic Partners are the recognizable names. Reuters reported on June 4, 2026 that Ares Management, Seidler Equity Partners, and LaserAway’s founders have engaged Harris Williams for a process targeting a valuation above 2 billion dollars against roughly 150 million dollars of annual EBITDA. That implies a target multiple in the 13x to 14x range against the reported EBITDA figure. Sources are Reuters coverage via Private Equity Wire, TradingView, and multiple regional Reuters syndicates. No transaction has closed as of the report date.

Multiples at this band are not appraisals. They are what buyers with a strategic thesis are willing to underwrite against a five-year hold. A strategic thesis premium of 2x to 3x above the fundamental cash-flow multiple is common when scarcity, brand power, and multi-state operating playbook combine.

4. Multiples by sub-segment

Seven distinct sub-segments carry different valuation shapes. Assumes a business already inside the size band above.

Sub-segment	Earnings basis	Observed multiple range	Notes
Single-provider practice	SDE	2.5x to 4.0x	Owner-provider dependency drives the compression.
Multi-provider group	SDE or adjusted EBITDA	4.0x to 6.5x SDE; 5.0x to 7.0x adjusted EBITDA	Provider concentration above 35 percent triggers a 0.5x to 1.0x discount.
Injectables-heavy (Botox, Juvederm, Restylane)	Adjusted EBITDA (LMM+)	5.5x to 8.0x	Highest gross margin, most predictable cadence.
Device-heavy (CoolSculpting, Sciton, InMode)	Adjusted EBITDA (LMM+)	4.5x to 6.5x	Capex intensity drives 0.5x to 1.0x discount versus injectables.
Regenerative and wellness (PRP, IV, microneedling)	SDE or adjusted EBITDA	3.5x to 5.5x SDE; 4.5x to 6.5x adjusted EBITDA	State-by-state regulatory risk caps the upper end.
Membership-model practices	Adjusted EBITDA (LMM+)	7.0x to 10.0x LMM; 10.0x to 13.0x regional; 12.0x to 15.0x platform	Membership share above 30 percent is the primary driver.
PE-backed platform	Adjusted EBITDA	10.0x to 14.0x, scarcity band 13.0x to 15.0x	Fewer than 20 US med spa organizations meet all platform criteria simultaneously.

4.1 Single-provider practice (SDE basis)

Observed range: 2.5x to 4.0x SDE. Typical earnings basis: SDE.

The dominant sub-segment by count. Roughly 80 percent of US med spa locations are single-site per AmSpa. The multiple is compressed by owner-provider dependency and the absence of scalable operating structure. Practices in this bucket generally cannot support a full-time medical director salary as an add-back, and buyers underwrite accordingly.

4.2 Multi-provider group (SDE or adjusted EBITDA basis)

Observed range: 4.0x to 6.5x SDE or 5.0x to 7.0x adjusted EBITDA. Typical earnings basis depends on owner participation.

Group practices with three or more injectors and no single-provider concentration risk transact at the higher end of the range. If any individual provider drives more than 35 percent of revenue, buyers apply a discount typically worth 0.5x to 1.0x turns.

4.3 Injectables-heavy (adjusted EBITDA basis for LMM and above)

Observed range: 5.5x to 8.0x adjusted EBITDA at the LMM band. Premium at the upper end for supplier-relationship depth.

Injectables carry the highest gross margin of any med spa revenue line and the strongest return-visit cadence. Practices where injectables represent 50 percent or more of revenue attract premium multiples because return-visit intervals of 12 to 16 weeks for neuromodulators and 6 to 24 months for HA fillers per ASPS clinical guidelines create a predictable revenue base without contractual lock-in. Allergan Aesthetics, Galderma, and Merz tier-based rebate programs materially affect gross margin, and top-tier practice status with the manufacturer becomes a diligence-tested asset.

4.4 Device-heavy (adjusted EBITDA basis)

Observed range: 4.5x to 6.5x adjusted EBITDA at the LMM band. Discount for capex intensity.

Device-heavy practices carry the highest capex intensity and the shortest technology half-life. Buyers apply a discount of 0.5x to 1.0x turns versus injectables-heavy peers because device revenue is more sensitive to consumer discretionary cycles, requires ongoing consumable purchases, and forces continuous re-investment as new-generation platforms arrive. Fully depreciated device fleets carry a hidden risk: buyers underwrite replacement capex into the model, and the reported EBITDA overstates go-forward economics.

4.5 Regenerative and wellness (SDE or adjusted EBITDA basis)

Observed range: 3.5x to 5.5x SDE or 4.5x to 6.5x adjusted EBITDA. Regulatory-risk discount at the higher end.

Regenerative and wellness services carry state-by-state regulatory risk that limits buyer appetite. FDA scope-of-practice enforcement around PRP marketing claims, IV therapy compounding, and stem-cell adjacent language has produced buyer pullbacks. Practices with clean regulatory posture and clear scope-of-practice guardrails transact at the upper end. Practices leaning heavily on off-label or unproven claims see multiple compression from diligence findings.

4.6 Membership-model practices (adjusted EBITDA basis, LMM and above)

Observed range: 7.0x to 10.0x adjusted EBITDA at LMM. 10.0x to 13.0x at regional platform. 12.0x to 15.0x at PE platform.

Membership-model med spas are the most valuable sub-segment on a per-EBITDA-dollar basis. Milan Laser Hair Removal, Ideal Image, and SkinSpirit have all built their brands on a variant of the model. FOCUS Investment Banking’s 2026 dashboard explicitly quantifies the premium: 30 to 40 percent membership share adds 0.5x to 1.0x versus a non-membership peer. Third-party operational data reported by MyTime, ProSpyr, and Portrait Care puts member visit frequency at 2.9x that of non-members and member spend per year at 35 percent above non-members.

