CSTL vs NTRA vs GRAL Stock Comparison

Castle Biosciences, Natera and Grail Prices as of Nov 2, 2026 Peers: Industry group
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CSTL Castle Biosciences Inc
$34.94 -1.7% 1M +37.0% 1Y
Market cap
$1.07B
P/E
–
Revenue (TTM)
$357.28M
Div. yield
–
Diagnostic Labs Healthcare
3 wins
NTRA Natera, Inc.
$378.92 -7.7% 1M +90.5% 1Y
Market cap
$54.42B
P/E
–
Revenue (TTM)
$2.71B
Div. yield
–
Diagnostic Labs Healthcare
6 wins
GRAL GRAIL, Inc.
$133.76 -6.6% 1M +45.5% 1Y
Market cap
$5.97B
P/E
–
Revenue (TTM)
$157.21M
Div. yield
–
Diagnostic Labs Healthcare

Head to Head

9 decided of 12

Natera leads on 6 of the 12 questions below (Natera 6, Castle Biosciences 3). Which ones matter depends on what you are buying for; a cheap multiple and slow growth often come together.

QuestionCSTLNTRAGRALLeader
Larger companyMarket capitalisation $1.07B $54.42B $5.97B NTRA
Cheaper on earningsLower P/E, profitable companies only -54.7x -282.2x -14.7x –
Cheaper on forward earningsLower price / next fiscal year consensus EPS — — — –
Faster revenue growthRevenue growth, trailing twelve months +3.2% +37.8% +17.1% NTRA
More profitableNet margin, trailing twelve months -5.4% -7.1% -249.1% 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 +37.0% +90.5% +45.5% NTRA
Better 5-year returnAnnualised price return, 5 years -10.9%/yr +27.6%/yr — NTRA
Less volatileAnnualised volatility, 1 year 59.1% 49.1% 112.1% NTRA
Higher overall scoreMean of the five percentile scores vs peers 50/100 50/100 43/100 CSTL

Percentile Scorecard

CSTLNTRAGRAL

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

AxisCSTLNTRAGRAL
Valuation 43 #54 of 94 16 #79 of 94 8 #87 of 94
Growth 51 #43 of 87 70 #27 of 87 59 #36 of 87
Profitability 39 #53 of 86 32 #59 of 86 6 #81 of 86
Financial Health 93 #8 of 99 86 #15 of 99 99 #2 of 99
Shareholder Returns 24 #43 of 56 46 #31 of 56 –
Overall 50 50 43
  • CSTL ranked among 102 companies in Healthcare Providers
  • NTRA ranked among 102 companies in Healthcare Providers
  • GRAL ranked among 102 companies in Healthcare Providers

Price Performance

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

Returns

PeriodCSTLNTRAGRALSPY
1 month -1.7%-7.7%-6.6% -2.3%
3 months +15.0%+40.2%+90.4% -0.7%
6 months +36.9%+79.1%+140.3% +4.8%
Year to date -10.2%+65.4%+56.3% +10.3%
1 year +37.0%+90.5%+45.5% +10.3%
3 years +94.3%+786.6%— +73.0%
3 years, per year +24.8%+107.1%— +20.1%
5 years -43.7%+238.6%— +61.9%
5 years, per year -10.9%+27.6%— +10.1%
10 years —+4,624.7%— +258.6%
10 years, per year —+47.0%— +13.6%

Risk

MeasureCSTLNTRAGRALSPY
Volatility, 1Y 59.1%49.1%112.1% 12.8%
Downside volatility, 1Y 61.9%46.9%127.3% 12.8%
Beta vs S&P 500, 1Y 1.011.302.84 1.00
Return / volatility, 1Y 0.631.840.41 0.80
Max drawdown, 5Y -81.2%-75.9%-62.9% -25.4%
From 52-week high -18.8%-13.1%-15.8% -3.5%
52-week high $43.04$436.00$158.92 $779.14
52-week low $18.15$182.65$43.03 $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.

