Imaging Center Valuation Multiples and M&A Trends 2025
- Will Hamilton
- Jun 5
- 4 min read
Updated: 1 hour ago
The diagnostic imaging center industry is a critical component of the healthcare sector, providing essential services for the detection, diagnosis, and monitoring of various medical conditions. These facilities utilize advanced imaging technologies such as X-rays, Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Ultrasound, and Positron Emission Tomography (PET) to produce detailed images of the body’s internal structures. The industry has seen significant growth over the past several decades due to increasing demand for early and accurate diagnosis, driven by the rising prevalence of chronic diseases, aging populations, and advancements in imaging technology. Diagnostic imaging centers operate in diverse settings, including standalone facilities, hospital outpatient departments, and mobile units, catering to a wide range of patients and healthcare providers. The industry is also influenced by regulatory standards, reimbursement policies, and the need for skilled radiologists and technicians to ensure high-quality patient care.
Despite its growth, the diagnostic imaging center industry faces challenges such as high operational costs, regulatory compliance, and competition from hospitals and other healthcare providers. The adoption of value-based care models and the shift towards outpatient services have created opportunities for imaging centers to enhance efficiency and patient satisfaction.
Additionally, the integration of artificial intelligence (AI) and machine learning into imaging processes is revolutionizing the industry by improving diagnostic accuracy, reducing turnaround times, and optimizing workflow. As healthcare systems worldwide continue to prioritize preventive care and personalized medicine, diagnostic imaging centers are poised to play an increasingly vital role in modern healthcare delivery. The industry’s future will likely be shaped by technological innovation, strategic partnerships, and a focus on cost-effective, patient-centered solutions.
Key Growth Drivers
Key growth drivers for the industry include the following:
Technological Advancements: Continuous innovation in imaging technologies, such as AI integration, 3D/4D imaging, and advanced modalities like PET-MRI and spectral CT, enhances diagnostic accuracy and efficiency, driving market growth.
Rising Prevalence of Chronic Diseases: The increasing incidence of chronic conditions like cancer, cardiovascular diseases, and neurological disorders necessitates advanced diagnostic imaging for early detection and treatment planning.
Aging Population: The growing elderly population is more susceptible to age-related diseases, increasing the demand for diagnostic imaging procedures.
Increasing Demand for Minimally Invasive Procedures: Diagnostic imaging plays a crucial role in guiding minimally invasive surgeries and interventions, which are preferred due to shorter recovery times and reduced risks.
Expansion of Healthcare Infrastructure: Emerging markets are investing in healthcare infrastructure, including diagnostic imaging facilities, to improve access to advanced medical services.
Imaging Center M&A Trends
The number of announced diagnostic imaging M&A deals has fluctuated in recent years, without a clear defining trend. Much of the M&A activity in the segment is dominated by hospitals, physician groups, and joint venture entities - where public announcements are infrequent.
The diagnostic imaging industry in the U.S. remains fragmented with a large number of potential acquirers, including local hospitals and health systems. The number of platforms that have made more than a handful of acquisitions over the past few years is fairly small. By far the largest acquirer in terms of announced deals since 2019 is publicly-traded RadNet, with 32.
Diagnostic Imaging EBITDA Multiples
Single Centers (typically revenue under $10M):
Single facility centers usually sell for lower multiples, ranging from 3x to 6x EBITDA, although outliers are common. The lower multiple is often due to higher operational risk, susceptibility to new competition and changing referral patterns, and limited geographic reach.
Small to Mid-Sized Portfolios (revenue $10-50M):
Larger, more established companies with proven profitability, modality diversification, and a broader geographical reach may command higher multiples. These can range from 5x to 8x EBITDA, depending on size, local market conditions, service mix, growth rate, and the stability of the cash flow.
Large Platforms, Tech-Driven Imaging:
Companies offering cutting-edge technologies, like state-of-the-art equipment and AI-driven image processing, with strong, continuing management teams can command multiples in the 8x to 14x EBITDAÂ range, especially if they have demonstrated the ability to grow quickly with favorable unit economics.
Cash Flow Multiples for Small Imaging Centers
There are a number of small, usually single modality imaging centers listed for sale currently, but it's difficult to glean much useful information from deals this small where the level of owner involvement is unclear. Our study of current and recently removed diagnostic imaging centers for sale shows a range of multiple from 3.89x cash flow to 5.17x cash flow at the 25th and 75th percentiles, with a median of 4.39x.
Factors Impacting the EBITDA Multiple for Imaging Centers
Acquisition multiples are a function of perceived risk and growth. Key considerations within the diagnostic imaging industry include the following:
Quality and Age of Equipment: Imaging centers with newer, high-end machines receive higher multiples due to lower near-term capital expenditure requirements, and lower risk of obsolescence.
Payer Mix and Reimbursement Trends: Imaging centers with a high percentage of commercial or cash-pay patients typically command higher multiples than those heavily reliant on Medicare/Medicaid. Favorable contracts with commercial payers or participation in value-based care models can also boost multiples.
Modality Mix and Service Complexity: Centers offering high-end modalities (e.g., MRI, PET/CT, cardiac imaging) with greater reimbursement and less commoditization often attract premium valuations. Diversified services reduce risk and can improve revenue per patient, enhancing buyer interest.
Scale and Geographic Density: Multi-site operators or those in high-growth metro areas benefit from economies of scale and strategic value to consolidators. Platforms with 5+ locations in a state or region are more attractive to private equity due to network effects and referral capture.
Operational Efficiency and Compliance Infrastructure: Well-managed centers with strong margins, modern equipment, optimized throughput, and compliance programs (e.g., HIPAA, accreditation) reduce perceived risk. Buyers are willing to pay more for turnkey operations that require minimal post-close investment.
About Scope Research
Scope Research compiles a variety of healthcare M&A databases and provides healthcare valuation services. The Scope Research Healthcare M&A Valuation Database currently has financial details for 45 imaging center deals going back to 2010, 26 of which include reported EBITDA multiples. The data can be purchased individually, while our affordable annual subscriptions provide access to all of our healthcare M&A databases and segments, updated continuously.
Don't hesitate to reach out to Will Hamilton at will@scoperesearch.co with questions about our imaging center valuation services or healthcare M&A databases.