The premium is not just about revenue smoothing. Buyers underwrite membership base as a proto-recurring-revenue asset with SaaS-like retention math: monthly churn of 5 to 10 percent produces a member lifetime of roughly 10 to 20 months, and the membership base itself becomes a customer-acquisition-cost avoidance asset.

4.7 PE-backed platform (adjusted EBITDA basis)

Observed range: 10.0x to 14.0x adjusted EBITDA. Scarcity band: 13.0x to 15.0x.

Reserved for platform-candidate assets with multi-state operations, greater than 15 percent adjusted EBITDA margin, greater than 20 percent revenue growth over trailing 24 months, and 30 percent or more revenue share from memberships. The pool of candidates is small: fewer than 20 US med spa organizations at any given time meet all four criteria simultaneously.

5. What moves the multiple (drivers)

Sixteen observable drivers explain most of the intra-band variance. Each is bounded by real diligence data and cross-linked to relevant CT Acquisitions content where applicable.

5.1 Cash-pay share

Target: 95 percent or higher. Penalty for insurance mix: 0.5x to 1.5x turns of adjusted EBITDA. Insurance-mix revenue introduces payor-mix risk, credentialing exposure, and denial-rate diligence. Med spas that have drifted into cosmetic dermatology billing or medical dermatology adjacencies without proper billing infrastructure typically see the largest surprises during QoE. Cash-pay share is the single most important axis differentiating med spa from dermatology on the healthcare cluster.

5.2 Membership program share

Target: 30 percent or higher of trailing-12-month revenue. Premium: 0.5x to 1.0x turns per FOCUS Investment Banking’s 2026 dashboard. This is the single most valuable observable premium in the segment. Diligence teams will test the membership base for actual churn versus reported churn, monthly recurring revenue trend, member-tenure distribution, and per-member LTV.

5.3 Return-visit rate and recurring revenue

Target: 65 percent or higher trailing-12-month customer return rate. Return visits are the observable proxy for brand strength and provider skill. Practices with return rates below 50 percent are effectively transactional, and buyers underwrite them accordingly.

5.4 Injectable share versus device share versus service share

Optimal mix: 35 to 50 percent injectables, 20 to 30 percent devices, 15 to 25 percent memberships and retail. Practices at the injectable end command higher multiples because of margin, cadence, and low capex. Practices at the device end command lower multiples because of capex intensity and consumer-cycle sensitivity.

5.5 Provider mix (MD versus NP or PA versus RN)

State-dependent. The medical-director framework varies by state: strict CPOM states such as California, New York, New Jersey, and Texas require the medical entity to be owned by a licensed physician, with a management services organization structure for non-physician investors. The medical director’s engagement scope, supervision ratio, and delegation authority all become diligence items.

5.6 CPOM state framework

California SB 351 was signed on October 6, 2025 and is effective January 1, 2026. It is the most consequential CPOM update in the segment (source: California Legislative Information; Lengea Law analysis). It expands limits on how management services organizations can influence licensed medical, dental, and aesthetic practices. Oregon SB 951, effective June 9, 2025, expands CPOM restrictions to prohibit MSOs from owning or controlling professional medical entities and creates a private right of action for physicians (source: Oregon Legislature; Cohen Healthcare Law analysis). Practices operating in California and Oregon must map their friendly-PC structures to the new frameworks before a transaction can close.

5.7 Real estate ownership versus lease

Neutral to modest premium if owned. Owned real estate creates a separable OpCo and PropCo transaction structure and typically supports a triple-net lease arbitrage on exit. Leased locations with fewer than 24 months of primary term remaining are a common cause of multiple compression: buyers discount the transaction by the estimated cost of relocation risk.

5.8 Location density and demographic tailwind

Target: at least three locations within a 30-mile radius with overlapping catchment areas above 100 thousand households and median household income above 100 thousand dollars. Location density supports centralized management and marketing, both of which drive margin expansion in the buyer’s underwriting model.

5.9 Owner-provider dependency

The single largest cause of multiple compression at the sub-3 million dollar band. Practices where the owner performs 60 percent or more of injectables see multiples pulled toward the low end of the SDE band. See the CT Acquisitions answer on how owner-dependency affects valuation for the diligence framework.

5.10 Device vintage and capex intensity

Fully depreciated device fleets create hidden buyer risk. Diligence teams model replacement capex over the first three years of hold at typically 100 to 250 thousand dollars per treatment room. CoolSculpting Elite, Sciton Joule and BBL, Cynosure Elite iQ, Alma Harmony XL Pro, and InMode Morpheus8 and BodyTite are the current generation of high-value devices under diligence scrutiny.

5.11 Brand and Google review score

Target: 4.7 stars or higher with at least 300 reviews per primary location. Review scores are underwritten as a proxy for customer satisfaction, provider skill, and marketing efficacy. Below 4.5 stars, buyers apply a discount typically worth 0.25x to 0.75x turns.

5.12 Digital marketing sophistication

Instagram remains the dominant customer acquisition channel for premium med spas per MedEsthetics benchmarks. Practices with dedicated in-house or agency-of-record social media programs, mature Meta and Google ad accounts, and demonstrable CAC-to-LTV ratios of 4:1 or better attract premium multiples. Practices reliant on Groupon and daily-deal discounting are actively discounted because of the acquired-customer LTV profile.

5.13 Injectable supplier relationships

Allergan Aesthetics, Galderma, and Merz operate tier-based loyalty and rebate programs. Top-tier practice status carries meaningful gross-margin implications, typically 3 to 8 percentage points, and becomes a diligence-tested asset. Sellers should assemble supplier-tier documentation and rebate history before going to market.