MultipleCSTLNTRAGRAL
P/E now vs peer median -54.7xmedian 25.3x -282.2xmedian 25.3x -14.7xmedian 25.3x
P/S now vs peer median 3.0xmedian 1.5x 20.1xmedian 1.5x 38.0xmedian 1.5x
EV/EBITDA now vs peer median -49.0xmedian 14.6x -238.2xmedian 14.6x -12.6xmedian 14.6x
P/FCF now vs peer median -2,180xmedian 21.6x 646.3xmedian 21.6x -20.2xmedian 21.6x
P/B now vs peer median 2.3xmedian 3.1x 29.9xmedian 3.1x 2.3xmedian 3.1x
PEG now vs peer median -1.29median 0.83 -8.50median 0.83 —median 0.83

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 monthsCSTLNTRAGRAL
Revenue $357.28M $2.71B $157.21M
Gross profit $276.03M $1.71B $75.51M
Operating income -$32.11M -$289.67M -$559.25M
Net income -$19.42M -$192.36M -$391.59M
Free cash flow -$489.00K $84.20M -$296.16M
R&D $55.45M $787.38M $190.72M
EPS (diluted) $-0.64 $-1.34 $-9.08
Cash & equivalents $62.12M $1.10B $55.65M
Total debt $10.08M $80.29M –
Shares (diluted) 30.40M 143.28M 43.11M
Enterprise value -$49.67M $50.10B $2.85B

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
MetricCSTLNTRAGRAL
P/E -54.7x -282.2x -14.7x
P/FCF -2,180x 646.3x -20.2x
P/Operating cash flow 25.0x 238.4x -20.3x
P/S 3.0x 20.1x 38.0x
P/B 2.3x 29.9x 2.3x
P/Tangible book 2.3x 37.2x 7.8x
EV/EBITDA -49.0x -238.2x -12.6x
EV/EBIT -25.2x -184.3x -9.1x
EV/Revenue 2.3x 19.7x 32.5x
EV/FCF -1,655x 634.2x -17.3x
EV/Operating cash flow 19.0x 234.0x -17.3x
PEG (3Y EPS CAGR) -1.29 -8.50 –

Growth

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

Profitability

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

Financial Health

11 metrics
MetricCSTLNTRAGRAL
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% 31.5% 10.6%
Equity / assets 83.8% 68.5% 89.4%
Interest coverage -85.6x -75.9x –
Current ratio 6.0x 3.0x 10.9x
Quick ratio 5.6x 2.8x 10.6x
Cash ratio 4.7x 2.0x 10.3x
Altman Z-score 7.47 38.67 6.54

Shareholder Returns

7 metrics
MetricCSTLNTRAGRAL
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.

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

Institutional Ownership

13F filings, quarter ended Jun 30, 2026
HoldersCSTLNTRAGRAL
Held by institutions 89.6% 95.5% 85.4%
Institutions holding 177 849 374
Change in shares held, QoQ -1.0% +2.7% +8.4%
Institutions buying 104 515 183
Institutions selling 55 240 101
Buyers to sellers 1.89 2.15 1.81

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.

CSTLNTRAGRAL
CSTL 1.00 0.46 0.44
NTRA 0.46 1.00 0.44
GRAL 0.44 0.44 1.00

Add a Peer

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Frequently Asked Questions

Which is bigger, CSTL, NTRA and GRAL?

Natera (NTRA) is the largest by market capitalisation: Castle Biosciences (CSTL) $1.07B, Natera (NTRA) $54.42B, Grail (GRAL) $5.97B.

Which company is growing faster?

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

Which company is more profitable?

Castle Biosciences (CSTL) has the highest net margin (Castle Biosciences (CSTL) -5.4%, Natera (NTRA) -7.1%, Grail (GRAL) -249.1%). 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) +37.0%, Natera (NTRA) +90.5%, Grail (GRAL) +45.5%. Over five years, Natera (NTRA) compounded fastest (Castle Biosciences (CSTL) -10.9%/yr, Natera (NTRA) +27.6%/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) 59.1%, Natera (NTRA) 49.1%, Grail (GRAL) 112.1%). Volatility measures how widely the price swings, not the risk of the business.

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

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 6. 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.