CSTL vs DGX vs TEM Stock Comparison

Castle Biosciences, Quest Diagnostics and Tempus AI Prices as of Oct 26, 2026 Peers: Industry group
CSTL Castle Biosciences Inc
$33.30 -7.0% 1M +35.9% 1Y
Market cap
$1.05B
P/E
–
Revenue (TTM)
$357.28M
Div. yield
–
Diagnostic Labs Healthcare
1 win
DGX Quest Diagnostics Inc
$242.92 +2.8% 1M +33.3% 1Y
Market cap
$26.64B
P/E
23.6x
Revenue (TTM)
$11.84B
Div. yield
0.01%
Diagnostic Labs Healthcare
7 wins
TEM Tempus AI, Inc.
$67.16 -21.0% 1M -24.7% 1Y
Market cap
$13.00B
P/E
–
Revenue (TTM)
$1.43B
Div. yield
–
Diagnostic Labs Healthcare
1 win

Head to Head

9 decided of 12

Quest Diagnostics leads on 7 of the 12 questions below (Quest Diagnostics 7, Tempus AI 1, Castle Biosciences 1). Which ones matter depends on what you are buying for; a cheap multiple and slow growth often come together.

QuestionCSTLDGXTEMLeader
Larger companyMarket capitalisation $1.05B $26.64B $13.00B DGX
Cheaper on earningsLower P/E, profitable companies only -54.0x 23.6x -51.1x –
Cheaper on forward earningsLower price / next fiscal year consensus EPS — 22.2x — –
Faster revenue growthRevenue growth, trailing twelve months +3.2% +9.1% +50.4% TEM
More profitableNet margin, trailing twelve months -5.4% 9.5% -17.8% DGX
Better return on capitalReturn on invested capital -6.7% 9.9% -52.0% DGX
Less leveragedLower net debt / EBITDA 15.5x 2.1x — DGX
Higher dividend yieldTrailing dividend yield 0.00% 0.01% 0.00% –
Better 1-year returnPrice return, last 12 months +35.9% +33.3% -24.7% CSTL
Better 5-year returnAnnualised price return, 5 years -11.3%/yr +11.0%/yr — DGX
Less volatileAnnualised volatility, 1 year 58.3% 23.8% 76.6% DGX
Higher overall scoreMean of the five percentile scores vs peers 50/100 64/100 26/100 DGX

Percentile Scorecard

CSTLDGXTEM

Each axis is the mean percentile of its metrics against the company's industry group. 100 is the best in the group, 50 the middle.

Scores by Axis

AxisCSTLDGXTEM
Valuation 47 #50 of 93 71 #28 of 93 9 #85 of 93
Growth 51 #44 of 88 40 #53 of 88 26 #65 of 88
Profitability 38 #54 of 87 77 #21 of 87 11 #78 of 87
Financial Health 92 #9 of 100 56 #45 of 100 57 #44 of 100
Shareholder Returns 20 #45 of 56 76 #14 of 56 –
Overall 50 64 26
  • CSTL ranked among 103 companies in Healthcare Providers
  • DGX ranked among 103 companies in Healthcare Providers
  • TEM ranked among 103 companies in Healthcare Providers

Price Performance

Price return, split-adjusted, before dividends. Click a name to hide or show it.

Returns

PeriodCSTLDGXTEMSPY
1 month -7.0%+2.8%-21.0% -0.8%
3 months +36.3%+4.7%+56.5% +3.5%
6 months +33.3%+23.5%+27.5% +7.0%
Year to date -14.4%+40.0%+13.7% +12.2%
1 year +35.9%+33.3%-24.7% +13.0%
3 years +155.0%+90.3%— +86.3%
3 years, per year +36.6%+23.9%— +23.1%
5 years -45.2%+68.8%— +68.6%
5 years, per year -11.3%+11.0%— +11.0%
10 years —+203.1%— +258.0%
10 years, per year —+11.7%— +13.6%

Risk

MeasureCSTLDGXTEMSPY
Volatility, 1Y 58.3%23.8%76.6% 12.7%
Downside volatility, 1Y 61.4%18.8%66.8% 12.7%
Beta vs S&P 500, 1Y 0.95-0.092.54 1.00
Return / volatility, 1Y 0.611.40-0.32 1.02
Max drawdown, 5Y -82.1%-30.3%-59.8% -25.4%
From 52-week high -22.6%-1.8%-26.7% -1.8%
52-week high $43.04$247.47$91.58 $779.14
52-week low $18.15$173.49$41.55 $631.97

Valuation History

Weekly multiples on trailing twelve-month fundamentals. Negative or extreme readings (a loss year, a collapsed denominator) are left out so the chart stays readable.