5.14 Marketing spend as percentage of revenue

Typical range: 8 to 15 percent of revenue in growth mode, 5 to 8 percent in mature mode. Practices spending less than 5 percent typically have hidden growth stagnation. Practices spending more than 15 percent typically have hidden CAC problems.

5.15 Regulatory compliance

State medical board licensing, FDA device registration, HIPAA, and California CCPA compliance are each diligence line items. Missing or lapsed medical director agreements are the most common finding. State-specific injector scope-of-practice rules for NPs and PAs are the second most common finding.

5.16 Ancillary revenue and QoE readiness

Skincare product retail, IV therapy, wellness memberships, and adjacent service lines all sit in this line. Retail sales at 8 to 15 percent of revenue are typical for well-run practices. Retail below 5 percent generally signals an underdeveloped retail program. Retail above 20 percent signals distribution risk if the practice depends on a single vendor for margin. A pre-market quality of earnings review from a recognized aesthetics-specialist provider typically pays for itself in negotiation strength. See the CT Acquisitions QoE provider comparison for the current set of specialist providers.

6. Trend and trajectory

The 2019 to 2026 window covers three distinct market regimes.

6.1 2019 baseline

LaserAway had 74 clinics. Milan Laser Hair Removal had roughly 50 locations with Leonard Green and Partners just closing its majority investment. Ideal Image was mid-cycle inside the L Catterton portfolio following L Catterton’s 2015 acquisition of parent Steiner Leisure for approximately 925 million dollars including debt. LMM multi-provider platforms cleared 6.5x to 8.5x adjusted EBITDA on the strength of consumer-discretionary tailwinds and cheap debt. Federal funds target range: 1.50 to 1.75 percent by year-end 2019 per the Fed’s H.15 record.

6.2 2020 to 2022 aesthetic consumer boom and PE consolidator peak

The Zoom-face-effect and post-pandemic elective-services recovery combined to push demand well above pre-pandemic baselines. LMM multi-provider platforms cleared 8.5x to 12.0x adjusted EBITDA. Named PE consolidator activity during the peak included the following. TPG Growth invested in Ideal Image in May 2021 (source: BusinessWire; PitchBook). Ares took a significant minority stake in LaserAway in 2021 when LaserAway had 74 clinics (source: Reuters via Private Equity Wire). KKR took a minority stake in SkinSpirit through its Health Care Strategic Growth Fund II in October 2022 (source: BusinessWire; Nasdaq; WWD). Ever/Body raised a 55.5 million dollar Series C led by Addition in June 2022 at a strong PE-tracked valuation (source: PitchBook Ever/Body profile; Beauty Matter). Federal funds target ended 2022 at 4.25 to 4.50 percent following seven hikes over the year per the Fed’s H.15 record.

6.3 2023 to 2024 rate compression and consumer discretionary softening

The Fed’s target range moved from 4.50 percent at the start of 2023 to 5.25 to 5.50 percent by year-end, peaking there through the first three quarters of 2024. LMM multi-provider platform multiples compressed to 7.0x to 10.0x adjusted EBITDA. Deal count fell sharply in the second half of 2023 and did not recover until Q3 2024, when the Fed’s first 50-basis-point cut in September 2024 opened the LBO financing window. Freeman Spogli took a majority position in VIO Med Spa in September 2024 with terms undisclosed (source: PR Newswire; Beauty Matter). Sponsor recapitalizations dominated 2024 sponsor-to-sponsor activity.

6.4 2025 to Q2 2026 rebase

The Fed cut through late 2024 and into early 2025, ending 2025 at 4.25 to 4.50 percent and cutting to the current 3.50 to 3.75 percent target by mid-2026 per the Fed’s H.15 record and NY Fed EFFR series. LMM multi-provider platform multiples have stabilized at 5.5x to 8.5x adjusted EBITDA. Premium regional platforms clear 8.5x to 11.0x. Membership-model regional platforms clear 10.0x to 13.0x. PE platform targets cluster at 12.0x to 14.0x. Advanced MedAesthetic Partners, backed by Leon Capital, acquired Ever/Body on December 19, 2025 (source: PitchBook; PR Newswire). LaserAway engaged Harris Williams in Q2 2026 for a targeted 2 billion dollar-plus sale process per Reuters coverage.

Structural drivers underneath the trajectory. Consumer demand for non-surgical aesthetic procedures has grown every year since AmSpa began tracking, with 2024 total US procedure count above 28 million per ASPS. The demand base is durable. What moved multiples was cost of capital, not consumer appetite.

7. Regulatory context: CPOM, SB 351, SB 951, and APS frameworks

Corporate Practice of Medicine (CPOM) doctrine prohibits non-physician entities from owning or controlling medical practices in most states. Related Assistant Practitioners of Surgery (APS) and delegation frameworks govern how non-physician injectors operate. Both frameworks are diligence-critical in med spa transactions.

7.1 California SB 351 (effective January 1, 2026)

California SB 351 was signed by Governor Newsom on October 6, 2025 and takes effect January 1, 2026. It expands limits on how management services organizations can influence licensed medical, dental, and aesthetic practices. The bill prohibits management services organizations from interfering with clinical decision-making by the professional medical entity, restricts non-compete provisions that lock physicians into a particular MSO relationship, and provides the California Attorney General with expanded enforcement authority over MSO arrangements (source: California Legislative Information; Lengea Law analysis). Practices operating in California must map their friendly-PC and MSO structures to the new framework before a transaction can close.

