CSTL vs GRAL vs NTRA Stock Comparison

Castle Biosciences, Grail and Natera Prices as of Oct 29, 2026 Peers: Industry group
CSTL Castle Biosciences Inc
$38.51 +10.4% 1M +62.2% 1Y
Market cap
$1.17B
P/E
–
Revenue (TTM)
$357.28M
Div. yield
–
Diagnostic Labs Healthcare
2 wins
GRAL GRAIL, Inc.
$158.92 +16.4% 1M +86.5% 1Y
Market cap
$7.10B
P/E
–
Revenue (TTM)
$157.21M
Div. yield
–
Diagnostic Labs Healthcare
NTRA Natera, Inc.
$436.00 +5.2% 1M +126.1% 1Y
Market cap
$62.61B
P/E
–
Revenue (TTM)
$2.71B
Div. yield
–
Diagnostic Labs Healthcare
7 wins

Head to Head

9 decided of 12

Natera leads on 7 of the 12 questions below (Natera 7, Castle Biosciences 2). Which ones matter depends on what you are buying for; a cheap multiple and slow growth often come together.

QuestionCSTLGRALNTRALeader
Larger companyMarket capitalisation $1.17B $7.10B $62.61B NTRA
Cheaper on earningsLower P/E, profitable companies only -60.3x -17.5x -324.7x –
Cheaper on forward earningsLower price / next fiscal year consensus EPS — — — –
Faster revenue growthRevenue growth, trailing twelve months +3.2% +17.1% +37.8% NTRA
More profitableNet margin, trailing twelve months -5.4% -249.1% -7.1% CSTL
Better return on capitalReturn on invested capital -6.7% — -11.7% CSTL
Less leveragedLower net debt / EBITDA 15.5x — 4.5x NTRA
Higher dividend yieldTrailing dividend yield — — — –
Better 1-year returnPrice return, last 12 months +62.2% +86.5% +126.1% NTRA
Better 5-year returnAnnualised price return, 5 years -9.2%/yr — +30.7%/yr NTRA
Less volatileAnnualised volatility, 1 year 58.8% 111.4% 47.9% NTRA
Higher overall scoreMean of the five percentile scores vs peers 51/100 43/100 51/100 NTRA

Percentile Scorecard

CSTLGRALNTRA

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

AxisCSTLGRALNTRA
Valuation 46 #50 of 92 8 #85 of 92 17 #77 of 92
Growth 52 #42 of 87 59 #36 of 87 71 #26 of 87
Profitability 39 #53 of 86 6 #81 of 86 32 #59 of 86
Financial Health 92 #9 of 97 99 #2 of 97 85 #15 of 97
Shareholder Returns 24 #42 of 55 – 52 #27 of 55
Overall 51 43 51
  • CSTL ranked among 102 companies in Healthcare Providers
  • GRAL ranked among 102 companies in Healthcare Providers
  • NTRA ranked among 102 companies in Healthcare Providers

Price Performance

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

Returns

PeriodCSTLGRALNTRASPY
1 month +10.4%+16.4%+5.2% +0.7%
3 months +43.7%+123.4%+61.7% +3.7%
6 months +57.2%+191.7%+111.5% +7.1%
Year to date -1.0%+85.7%+90.3% +12.8%
1 year +62.2%+86.5%+126.1% +11.9%
3 years +170.6%—+1,061.1% +85.2%
3 years, per year +39.4%—+126.6% +22.8%
5 years -38.2%—+280.6% +67.6%
5 years, per year -9.2%—+30.7% +10.9%
10 years ——+5,023.4% +262.0%
10 years, per year ——+48.2% +13.7%

Risk

MeasureCSTLGRALNTRASPY
Volatility, 1Y 58.8%111.4%47.9% 12.7%
Downside volatility, 1Y 61.6%126.6%44.6% 12.6%
Beta vs S&P 500, 1Y 0.962.691.23 1.00
Return / volatility, 1Y 1.060.782.63 0.94
Max drawdown, 5Y -82.1%-62.9%-76.4% -25.4%
From 52-week high -10.5%0.0%0.0% -1.2%
52-week high $43.04$158.92$436.00 $779.14
52-week low $18.15$43.03$182.65 $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.