MultipleCSTLDGXTEM
P/E now vs peer median -52.1xmedian 25.1x 23.7xmedian 25.1x -47.5xmedian 25.1x
P/S now vs peer median 2.8xmedian 1.6x 2.3xmedian 1.6x 8.2xmedian 1.6x
EV/EBITDA now vs peer median -46.0xmedian 14.5x 13.6xmedian 14.5x —median 14.5x
P/FCF now vs peer median -2,078xmedian 22.4x 19.4xmedian 22.4x -44.7xmedian 22.4x
P/B now vs peer median 2.2xmedian 3.1x 3.4xmedian 3.1x 26.4xmedian 3.1x
PEG now vs peer median -1.23median 0.66 1.62median 0.66 —median 0.66

Financial History

Reported figures by fiscal period, placed on the calendar year (or quarter) each period ended in, so companies with different fiscal years line up.

Trailing twelve monthsCSTLDGXTEM
Revenue $357.28M $11.84B $1.43B
Gross profit $276.03M $3.92B $916.19M
Operating income -$32.11M $1.72B -$283.03M
Net income -$19.42M $1.18B -$254.43M
Free cash flow -$489.00K $1.38B -$263.22M
R&D $55.45M – $196.31M
EPS (diluted) $-0.64 $10.08 $-1.39
Cash & equivalents $62.12M $797.00M $599.61M
Total debt $10.08M $5.55B –
Shares (diluted) 30.40M 112.00M 182.40M
Enterprise value -$66.57M $24.41B $10.03B

All Metrics

58 metrics · best in bold

Bold marks the best reading: the lowest positive value for multiples, leverage and payout, the highest for everything else. The bar under each value is its percentile against that company's own peers. Hover a value for its rank and the peer median.

Valuation

12 metrics
MetricCSTLDGXTEM
P/E -52.1x 23.7x -47.5x
P/FCF -2,078x 19.4x -44.7x
P/Operating cash flow 23.8x 13.7x -49.6x
P/S 2.8x 2.3x 8.2x
P/B 2.2x 3.4x 26.4x
P/Tangible book 2.2x 4.2x 88.8x
EV/EBITDA -46.0x 13.6x –
EV/EBIT -23.6x 18.3x -38.7x
EV/Revenue 2.1x 2.7x 7.6x
EV/FCF -1,553x 22.9x -41.6x
EV/Operating cash flow 17.8x 16.1x -46.1x
PEG (3Y EPS CAGR) -1.23 1.62 –

Growth

14 metrics
MetricCSTLDGXTEM
Revenue growth (1Y) 3.2% 9.1% 50.4%
Revenue CAGR (3Y) 28.7% 8.4% –
Gross profit growth (1Y) -1.6% 8.5% 58.5%
Gross profit CAGR (3Y) 29.2% 8.4% –
Operating income growth (1Y) -39.3% 12.5% -20.6%
Operating income CAGR (3Y) 30.8% 15.1% –
Net income growth (1Y) -105.1% 15.0% -27.4%
Net income CAGR (3Y) 39.8% 12.9% –
EPS growth (1Y) -99.3% 17.6% -21.1%
EPS CAGR (3Y) 42.3% 14.6% –
Operating cash flow growth (1Y) -31.8% 3.5% -356.2%
Operating cash flow CAGR (3Y) 45.1% 21.8% –
Free cash flow growth (1Y) -101.4% -1.3% -278.0%
Free cash flow CAGR (3Y) 78.8% 32.1% –

Profitability

14 metrics
MetricCSTLDGXTEM
Gross margin 77.3% 33.1% 64.0%
EBITDA margin -4.6% 19.5% –
Operating margin -9.0% 14.6% -19.8%
Pretax margin -5.4% 12.6% -17.6%
Net margin -5.4% 9.5% -17.8%
FCF margin -0.1% 11.6% -18.4%
Operating cash flow margin 11.9% 16.5% -16.6%
Return on equity -4.2% 15.0% -57.3%
Return on assets -3.5% 6.9% -11.0%
Return on invested capital -6.7% 9.9% -52.0%
Return on capital employed -6.4% 11.3% -15.2%
Asset turnover 0.6x 0.7x 0.6x
Cash conversion (OCF / net income) -2.2x 1.7x 0.9x
Stock comp / revenue 12.6% 0.7% 13.0%

Financial Health

11 metrics
MetricCSTLDGXTEM
Debt / assets 1.8% 32.2% –
Debt / equity 0.0x 0.7x –
Net debt / EBITDA 15.5x 2.1x –
Debt / FCF -20.6x 4.0x –
Liabilities / assets 16.2% 53.8% 81.2%
Equity / assets 83.8% 46.2% 18.8%
Interest coverage -85.6x 6.5x -5.1x
Current ratio 6.0x 1.7x 3.3x
Quick ratio 5.6x 1.4x 3.1x
Cash ratio 4.7x 0.4x 2.1x
Altman Z-score 7.14 3.70 2.85

