CSTL vs NTRA vs GRAL Stock Comparison

Castle Biosciences, Natera and Grail Prices as of Nov 5, 2026 Peers: Industry group
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CSTL Castle Biosciences Inc
$34.20 +2.5% 1M +1.9% 1Y
Market cap
$1.05B
P/E
–
Revenue (TTM)
$377.13M
Div. yield
–
Diagnostic Labs Healthcare
1 win
NTRA Natera, Inc.
$363.76 -9.2% 1M +82.0% 1Y
Market cap
$52.51B
P/E
–
Revenue (TTM)
$2.91B
Div. yield
–
Diagnostic Labs Healthcare
8 wins
GRAL GRAIL, Inc.
$119.13 -13.2% 1M +40.7% 1Y
Market cap
$5.33B
P/E
–
Revenue (TTM)
$159.20M
Div. yield
–
Diagnostic Labs Healthcare

Head to Head

9 decided of 12

Natera leads on 8 of the 12 questions below (Natera 8, Castle Biosciences 1). Which ones matter depends on what you are buying for; a cheap multiple and slow growth often come together.

QuestionCSTLNTRAGRALLeader
Larger companyMarket capitalisation $1.05B $52.51B $5.33B NTRA
Cheaper on earningsLower P/E, profitable companies only -45.5x -318.1x -13.7x –
Cheaper on forward earningsLower price / next fiscal year consensus EPS — — — –
Faster revenue growthRevenue growth, trailing twelve months +9.8% +37.4% +12.3% NTRA
More profitableNet margin, trailing twelve months -6.1% -5.7% -255.1% NTRA
Better return on capitalReturn on invested capital -5.8% -9.9% — CSTL
Less leveragedLower net debt / EBITDA 22.2x 5.6x — NTRA
Higher dividend yieldTrailing dividend yield — — — –
Better 1-year returnPrice return, last 12 months +1.9% +82.0% +40.7% NTRA
Better 5-year returnAnnualised price return, 5 years -10.5%/yr +25.7%/yr — NTRA
Less volatileAnnualised volatility, 1 year 55.5% 49.6% 113.0% NTRA
Higher overall scoreMean of the five percentile scores vs peers 47/100 51/100 37/100 NTRA

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 42 #56 of 95 17 #79 of 95 7 #88 of 95
Growth 49 #45 of 88 77 #21 of 88 35 #58 of 88
Profitability 37 #55 of 87 31 #60 of 87 6 #82 of 87
Financial Health 86 #15 of 100 85 #16 of 100 99 #2 of 100
Shareholder Returns 22 #47 of 60 46 #33 of 60 –
Overall 47 51 37
  • 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 +2.5%-9.2%-13.2% -5.9%
3 months +12.2%+37.1%+87.9% -4.6%
6 months +77.8%+65.5%+89.3% +0.2%
Year to date -12.1%+58.8%+39.2% +7.5%
1 year +1.9%+82.0%+40.7% +8.2%
3 years +89.4%+744.0%— +68.3%
3 years, per year +23.7%+103.7%— +19.0%
5 years -42.6%+213.7%— +56.5%
5 years, per year -10.5%+25.7%— +9.4%
10 years —+4,204.9%— +251.5%
10 years, per year —+45.7%— +13.4%

Risk

MeasureCSTLNTRAGRALSPY
Volatility, 1Y 55.5%49.6%113.0% 13.6%
Downside volatility, 1Y 62.0%48.1%129.2% 14.2%
Beta vs S&P 500, 1Y 1.141.332.92 1.00
Return / volatility, 1Y 0.031.650.36 0.60
Max drawdown, 5Y -81.0%-75.9%-62.9% -25.4%
From 52-week high -20.5%-16.6%-25.0% -5.9%
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 -45.5xmedian 24.8x -318.1xmedian 24.8x -13.7xmedian 24.8x
P/S now vs peer median 2.8xmedian 1.6x 18.1xmedian 1.6x 33.5xmedian 1.6x
EV/EBITDA now vs peer median -65.0xmedian 15.9x -283.6xmedian 15.9x -10.7xmedian 15.9x
P/FCF now vs peer median 265.6xmedian 20.9x 1,001xmedian 20.9x -17.1xmedian 20.9x
P/B now vs peer median 2.2xmedian 3.3x 28.1xmedian 3.3x 2.2xmedian 3.3x
PEG now vs peer median -1.28median 0.88 -8.87median 0.88 —median 0.88