MultipleCSTLGRALNTRA
P/E now vs peer median -60.3xmedian 26.0x -17.5xmedian 26.0x -324.7xmedian 26.0x
P/S now vs peer median 3.3xmedian 1.6x 45.2xmedian 1.6x 23.1xmedian 1.6x
EV/EBITDA now vs peer median -55.6xmedian 15.4x -15.4xmedian 15.4x -274.7xmedian 15.4x
P/FCF now vs peer median -2,403xmedian 21.5x -24.0xmedian 21.5x 743.7xmedian 21.5x
P/B now vs peer median 2.5xmedian 3.2x 2.8xmedian 3.2x 34.4xmedian 3.2x
PEG now vs peer median -1.43median 0.87 —median 0.87 -9.78median 0.87

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 monthsCSTLGRALNTRA
Revenue $357.28M $157.21M $2.71B
Gross profit $276.03M $75.51M $1.71B
Operating income -$32.11M -$559.25M -$289.67M
Net income -$19.42M -$391.59M -$192.36M
Free cash flow -$489.00K -$296.16M $84.20M
R&D $55.45M $190.72M $787.38M
EPS (diluted) $-0.64 $-9.08 $-1.34
Cash & equivalents $62.12M $55.65M $1.10B
Total debt $10.08M – $80.29M
Shares (diluted) 30.40M 43.11M 143.28M
Enterprise value $59.24M $3.97B $58.30B

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
MetricCSTLGRALNTRA
P/E -60.3x -17.5x -324.7x
P/FCF -2,403x -24.0x 743.7x
P/Operating cash flow 27.6x -24.1x 274.3x
P/S 3.3x 45.2x 23.1x
P/B 2.5x 2.8x 34.4x
P/Tangible book 2.5x 9.3x 42.8x
EV/EBITDA -55.6x -15.4x -274.7x
EV/EBIT -28.6x -11.2x -212.6x
EV/Revenue 2.6x 39.7x 22.8x
EV/FCF -1,878x -21.1x 731.6x
EV/Operating cash flow 21.5x -21.2x 269.9x
PEG (3Y EPS CAGR) -1.43 – -9.78

Growth

14 metrics
MetricCSTLGRALNTRA
Revenue growth (1Y) 3.2% 17.1% 37.8%
Revenue CAGR (3Y) 28.7% – 42.7%
Gross profit growth (1Y) -1.6% 30.2% 43.6%
Gross profit CAGR (3Y) 29.2% – 68.1%
Operating income growth (1Y) -39.3% 11.6% 1.3%
Operating income CAGR (3Y) 30.8% – 17.3%
Net income growth (1Y) -105.1% 11.6% 24.0%
Net income CAGR (3Y) 39.8% – 27.8%
EPS growth (1Y) -99.3% 26.6% 27.7%
EPS CAGR (3Y) 42.3% – 33.2%
Operating cash flow growth (1Y) -31.8% 20.3% 22.2%
Operating cash flow CAGR (3Y) 45.1% – 38.6%
Free cash flow growth (1Y) -101.4% 20.3% -26.8%
Free cash flow CAGR (3Y) 78.8% – 30.4%

Profitability

14 metrics
MetricCSTLGRALNTRA
Gross margin 77.3% 48.0% 63.2%
EBITDA margin -4.6% -257.6% -8.3%
Operating margin -9.0% -355.7% -10.7%
Pretax margin -5.4% -336.8% -9.3%
Net margin -5.4% -249.1% -7.1%
FCF margin -0.1% -188.4% 3.1%
Operating cash flow margin 11.9% -187.5% 8.4%
Return on equity -4.2% -15.5% -10.7%
Return on assets -3.5% -13.9% -7.3%
Return on invested capital -6.7% – -11.7%
Return on capital employed -6.4% -20.4% -13.9%
Asset turnover 0.6x 0.1x 1.0x
Cash conversion (OCF / net income) -2.2x 0.8x -1.2x
Stock comp / revenue 12.6% 40.9% 14.1%