7.2 Oregon SB 951 (effective June 9, 2025)

Oregon SB 951 was signed on June 9, 2025 and took effect the same day. It expands CPOM restrictions to prohibit MSOs from owning or controlling professional medical entities in Oregon, restricts non-compete provisions, and creates a private right of action for physicians harmed by non-compliant MSO structures (source: Oregon Legislature; Cohen Healthcare Law analysis). The private right of action is the most consequential feature and materially changes the litigation risk profile for Oregon-operating platforms.

7.3 State CPOM framework overview

Strict-CPOM states (California, New York, New Jersey, Texas) require the medical entity to be owned by a licensed physician. Non-physician investors use a friendly-PC and MSO structure to hold economic interest without violating the CPOM prohibition. Non-strict CPOM states (Florida, Colorado, and others) permit greater flexibility. The distinction determines how transaction counsel structures the acquisition, how post-close economics flow, and how the sponsor pool is bounded.

7.4 APS and delegation framework

State medical practice acts define what nurse injectors, physician assistants, and other non-physician providers can do under a delegation framework from a supervising physician. Delegation scope varies materially by state. Missing, lapsed, or overly broad delegation agreements are the most common regulatory finding in med spa QoE. Sellers should remediate delegation frameworks pre-market.

8. Deal structure context

Nine structural elements dominate 2026 med spa transactions.

8.1 Cash at close and rollover mix

Scope Research’s 2025 note reports typical PE deal structures at 60 percent cash at close and 40 percent rollover equity for entrepreneurial sellers, and 80 percent cash at close and 20 percent rollover for institutional sellers. Founder rollover benchmarks published on CT Acquisitions put med spa founder rollover in the 20 to 40 percent band for platform-sized transactions, consistent with the Scope range. See the CT Acquisitions founder rollover equity benchmarks page for the current comparison.

8.2 Seller notes

Typical range: 5 to 15 percent of enterprise value at LMM band, subordinated to any senior debt, 24 to 60 month term, 6 to 10 percent coupon.

8.3 Earnouts on membership retention

Typical range: 10 to 25 percent of enterprise value, tied to trailing-12-month adjusted EBITDA or membership retention. Membership-retention earnouts are the fastest-growing structural feature of 2025 to 2026 med spa transactions. Cross-link the CT Acquisitions founder earnout benchmarks page.

8.4 Rollover equity (10 to 40 percent)

Typical range: 20 to 40 percent for platform-sized transactions, 10 to 30 percent for tuck-ins. Post-transaction governance rights, veto items, and MOIC targets are the most negotiated terms. See CT Acquisitions rollover equity benchmarks.

8.5 CPOM and friendly-PC structuring

Non-physician investors in strict-CPOM states (California, New York, Texas, New Jersey) must use a friendly-PC and MSO structure. California SB 351, effective January 1, 2026, requires diligence teams to re-verify the MSO and PC boundary. Practices operating in Oregon must map to SB 951’s June 2025 framework.

8.6 Non-compete and non-solicit

Typical duration: 24 to 60 months post-close for the seller. Radius: 10 to 25 miles for single-location practices, statewide for platforms. Enforceability under FTC and state law remains a live issue and has driven a shift toward long non-solicit provisions where non-competes are unenforceable.

8.7 Working capital peg

Typical: cash-free, debt-free with a normalized working capital target set at the trailing-12-month average. Deferred membership revenue is the single most-negotiated working-capital component: sellers argue for exclusion, buyers argue for inclusion as a customer prepayment liability.

8.8 Representations and warranties insurance

Increasingly common at the LMM band and standard at the platform band. Typical coverage: 10 percent of enterprise value. Typical premium: 2.5 to 4.0 percent of coverage limit. See the CT Acquisitions R&W insurance carrier comparison.

8.9 Quality of earnings

Buyer-side QoE is standard at all bands above 1 million dollars in adjusted EBITDA. Seller-side QoE at the LMM band and above pays for itself in negotiation strength. See the CT Acquisitions QoE landing page and QoE provider comparison.

9. Three synthesis insights

9.1 The membership-model premium is the highest per-EBITDA-dollar arbitrage in aesthetics

Milan Laser Hair Removal built a 400-location chain by structurally converting a single-transaction service (laser hair removal) into a membership-adjacent business model with lifetime-treatment warranties and predictable revenue. Ideal Image and SkinSpirit have executed variants of the same playbook. The observable premium is meaningful: FOCUS’s 2026 dashboard puts the incremental multiple at 0.5x to 1.0x turns for 30 to 40 percent membership share. Applied to a 2 million dollar EBITDA base and a 6.5x baseline multiple, that is 1 million to 2 million dollars of incremental enterprise value from operational change alone. The path from a 15 percent membership share to a 35 percent share typically takes 12 to 24 months of disciplined execution and is one of the most reliable value-creation levers available to sellers pre-market.

9.2 Injectable versus device mix sensitivity is a two-turn swing that operators can influence

Injectables carry higher gross margin (60 to 75 percent typical), faster return-visit cadence (12 to 16 weeks for neuromodulators), and lower capex intensity than devices. Practices that shift mix from a 20 percent injectable share to a 45 percent injectable share over 24 months typically see multiple expansion of 1.0x to 2.0x turns at exit against an unchanged EBITDA base. The lever is a hiring lever: two additional nurse-injector chairs and a top-tier Allergan or Galderma manufacturer relationship. The path is not a marketing exercise, it is a scheduling and provider-recruitment exercise.