Shareholder Returns

7 metrics
MetricCSTLDGXTEM
Dividend yield – 1.4% –
Net buyback yield -0.6% 1.2% –
Shareholder yield -0.6% 2.6% 0.0%
Payout ratio (earnings) – 31.3% –
Payout ratio (FCF) – 26.8% –
Dividend growth (1Y) – 6.3% –
Dividend CAGR (3Y) – 6.1% –

Analyst Estimates

Solid lines are reported fiscal-year results; dashed lines are the consensus for the years ahead. Hover a year for the analysts' high and low, and how each result compared with its estimate.

ConsensusCSTLDGXTEM
Forward P/E – 22.2xFY2026 –
EPS, next fiscal year $-1.31FY2026 $10.96FY2026 $-0.21FY2026
EPS growth, next FY – +11.3%FY2026 –
EPS growth, the year after – +6.8% –
Revenue, next fiscal year $385.85MFY2026 $11.25BFY2026 $1.64BFY2026
Revenue growth, next FY +12.1%FY2026 +1.9%FY2026 +29.0%FY2026
Revenue growth, the year after +2.3% +7.7% +24.1%

Institutional Ownership

13F filings, quarter ended Jun 30, 2026
HoldersCSTLDGXTEM
Held by institutions 89.6% 94.4% 61.3%
Institutions holding 177 1,096 483
Change in shares held, QoQ -1.0% +2.7% +5.0%
Institutions buying 104 549 284
Institutions selling 55 341 118
Buyers to sellers 1.89 1.61 2.41

Return Correlation

Daily returns, last 12 months

1.00 means two stocks move in lockstep, 0 that they move independently. Pairs below about 0.5 diversify each other.

CSTLDGXTEM
CSTL 1.00 0.18 0.49
DGX 0.18 1.00 0.19
TEM 0.49 0.19 1.00

Add a Peer

Largest companies in the same industry

Related Comparisons

Frequently Asked Questions

Which is bigger, CSTL, DGX and TEM?

Quest Diagnostics (DGX) is the largest by market capitalisation: Castle Biosciences (CSTL) $1.05B, Quest Diagnostics (DGX) $26.64B, Tempus AI (TEM) $13.00B.

Which company is growing faster?

Tempus AI (TEM) grew revenue fastest over the trailing twelve months: Castle Biosciences (CSTL) +3.2%, Quest Diagnostics (DGX) +9.1%, Tempus AI (TEM) +50.4%.

Which company is more profitable?

Quest Diagnostics (DGX) has the highest net margin (Castle Biosciences (CSTL) -5.4%, Quest Diagnostics (DGX) 9.5%, Tempus AI (TEM) -17.8%). On return on invested capital, Quest Diagnostics (DGX) leads (Castle Biosciences (CSTL) -6.7%, Quest Diagnostics (DGX) 9.9%, Tempus AI (TEM) -52.0%).

Which stock has performed better?

Over the past year Castle Biosciences (CSTL) returned the most: Castle Biosciences (CSTL) +35.9%, Quest Diagnostics (DGX) +33.3%, Tempus AI (TEM) -24.7%. Over five years, Quest Diagnostics (DGX) compounded fastest (Castle Biosciences (CSTL) -11.3%/yr, Quest Diagnostics (DGX) +11.0%/yr). Returns are price only, before dividends.

Which pays a higher dividend?

Only one of these companies pays a dividend: Castle Biosciences (CSTL) 0.00%, Quest Diagnostics (DGX) 0.01%, Tempus AI (TEM) 0.00%. Castle Biosciences (CSTL) and Tempus AI (TEM) pays no regular dividend.

Which stock is riskier?

By one-year price volatility, Quest Diagnostics (DGX) has been the steadiest (Castle Biosciences (CSTL) 58.3%, Quest Diagnostics (DGX) 23.8%, Tempus AI (TEM) 76.6%). Volatility measures how widely the price swings, not the risk of the business.

Which is the better stock, CSTL, DGX and TEM?

There is no single answer; it depends on what you are buying for. On the 12 head-to-head measures on this page, Quest Diagnostics (DGX) leads on 7. Business Quant does not give investment advice; use the comparison as a starting point for your own research.

Data from SEC filings, exchange prices and consensus estimates, via Business Quant. Percentile scores compare each company with its own peer group, so two companies' scores are each relative to different peers unless you rank against the whole market. Price returns exclude dividends. Nothing on this page is investment advice.