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BillionToOne, Inc. helps doctors assess fetal health risks and guide cancer treatment. Its UNITY tests use maternal blood to screen for genetic conditions and assess fetal risk, and account for most revenue. Its smaller Northstar oncology business serves patients with late-stage solid tumors: Northstar Select helps doctors choose treatments, while Northstar Response tracks how tumors respond to treatment through blood testing.
The company markets directly to U.S. physicians, performs the tests they order and bills for the results. Most revenue comes from U.S. testing reimbursed by commercial insurers and government programs such as Medicare and Medicaid; patients contribute a small share. Revenue depends on both how many tests providers order and what payors agree to cover and actually pay. Carrier screening and screening for abnormal chromosome numbers have broad insurance coverage, but coverage for some other prenatal tests varies. Northstar Select has Medicare coverage for eligible patients; Northstar Response does not currently have Medicare coverage and is covered by relatively few insurers.
Nearly all revenue comes from tests processed at the Union City, California laboratory. The business therefore depends on that facility continuing to operate. It must also maintain laboratory certification under federal CLIA rules and applicable state licenses to keep testing and billing healthcare programs and many insurers.
The risk section is the longest, dullest part of the filing. This keeps only what can really hurt you: where it hits, how hard, when it plays out.
Every company claims an edge. Each one is checked against hard numbers like margins and returns: which hold, and which line gives way first.
Natera competes with BillionToOne for prenatal screening, carrier testing and blood-based cancer-monitoring orders. Its work on noninvasive tests for fetal recessive-disease risk is especially relevant to UNITY: prenatal tests generated 91% of BillionToOne’s revenue in the year ended December 31, 2025.
Myriad Genetics Inc competes with BillionToOne in prenatal screening and carrier testing, including noninvasive assessment of fetal recessive-disease risk. Watch its competing product development: BillionToOne says launches could challenge UNITY while also increasing providers’ acceptance of this type of testing.
Guardant Health competes with BillionToOne’s Northstar tests by selling blood-based tests that help oncologists choose treatments and monitor cancer. Its clinical oncology testing revenue is the relevant line to follow, rather than its separate screening or biopharma businesses; it bills Medicare and private insurers for qualifying U.S. patients’ tests.
Labcorp competes for the noninvasive prenatal screening and carrier-testing orders that underpin BillionToOne’s main revenue source. Labcorp sells routine and specialized laboratory tests to clients and patients, with government programs and third parties also paying; its broad laboratory network and in-office blood-collection staff show the reach behind that competition.
Quest Diagnostics competes with BillionToOne for noninvasive prenatal testing and comprehensive carrier-screening orders. Quest provides laboratory-testing information to clinicians and hospitals; its connections to their electronic health records show its reach into the providers choosing those tests.
Tempus AI competes with BillionToOne for diagnostic orders that guide cancer treatment selection and monitor treatment response. It provides testing to healthcare providers and life-sciences customers, so its oncology diagnostics and provider network are more relevant to Northstar than its separate data-licensing business.
Caris Life Sciences, Inc. competes with BillionToOne for tests that analyze cancer’s molecular features and for blood-based treatment monitoring. Caris sells testing to physicians, researchers and biopharma companies; its blood-based Caris Assure offering and clinical monitoring business are the parts to watch alongside Northstar.
Fulgent Genetics, Inc. competes with BillionToOne for comprehensive carrier-screening orders from prenatal-care providers. Fulgent earns revenue from laboratory testing and physicians’ interpretation of results; its carrier-screening offerings, rather than its separate drug-development business, are the relevant competition for UNITY.
NeoGenomics, Inc. competes with BillionToOne for oncologists’ orders to select therapies and monitor treatment response. It provides laboratory testing and expert interpretation to community oncology and pathology practices, making its clinical cancer-testing business the relevant comparison for Northstar.
Personalis, Inc. competes with BillionToOne by selling cancer genomic tests that help physicians choose therapies and monitor treatment response. Its physician-facing testing is the part to compare with Northstar, distinct from its research and clinical-trial services for pharmaceutical and biopharmaceutical companies.
BillionToOne, Inc. earningsThis company
BillionToOne earns most of its revenue from prenatal tests, and this report will show whether delivered test volume and average selling prices can grow together while the company controls per-test costs and protects its gross margin.
Read delivered and billable test volume alongside Overall ASP (average selling price), gross margin and cost per test. More delivered tests with a rising ASP and steady or improving margin would show that more tests are turning into revenue at better prices without eroding the economics of each test. If volume grows but ASP or margin weakens, reimbursement or testing costs are absorbing that growth.
Natera, Inc. earningsNTRA
Natera's report will show how demand for prenatal and carrier screening, and competition in fetal recessive-disease risk testing, are shaping the market for BillionToOne's UNITY tests.
Compare Natera's reported prenatal-testing performance and updates on fetal recessive-disease risk tests with BillionToOne's delivered UNITY test volume and average selling price. Natera's growth alongside wider use of this type of testing would point to a growing market. If its product progress strengthens competition while BillionToOne's measures weaken, UNITY may be under greater pressure. Weak prenatal activity at Natera too would point more to a soft market than to a problem unique to BillionToOne.
Guardant Health, Inc. earningsGH
Guardant Health's report will show how oncologist demand and insurer payment for blood-based cancer tests are developing, offering a comparison for BillionToOne's Northstar tests.
Compare Guardant's reported clinical oncology testing business and test volume with BillionToOne's Northstar volume and oncology revenue; include any reimbursement detail Guardant reports. Stronger Guardant volume and revenue would show that clinicians are using blood-based cancer tests and that this use is translating into business, supporting the market Northstar serves. Weakness would point to provider adoption or insurer payment as possible barriers for this type of testing.