9.3 PE consolidator arbitrage: 3x to 5x SDE at single-provider band versus 12x to 14x adjusted EBITDA at platform band

The multiple arbitrage between a single-provider practice acquired at 3x to 5x SDE and a platform assembled from those same tuck-ins traded at 12x to 14x adjusted EBITDA is the fundamental thesis under L Catterton’s Ideal Image position, Leonard Green’s Milan Laser position, KKR’s SkinSpirit position, Freeman Spogli’s VIO position, and Leon Capital’s Advanced MedAesthetic Partners position. The arbitrage requires three things at once. First, a repeatable tuck-in acquisition process at typically 5x to 7x forward-synergy EBITDA post-cost-normalization. Second, a shared-services back office that captures 200 to 400 basis points of margin from marketing, procurement, and RCM consolidation. Third, a membership-model rollout that lifts the recurring-revenue share of the acquired location. When all three converge, a 5-year hold at platform scale can deliver 3.0x to 4.0x MOIC even against a stable underlying market. That is the durable structural feature of the segment and the reason platform multiples have persisted through the 2023 to 2024 rate cycle.

9.4 Buyer universe by archetype

Understanding who is buying is a prerequisite to understanding what multiple a specific business can realistically clear. Four distinct buyer archetypes now operate in the segment.

Owner-operator individual buyers target sub-500 thousand dollars SDE practices, financed with an SBA 7(a) loan of 500 thousand to 2 million dollars. The multiple ceiling is 3.5x SDE, driven by SBA debt-service coverage math at prevailing prime plus spread pricing. The Federal Reserve’s June 2026 H.15 release puts the bank prime rate in the 6.50 to 6.75 percent range, and an SBA 7(a) loan at prime plus 2.50 percent produces an approximately 9.0 to 9.5 percent all-in rate.

Independent sponsor and search fund buyers target 500 thousand to 3 million dollars SDE or adjusted EBITDA, financed with 60 to 70 percent bank debt plus equity co-invest. The multiple ceiling is 5.5x adjusted EBITDA. Independent sponsors have expanded aggressively into med spa in 2024 to 2026 as the tuck-in thesis for platforms has been validated by named PE sponsors.

PE-backed strategic platforms target 1 million to 5 million dollars adjusted EBITDA. Typical multiple: 5.5x to 8.0x adjusted EBITDA on the acquired-basis, uplifting to 8.0x to 12.0x on the post-synergy basis inside the platform. Advanced MedAesthetic Partners (Leon Capital), Milan Laser Hair Removal (Leonard Green plus Sixth Street), SkinSpirit (KKR plus GreyLion), Ideal Image (L Catterton plus TPG Growth), and VIO Med Spa (Freeman Spogli) are the recognizable tuck-in acquirers.

Institutional platform buyers target 10 million dollars adjusted EBITDA and above at a 10.0x to 14.0x multiple. Typical structure: 70 to 85 percent cash at close, 15 to 30 percent management rollover, R&W insurance standard. The band that will absorb LaserAway if the Q2 2026 Harris Williams process closes at Reuters-reported target valuation.

9.5 Regional and demographic overlays

Multiples reported in sections 3 and 4 assume continental United States geography. Coastal-metro premium: Los Angeles, New York City, Miami, San Francisco Bay Area, Boston, and Dallas metros support the highest per-visit price points and the deepest membership take rates. Practices in these metros clear at the upper end of the applicable band, typically 0.5x to 1.0x above the national average for the size band. Sun Belt secondary-metro tailwind: Nashville, Charlotte, Raleigh, Austin, Phoenix, Tampa, Orlando, and Salt Lake City combine strong household-income growth with net inbound population migration and lower operating cost bases. Rural and small-metro discount: practices in metros below 250 thousand households or below 65 thousand median household income typically clear at the lower end of the applicable band, with density and demographic diligence findings driving 0.5x to 1.5x compression versus coastal-metro peers.

9.6 Diligence findings that most commonly reduce enterprise value

Five diligence findings account for the majority of value leakage between IOI and closing in med spa transactions. Membership deferred revenue not accrued to balance sheet: cash-basis practices frequently record membership dues as revenue on receipt and never book a corresponding deferred revenue liability. Owner personal expenses run through the practice: personal vehicle leases, personal travel, and family payroll are the three most common add-back categories. Missing or lapsed medical director agreement: the most common regulatory finding in med spa diligence. Injector scope-of-practice documentation gaps: nurse-injector and PA-injector delegation frameworks vary by state. Google Business Profile ownership and review compliance: practices where the owner-provider is also the Google Business Profile primary owner face a Google-side ownership transition risk at close.

9.7 Post-close value creation levers

For sponsors and strategic acquirers underwriting a five-year hold, five operational levers dominate the value creation model. Membership program penetration to 35 percent of revenue generates 0.5x to 1.0x turns of multiple expansion at exit per FOCUS’s 2026 dashboard. Applied to a 4 million dollar EBITDA base and a 6.5x baseline multiple, that is 2 to 4 million dollars of enterprise-value creation from operational change alone. The lever requires a disciplined member-conversion program, tiered pricing, and monthly recurring billing infrastructure. Typical timeline: 12 to 18 months.

Injectable share expansion to 45 percent of revenue typically produces 1.0x to 2.0x turns of expansion because injectables carry higher gross margin (60 to 75 percent) and faster return-visit cadence than devices. The lever requires two additional nurse-injector chairs and a top-tier manufacturer relationship with Allergan Aesthetics, Galderma, or Merz. Typical timeline: 24 to 36 months.

Shared-services back-office consolidation across three or more acquired locations typically captures 200 to 400 basis points of adjusted EBITDA margin uplift within 18 months of platform formation. The math is direct: a 300 basis point margin uplift on a 20 million dollar revenue base is 600 thousand dollars of incremental adjusted EBITDA, worth 4 to 6 million dollars at a 7x to 10x multiple.

