BillionToOne (NASDAQ: BLLN) raises its revenue outlook and oncology sales jump 96%

What happened

BillionToOne, Inc. (NASDAQ: BLLN) raised its full-year 2026 revenue guidance to $460 million to $470 million on Nov. 4. The new range implies growth of 51% to 54% over 2025.

Prior guidance was $450 million to $465 million, so both ends moved up. By OptimistFi's calculation, the midpoint rose $7.5 million, to $465.0 million from $457.5 million.

The raise follows third-quarter revenue of $123.0 million, up 47% from $83.5 million a year earlier. The company said volume and price both drove the gain. Tests delivered rose 25% to 206,000, and overall average selling price rose 18% to $589.

Key numbers

Metric	Latest	Change	Source
Third-quarter total revenue	$123.0 million	from $83.5 million, +47%	SEC 8-K earnings release
Full-year 2026 revenue guidance (prior range in second column)	$460 million to $470 million	from $450 million to $465 million, +$7.5 million at midpoint	SEC 8-K earnings release, midpoint calculated by OptimistFi
Third-quarter oncology revenue	$17.1 million	from $8.7 million, +96%	SEC 8-K earnings release
Third-quarter gross margin	71%	from 70%, +1 percentage point	SEC 8-K earnings release
Third-quarter income from operations	$11.0 million	from $9.6 million, +$1.4 million	SEC 8-K earnings release
Third-quarter free cash flow	$8.6 million	from $7.9 million, +$0.73 million	Calculated from SEC 8-K earnings release

Read more: BillionToOne (BLLN) company research

Where the growth came from

Prenatal testing is still the larger business, with revenue of $104.3 million, up 41%. Oncology is growing faster. Its revenue was $17.1 million, 96% higher than the $8.7 million reported in the third quarter of 2025.

The nine-month figures show the same split. Oncology revenue was $41.4 million, up 162% from $15.8 million. Prenatal revenue was $295.1 million, up 54% from $191.0 million.

The company paired the numbers with new clinical data. In August, a study in The Green Journal, run with nine U.S. institutions, reported that Unity Fetal Risk Screen had 94.4% sensitivity and 99.5% specificity as a first-line prenatal screen.

In October, The Journal of Liquid Biopsy published a head-to-head comparison of Northstar Response with the most widely used tumor-informed assay. The two agreed on the direction of ctDNA change in 94% of sequential pairs (67 of 71). Clinical records supported Northstar Response in all four cases where they differed.

Stock perps: every US stock that trades as a perpetual future, by leverage, live

Why it matters

OptimistFi has argued that BillionToOne works if its tests stay clinically differentiated enough to keep winning orders and reimbursement while lab scale turns volume into durable cash. The quarter supports that view. CEO Oguzhan Atay said more clinicians are choosing the company's tests. Gross margin edged up to 71% from 70%, which the company credits to higher average selling price.

Spending is growing faster than sales, though. Operating expenses rose 56% to $76.1 million from $48.8 million. Income from operations rose only to $11.0 million from $9.6 million, a 9% operating margin.

Net income of $17.4 million, or $0.32 per diluted share, runs well above operating income. It includes $4.9 million of interest income and a $1.48 million gain from a change in the fair value of the company's term loan. The company treats that change as a non-cash item and excludes it from adjusted EBITDA.

The raised outlook is still management guidance, and the release says actual results could differ materially. The company also said it expects profitability similar to current levels even with continued investments.

Cash, receivables and debt

Free cash flow was $8.6 million in the third quarter, up from $7.9 million a year earlier. For the nine months it was $24.65 million against $6.46 million, on operating cash flow of $37.1 million.

Receivables grew fast. Accounts receivable stood at $88.3 million on Sept. 30, up from $41.6 million on Dec. 31, 2025. Receivables absorbed $46.7 million of operating cash in the nine months.

Cash and cash equivalents were $561.5 million, up from $496.0 million at year-end. Long-term debt was $89.0 million against $57.2 million. The company took in $30.0 million of debt proceeds during the nine months.

What's next

Northstar Clear, a tissue-free MRD test for all solid tumors, becomes commercially available on Dec. 15. The company said initial colorectal cancer data will show head-to-head performance against a tumor-informed assay. Orders for the new test would show whether oncology's rapid growth carries into a new product.

The guidance range less nine-month revenue of $340.8 million implies fourth-quarter revenue of $119.2 million to $129.2 million, by OptimistFi's calculation. A result at the low end would be a sequential decline from the third quarter and would weaken the case.

More from OptimistFi

• BLLN stock: research and coverage of BillionToOne
• Stock research on every company OptimistFi covers

From OptimistFi Perps