Financial Health

11 metrics
MetricCSTLGRALNTRA
Debt / assets 1.8% – 3.0%
Debt / equity 0.0x – 0.0x
Net debt / EBITDA 15.5x – 4.5x
Debt / FCF -20.6x – 1.0x
Liabilities / assets 16.2% 10.6% 31.5%
Equity / assets 83.8% 89.4% 68.5%
Interest coverage -85.6x – -75.9x
Current ratio 6.0x 10.9x 3.0x
Quick ratio 5.6x 10.6x 2.8x
Cash ratio 4.7x 10.3x 2.0x
Altman Z-score 8.19 8.78 44.55

Shareholder Returns

7 metrics
MetricCSTLGRALNTRA
Dividend yield – – –
Net buyback yield -0.5% – -0.1%
Shareholder yield -0.5% – -0.1%
Payout ratio (earnings) – – –
Payout ratio (FCF) – – –
Dividend growth (1Y) – – –
Dividend CAGR (3Y) – – –

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.

ConsensusCSTLGRALNTRA
EPS, next fiscal year $-1.31FY2026 $-9.05FY2026 $-1.48FY2026
Revenue, next fiscal year $385.85MFY2026 $169.78MFY2026 $3.07BFY2026
Revenue growth, next FY +12.1%FY2026 +15.4%FY2026 +32.8%FY2026
Revenue growth, the year after +2.3% +38.2% +7.2%

Institutional Ownership

13F filings, quarter ended Jun 30, 2026
HoldersCSTLGRALNTRA
Held by institutions 89.6% 85.4% 95.5%
Institutions holding 177 373 848
Change in shares held, QoQ -1.0% +8.4% +2.7%
Institutions buying 104 183 514
Institutions selling 55 100 240
Buyers to sellers 1.89 1.83 2.14

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.

CSTLGRALNTRA
CSTL 1.00 0.37 0.42
GRAL 0.37 1.00 0.43
NTRA 0.42 0.43 1.00

Add a Peer

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Frequently Asked Questions

Which is bigger, CSTL, GRAL and NTRA?

Natera (NTRA) is the largest by market capitalisation: Castle Biosciences (CSTL) $1.17B, Grail (GRAL) $7.10B, Natera (NTRA) $62.61B.

Which company is growing faster?

Natera (NTRA) grew revenue fastest over the trailing twelve months: Castle Biosciences (CSTL) +3.2%, Grail (GRAL) +17.1%, Natera (NTRA) +37.8%.

Which company is more profitable?

Castle Biosciences (CSTL) has the highest net margin (Castle Biosciences (CSTL) -5.4%, Grail (GRAL) -249.1%, Natera (NTRA) -7.1%). On return on invested capital, Castle Biosciences (CSTL) leads (Castle Biosciences (CSTL) -6.7%, Natera (NTRA) -11.7%).

Which stock has performed better?

Over the past year Natera (NTRA) returned the most: Castle Biosciences (CSTL) +62.2%, Grail (GRAL) +86.5%, Natera (NTRA) +126.1%. Over five years, Natera (NTRA) compounded fastest (Castle Biosciences (CSTL) -9.2%/yr, Natera (NTRA) +30.7%/yr). Returns are price only, before dividends.

Which stock is riskier?

By one-year price volatility, Natera (NTRA) has been the steadiest (Castle Biosciences (CSTL) 58.8%, Grail (GRAL) 111.4%, Natera (NTRA) 47.9%). Volatility measures how widely the price swings, not the risk of the business.

Which is the better stock, CSTL, GRAL and NTRA?

There is no single answer; it depends on what you are buying for. On the 12 head-to-head measures on this page, Natera (NTRA) 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.