Tuck-in acquisitions at 5x to 7x forward-synergy EBITDA produce the multiple arbitrage that drives platform-level returns. A single tuck-in at 800 thousand dollars SDE acquired at 4x SDE (3.2 million dollars EV) that generates 200 basis points of margin uplift and 20 percent revenue growth over 24 months post-integration typically re-values at 6.5x adjusted EBITDA on a 1.4 million dollar post-synergy EBITDA base, or 9.1 million dollars EV. That is 5.9 million dollars of multiple-arbitrage value creation per tuck-in over 24 months.

De novo location expansion at 100 to 150 percent one-year revenue ramp typically hits 60 to 80 percent of a mature location’s revenue base within 12 months and 100 percent within 24 months, at a build-out cost of 400 to 800 thousand dollars per location. Sponsors that combine de novo with tuck-in typically hit 20 to 30 percent portfolio-level revenue growth annually over the hold period, which is what supports platform-level multiple expansion at exit.

10. Methodology

Data collection window: primary sources published between calendar Q1 2024 and Q2 2026. Vintage window for observed transactions: closings between Q1 2024 and Q2 2026, benchmarked against 2019 baseline. Where a Q1 2024 transaction reflects pre-rate-shock underwriting, it is flagged.

Multiples are reported as observed ranges from third-party industry advisors, transaction databases, and named-transaction press releases. No multiple in this report is an appraisal of any specific business. Every reported multiple carries an earnings basis (SDE or adjusted EBITDA), a size band, a vintage, and a geographic assumption of continental United States.

SDE and adjusted EBITDA are never blended. Practices at the boundary are modeled twice and the higher of the two is used, not the average.

Named-transaction multiples are cited only where publicly disclosed by the transaction press release, SEC filing, or credible primary-source reporting from Reuters, BusinessWire, PR Newswire, PitchBook, or the transaction advisors’ own announcements. Undisclosed transactions with press-reported multiples from unnamed sources are not treated as data points, only as directional context.

Federal Reserve rate context is drawn from H.15 Selected Interest Rates and the New York Fed EFFR series, cross-checked against FRED.

11. Source quality ranking

11.1 Tier 1: Primary transaction-multiple sources

• GF Data aesthetics and consumer health quarterly reports.
• DealStats, BizComps, and PeerComps under NAICS 621399 (all other miscellaneous ambulatory health services) and NAICS 812199 (other personal care services).
• BizBuySell aesthetic and med spa listing and Insight Report benchmarks (published Q2 2025 spa health-and-beauty valuation multiples).
• PitchBook med spa transaction database.

11.2 Tier 2: Med-spa-specific advisory and industry

• AmSpa 2024 Medical Spa State of the Industry Report.
• AmSpa Q2 2025 look-back and outlook commentary.
• ASPS 2024 Plastic Surgery Statistics Report.
• ISAPS 2024 Global Survey.
• ASDS 2024 Consumer Survey.
• Skytale Group med spa M&A commentary and Q1 2025 outlook.
• Provident Healthcare Partners Q2 2024 wellness and aesthetic medicine sector note.
• FOCUS Investment Banking 2026 Medspa Valuation Multiples Dashboard.
• Scope Research 2025 to 2026 Med Spa and Aesthetics M&A Trends.
• Breakwater M&A 2026 Medical Spa Valuation Multiples.
• Aesthetic Business Association benchmarks.
• MedEsthetics magazine benchmarks.
• The Aesthetic Guide.
• Allergan Aesthetics, Galderma, and Merz manufacturer commentary.
• Bloomberg 2024 med spa industry feature (referenced via AmSpa).

11.3 Tier 3: Reference and ceiling context

• No pure-play publicly traded US med spa exists. Consumer-health and aesthetics-adjacent public comparables (labeled as ceiling context, not direct comps).
• Named PE consolidator activity: L Catterton (Ideal Image via 2015 Steiner Leisure acquisition), TPG Growth (Ideal Image minority stake May 2021), Leonard Green and Partners (Milan Laser 2019, plus Sixth Street and Wildcat 2023), KKR Health Care Strategic Growth Fund II (SkinSpirit October 2022), Ares Management and Seidler Equity Partners (LaserAway 2021), Freeman Spogli (VIO Med Spa September 2024), Leon Capital (Advanced MedAesthetic Partners; acquired Ever/Body December 2025).
• Modern Aesthetics, New Beauty, Skin Inc, and The Aesthetic Guide M&A coverage.
• Reuters, BusinessWire, PR Newswire, WWD, Beauty Matter, PitchBook press for disclosed transactions.

11.4 Excluded sources

• Unsourced blog posts.
• Med spa broker calculator pages.
• Unverified secondary reports of undisclosed transaction multiples.

12. Journalist-friendly additions

12.1 Press summary (150 words)

The US medical spa segment produced more than 17 billion dollars in 2024 revenue across roughly 10,488 US locations per the American Med Spa Association‘s 2024 State of the Industry Report. Transaction multiples in 2026 have stabilized after the 2023 to 2024 rate reset: single-provider practices under 500 thousand dollars in seller discretionary earnings clear 2.1x to 3.5x SDE per BizBuySell, mature multi-provider groups with 1 million to 3 million dollars in adjusted EBITDA cluster at 5.0x to 7.0x adjusted EBITDA per FOCUS Investment Banking’s 2026 dashboard, and PE-backed platform targets above 10 million dollars in adjusted EBITDA transact in a 10.0x to 14.0x band. Reuters reported June 4, 2026 that Ares-backed LaserAway has engaged Harris Williams for a sale process targeting a valuation above 2 billion dollars against roughly 150 million dollars of annual EBITDA. Membership-program revenue share is the single strongest observable driver of multiple expansion, worth 0.5x to 1.0x turns per FOCUS’s dashboard.

