Billiontoone NASDAQ: BLLN reported second-quarter 2026 revenue growth of 64% year over year, driven by higher testing volumes and average selling prices across its prenatal and oncology businesses. The molecular diagnostics company also posted positive operating income and free cash flow while reiterating its full-year revenue outlook.
Total revenue for the quarter ended June 30 was $109.4 million, compared with $66.6 million a year earlier. Test volume increased 35% to approximately 196,000 tests, while overall average selling price rose 21% year over year to $551 per test.
Chief Executive Officer Oguzhan Atay said the company’s annualized revenue run rate reached $438 million, while its gross margin remained above 70% despite the increasing contribution of oncology testing.
Profitability and Cash Generation
Gross profit rose to $77.1 million from $43.5 million in the prior-year quarter, and gross margin expanded to 70.5% from 65.3%. The company attributed the increase primarily to higher average selling prices.
Operating expenses increased 59% to $71.6 million, including research and development expense of $17.3 million and selling, general and administrative expense of $54.3 million. Still, Billiontoone generated operating income of $5.5 million, compared with an operating loss of $1.6 million a year earlier. Its GAAP operating margin was 5%.
Net income available to common shareholders was $8.1 million, or $0.15 per diluted share, compared with a net loss of $0.2 million in the second quarter of 2025. Adjusted EBITDA margin was 15%, according to Chief Financial Officer Ross Taylor.
Cash flow from operations totaled $9.1 million, while capital expenditures were $4 million, resulting in free cash flow of $5.1 million. The company ended the quarter with $549 million in cash and equivalents.
Prenatal and Oncology Growth
Prenatal revenue increased 56% year over year to $95.8 million, supported by commercial execution and rising average selling prices. Oncology revenue grew 176% to $13.7 million, representing an annualized run rate of roughly $55 million.
The company said reported revenue was only slightly higher sequentially due to the timing of revenue true-ups. True-up revenue was $2.8 million in the second quarter, compared with $9.2 million in the first quarter. Excluding true-up revenue, total revenue increased 8% sequentially.
Atay said the company held more than $10 million in claims during the quarter while awaiting implementation of its codes by national in-network payers. He said the move temporarily affected cash collections, realized average selling prices and potentially true-up revenue. Billiontoone expects the claims to be processed during the second half of the year, but said it was maintaining its guidance until the ultimate timing and amount of collections are clearer.
Cost of goods sold per test was $161, up from $152 in the first quarter, largely because oncology testing represented a greater portion of volume. However, the company said prenatal cost of goods sold was roughly flat sequentially, while oncology cost of goods sold declined by more than 10% sequentially.
Management said it expects overall cost of goods sold per test to rise gradually as oncology grows faster than prenatal, but intends to maintain gross margins at or above 70% through pricing improvements and further oncology cost reductions.
Product Launches and Coverage Efforts
Billiontoone launched Unity Confirm on May 28 as a noninvasive follow-on assay for high-risk pregnancies identified through its Unity aneuploidy screen. The test captures and sequences circulating fetal cells. Atay said providers were ordering Unity Confirm for more than 50% of eligible high-risk Unity aneuploidy patients.
The company plans to expand its Unity Fetal Risk Screen to 130 genes on Aug. 17. Management said it expects the larger panel to broaden its addressable market, particularly among health systems and providers that prefer larger inherited-condition panels.
In oncology, Billiontoone published a peer-reviewed study in the Journal of Liquid Biopsy evaluating Northstar Response for monitoring immunotherapy and immunotherapy-combination treatments. The study included 142 patients, more than 750 samples, two prospective cohorts and 12 tumor types.
According to Atay, the study found molecular progression was a stronger predictor of worse survival than imaging alone, with the combination of molecular testing and imaging providing greater predictive value. The company said the publication is intended to support its pursuit of MolDX Medicare coverage for Northstar Response in immunotherapy settings. Management continues to expect a coverage decision by year-end.
The company also said it remains on track to launch a tumor-naive minimal residual disease test by the end of 2026. On Sept. 1, it plans to expand its Northstar Select panel to 102 genes and introduce Northstar Origin, a tissue-of-origin add-on. Management said Northstar Origin demonstrated 91% top-three accuracy and 86% top-one accuracy in identifying tissue of origin.
Commercial Investments and Outlook
Billiontoone added approximately 70 sales representatives in the first half of 2026, ahead of its prior hiring plan. Atay said the expanded commercial team should support growth as representatives become productive and as the company pursues health-system accounts.
The company also launched on Epic Aura and completed its first health-system integration in two weeks from the start of integration to the first test order. While individual health systems may take two to four quarters to place integrations on their information-technology roadmaps, management expects the impact to become more meaningful next year.
Billiontoone signed a lease for a 62,000-square-foot dedicated oncology production laboratory in Union City, California. The facility is expected to begin production by the end of 2027 and is designed to support capacity of about 5,000 oncology tests per day over time.
The company reiterated its 2026 revenue outlook of $450 million to $465 million, representing projected growth of approximately 48% to 52% from 2025. Taylor said Billiontoone expects to sustain profitability at levels similar to current performance while continuing to invest in commercial operations and research and development.
About Billiontoone (NASDAQ:BLLN)
BillionToOne NASDAQ: BLLN is a molecular diagnostics company that develops and commercializes high-precision genetic testing solutions based on single-molecule counting technology. The company’s platform is designed to detect and quantify rare genetic variants and chromosomal abnormalities from cell-free DNA, with a primary focus on applications in prenatal screening and other clinical genetic tests where sensitivity and specificity at very low allele fractions are critical.
BillionToOne’s offerings center on assay development and clinical testing workflows that enable non-invasive prenatal testing (NIPT) and targeted molecular diagnostics.
This instant news alert was generated by narrative science technology and financial data from MarketBeat in order to provide readers with the fastest reporting and unbiased coverage. Please send any questions or comments about this story to contact@marketbeat.com.
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