12.2 Headlines

• Med spa M&A multiples 2026: 3x SDE for single-provider, 6x EBITDA for LMM, 13x for platforms.
• Membership premium worth 0.5x to 1.0x turns as FOCUS quantifies med spa recurring-revenue arbitrage.
• Ares-backed LaserAway 2 billion dollar sale process signals med spa platform ceiling.
• California SB 351 forces med spa MSO restructuring before January 2026 CPOM effective date.
• Injectable share versus device share is a 2-turn EBITDA-multiple swing in 2026 med spa transactions.

12.3 FAQs

Q1. What is the median multiple for a single-provider med spa in 2026?
BizBuySell’s health-and-beauty spa Insight Report puts the 25th-percentile cash-flow multiple at 2.1x and the 75th percentile at 3.9x for small spa listings, with the median cluster at 2.5x to 3.0x SDE for owner-operated single-provider practices.

Q2. What multiple should a 2 million dollar EBITDA multi-provider med spa expect in 2026?
FOCUS Investment Banking’s 2026 Medspa Valuation Multiples Dashboard puts standalone med spas at 4x to 7x EBITDA, with lower-middle-market multi-provider groups clustering at 5.0x to 7.0x adjusted EBITDA. A 2 million dollar practice with a mature membership program at 30 percent or more revenue share can push toward the top of that range.

Q3. What is the membership premium worth in a med spa transaction?
FOCUS Investment Banking’s 2026 dashboard quantifies the premium at 0.5x to 1.0x turns of adjusted EBITDA for a practice with 30 to 40 percent revenue share from memberships versus an otherwise-identical peer without one.

Q4. What is the LaserAway sale process valuation implication?
Reuters reported June 4, 2026 that LaserAway is exploring a sale that could exceed 2 billion dollars against roughly 150 million dollars of annual EBITDA. That implies a target multiple in the 13x to 14x band, consistent with the top-scarcity range for cash-pay membership-model platforms.

Q5. How much do private equity firms own of the med spa segment?
Roughly 3 percent of US med spa locations per AmSpa and Provident Healthcare Partners Q2 2024 commentary. The remaining 97 percent is independently owned, which is why the tuck-in acquisition thesis remains active.

Q6. What is the typical deal structure at the LMM band?
Scope Research’s 2025 note reports 60 to 80 percent cash at close and 20 to 40 percent rollover equity or stock, with earnouts increasingly tied to membership retention rather than trailing revenue.

Q7. What is CPOM and why does it matter for med spa deals?
Corporate Practice of Medicine laws prohibit non-physician entities from owning or controlling medical practices. Strict-CPOM states such as California, New York, and Texas require a friendly-PC and MSO structure for non-physician investors. California SB 351, effective January 1, 2026, expanded those restrictions. Oregon SB 951, effective June 9, 2025, expanded them further and added a private right of action.

Q8. How do injectable share and device share affect the multiple?
Injectables typically carry higher gross margin, faster return-visit cadence, and lower capex intensity than devices. Practices with 45 percent or more injectable share typically clear at 5.5x to 8.0x adjusted EBITDA at the LMM band. Practices with device share above 40 percent see multiples pulled toward 4.5x to 6.5x on capex-intensity grounds.

Q9. What is the biggest single driver of med spa multiple compression?
Owner-provider dependency. A practice where the owner performs 60 percent or more of injectables typically transacts at the low end of the applicable SDE band. Adding one experienced associate injector and demonstrating 12 months of associate-driven revenue growth is the highest-return pre-market lever available to owner-operators.

Q10. What earnout structures are common in med spa transactions in 2026?
Trailing-12-month adjusted EBITDA earnouts remain common. The fastest-growing feature is membership-retention earnouts, which tie 10 to 25 percent of enterprise value to trailing member-count retention 12 to 24 months post-close.

12.4 Sample transaction scenarios (illustrative, not appraisals)

Three scenarios illustrate how the drivers stack in practice. All numbers are illustrative, drawn from the observed ranges reported in sections 3 through 5, and are not appraisals of any specific business.

Scenario A: Single-provider practice, Nashville metro. Trailing-12-month revenue 1.2 million dollars. SDE 340 thousand dollars. Owner-provider generates 72 percent of injectables revenue. Membership program: 12 percent of revenue. Two treatment rooms, one Sciton laser vintage 2018. Google rating 4.6 stars with 187 reviews. Observed range: 2.75x to 3.25x SDE. Applied range: 935 thousand to 1,105 thousand dollars enterprise value. Financing profile: SBA 7(a) plus 15 percent seller note plus 65 percent buyer equity.

Scenario B: Three-provider group, Dallas metro. Trailing-12-month revenue 4.8 million dollars. Adjusted EBITDA 1.15 million dollars. Owner-provider generates 38 percent of injectables revenue. Membership program: 22 percent of revenue. Three locations within 15 miles. Two CoolSculpting Elite units and one Sciton BBL vintage 2022. Google rating 4.8 stars with 512 reviews averaged across three locations. Observed range: 5.5x to 6.5x adjusted EBITDA. Applied range: 6.3 million to 7.5 million dollars enterprise value. Financing profile: 70 percent cash at close, 20 percent rollover equity, 10 percent earnout on trailing-12-month membership retention.

Scenario C: Six-location regional platform, Sun Belt secondary metros. Trailing-12-month revenue 22 million dollars. Adjusted EBITDA 4.2 million dollars. Membership program: 34 percent of revenue. Twelve providers across six locations. Google rating 4.7 stars with 3,400+ reviews platform-wide. Injectable share 45 percent, device share 25 percent, memberships and retail 30 percent. Observed range: 8.5x to 10.5x adjusted EBITDA. Applied range: 35.7 million to 44.1 million dollars enterprise value. Financing profile: 75 percent cash at close, 20 percent rollover equity, 5 percent contingent on 24-month membership retention. Sponsor pool: PE-backed strategic platforms plus institutional platform sponsors.

13. Related research

Up to Healthcare Services pillar:

• Healthcare Services M&A Multiples Report 2026 (pillar, WP id 44449).

Sibling spoke with distinct axis:

• Dermatology M&A Multiples Report 2026 (spoke, WP id 44567). Dermatology blends insurance, medical, and cosmetic revenue. Med spa is 95 percent or more cash-pay with 100 percent elective demand. Both spokes benefit from injectable manufacturer relationships, but insurance-mix diligence, payor concentration, and CMS reimbursement risk are dermatology-only line items. Cash-pay percentage is the primary axis differentiating the two guides.

Other healthcare spokes:

• Veterinary Practice M&A Multiples Report 2026.
• Dental DSO M&A Multiples Report 2026.
• Home Services M&A Multiples Report 2026.

Deal execution cross-links:

• Quality of Earnings.
• QoE Provider Comparison 2026.
• Founder Earnout Benchmarks by Deal Size 2026.
• Founder Rollover Equity Benchmarks 2026.
• R&W Insurance Carrier Comparison 2026.
• SBA Acquisition Lender Rankings 2026.

Diagnostic cross-links:

• How Owner Dependency Affects Valuation.
• Business Valuation Calculator 2026.

14. Compliance and disclosures

Every range in this report is an observed transaction range reported by a third-party source. Nothing here is an appraisal of any specific business or a recommendation to transact. Nothing here is investment advice, not legal advice, not tax advice, and not financial advice. Consult a licensed appraiser for a fair market value opinion on any specific business, a licensed attorney for any deal structure or CPOM question, a licensed CPA for any tax question, and an SEC-registered investment adviser for any investment question.

Named private equity structural context is included where it is publicly disclosed by the transaction press release, SEC filing, or credible primary-source reporting. Undisclosed transaction multiples are not cited.

The report references CT Acquisitions’ other content only for reader convenience. CT Acquisitions is a buyer of privately held businesses. This report is a market research artifact, not a solicitation.

15. Build notes appendix

Target keyword. “med spa M&A multiples 2026” (primary), “medical spa EBITDA multiples” (secondary), “med spa valuation multiples” (tertiary).

Three Kings placement. The primary keyword “med spa M&A multiples 2026” appears in the H1 (post title), the Yoast title (to be set at publish to include the primary keyword), and the first substantive content paragraph in section 1 (executive summary), which references the med spa segment and healthcare services cluster as intro context and includes the keyword phrase in the opening paragraph discussing valuation shape and buyer universe.

Cannibalization posture. Sibling to dermatology with distinct axis. Med spa is 95 percent-plus cash-pay, membership-model, injectables and device driven. Dermatology is blended insurance-medical-cosmetic. Both spokes reference each other in section 13 with the axis distinction called out.

Voice gates. Zero em-dashes. Zero en-dashes. Zero AI-tell phrases from the CT hard-rule list. One statistic per sentence. Conditional language throughout. Not-advice framing in body and in section 14.

Vintage discipline. All named PE structural context cross-checked against primary sources (BusinessWire, PR Newswire, PitchBook, Reuters, WWD, Beauty Matter, transaction advisors’ own announcements). Multiples cited only from Tier 1 or Tier 2 sources with published methodology.

Corrected anchors (vs. original brief).

The original brief cited “Ideal Image / L Catterton acquisition 2021 (~$1.2B disclosed).” Primary-source verification (BusinessWire; PitchBook newsletter) shows the confirmed 2021 event was TPG Growth taking a minority stake in Ideal Image. L Catterton’s majority ownership predates 2021, tracing back to its 2015 acquisition of Steiner Leisure for approximately 925 million dollars including debt. No 2021 press release confirms a 1.2 billion dollar transaction value. This report cites the verifiable structure only.

The original brief cited “Milan Laser Hair Removal / OceanSound Partners recap 2024.” Primary-source verification shows Milan Laser’s PE sponsor is Leonard Green and Partners since 2019, with Sixth Street and Wildcat Capital adding growth investment in 2023 per Leonard Green’s own press release. No OceanSound Partners transaction is verifiable. This report cites the verifiable sponsor structure only.

The original brief cited “SkinSpirit / L Catterton acquisition (Sep 2022).” Primary-source verification (BusinessWire October 20, 2022; Nasdaq; WWD) confirms the transaction was a KKR minority investment through KKR’s Health Care Strategic Growth Fund II announced October 2022, with prior sponsor GreyLion remaining a minority holder. No L Catterton SkinSpirit transaction is verifiable. This report cites the verifiable sponsor only.

The original brief cited “LaserAway / TPG (2020).” Primary-source verification (Reuters via Private Equity Wire; multiple regional syndicates) shows LaserAway is backed by Ares Management and Seidler Equity Partners with founders retaining a stake, with the Ares investment made in 2021 (not 2020, and not TPG). This report cites the verifiable sponsor and vintage only.

The original brief cited “Ever/Body / Volition Capital + Prytek.” Primary-source verification shows Ever/Body’s growth-round investors were Tiger Global, Addition, Acme Capital, Declaration Partners, Fifth Wall, MetaProp, Gaingels, Imaginary Ventures, and Redesign Health across three rounds (October 2019 seed and Series A, May 2021 Series B, June 2022 Series C). No Volition Capital or Prytek investment is verifiable. Ever/Body was subsequently acquired by Advanced MedAesthetic Partners (backed by Leon Capital) on December 19, 2025 per PitchBook and PR Newswire. This report cites the verifiable ownership structure only.

End of report. Compliance restated: observed transaction ranges reported by third-party sources. Not an appraisal, not investment advice, not legal, tax, or financial advice.