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 $377.13M $2.91B $159.20M
Gross profit $290.66M $1.84B $75.17M
Operating income -$28.04M -$260.42M -$578.58M
Net income -$23.01M -$164.72M -$406.18M
Free cash flow $3.96M $52.47M -$312.00M
R&D $58.29M $856.40M $188.17M
EPS (diluted) $-0.75 $-1.14 $-8.68
Cash & equivalents $78.00M $1.10B $29.00M
Total debt $10.08M $80.30M –
Shares (diluted) 30.63M 144.07M 46.78M
Enterprise value -$53.36M $48.13B $1.95B

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 -45.5x -318.1x -13.7x
P/FCF 265.6x 1,001x -17.1x
P/Operating cash flow 26.5x 246.8x -17.4x
P/S 2.8x 18.1x 33.5x
P/B 2.2x 28.1x 2.2x
P/Tangible book 2.2x 34.6x 7.5x
EV/EBITDA -65.0x -283.6x -10.7x
EV/EBIT -28.0x -197.7x -7.9x
EV/Revenue 2.1x 17.7x 28.5x
EV/FCF 198.0x 981.3x -14.6x
EV/Operating cash flow 19.7x 242.0x -14.8x
PEG (3Y EPS CAGR) -1.28 -8.87 –

Growth

14 metrics
MetricCSTLNTRAGRAL
Revenue growth (1Y) 9.8% 37.4% 12.3%
Revenue CAGR (3Y) 25.2% 43.3% –
Gross profit growth (1Y) 5.8% 41.1% 13.1%
Gross profit CAGR (3Y) 24.7% 68.2% –
Operating income growth (1Y) 19.7% 26.0% -0.7%
Operating income CAGR (3Y) 30.9% 19.7% –
Net income growth (1Y) -88.1% 46.7% 0.0%
Net income CAGR (3Y) 32.7% 30.9% –
EPS growth (1Y) -78.5% 49.3% 22.8%
EPS CAGR (3Y) 35.6% 35.9% –
Operating cash flow growth (1Y) -35.7% 9.5% 6.8%
Operating cash flow CAGR (3Y) 49.1% 40.7% –
Free cash flow growth (1Y) -84.4% -50.5% 5.4%
Free cash flow CAGR (3Y) 28.0% 29.4% –

Profitability

14 metrics
MetricCSTLNTRAGRAL
Gross margin 77.1% 63.3% 47.2%
EBITDA margin -3.2% -6.2% -267.5%
Operating margin -7.4% -9.0% -363.4%
Pretax margin -6.0% -7.7% -344.3%
Net margin -6.1% -5.7% -255.1%
FCF margin 1.1% 1.8% -196.0%
Operating cash flow margin 10.5% 7.3% -192.4%
Return on equity -4.9% -8.9% -16.3%
Return on assets -4.0% -6.1% -14.6%
Return on invested capital -5.8% -9.9% –
Return on capital employed -5.6% -12.5% -21.5%
Asset turnover 0.7x 1.1x 0.1x
Cash conversion (OCF / net income) -1.7x -1.3x 0.8x
Stock comp / revenue 11.7% 13.6% 40.3%

Financial Health

11 metrics
MetricCSTLNTRAGRAL
Debt / assets 1.7% 2.9% –
Debt / equity 0.0x 0.0x –
Net debt / EBITDA 22.2x 5.6x –
Debt / FCF 2.5x 1.5x –
Liabilities / assets 17.4% 32.0% 10.1%
Equity / assets 82.6% 68.0% 89.9%
Interest coverage -51.2x -70.8x –
Current ratio 5.3x 2.8x 8.9x
Quick ratio 4.9x 2.6x 8.6x
Cash ratio 4.1x 1.8x 8.4x
Altman Z-score 6.75 35.55 5.84

Shareholder Returns

7 metrics
MetricCSTLNTRAGRAL
Dividend yield – – –
Net buyback yield -0.7% -0.1% –
Shareholder yield -0.7% -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 $-1.30FY2026 $-1.48FY2026 $-9.05FY2026
Revenue, next fiscal year $386.63MFY2026 $3.07BFY2026 $169.78MFY2026
Revenue growth, next FY +12.3%FY2026 +32.8%FY2026 +15.4%FY2026
Revenue growth, the year after +3.9% +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 177 850 374
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 0.47 0.44
NTRA 0.47 1.00 0.46
GRAL 0.44 0.46 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) $1.05B, Natera (NTRA) $52.51B, Grail (GRAL) $5.33B.

Which company is growing faster?

Natera (NTRA) grew revenue fastest over the trailing twelve months: Castle Biosciences (CSTL) +9.8%, Natera (NTRA) +37.4%, Grail (GRAL) +12.3%.

Which company is more profitable?

Natera (NTRA) has the highest net margin (Castle Biosciences (CSTL) -6.1%, Natera (NTRA) -5.7%, Grail (GRAL) -255.1%). On return on invested capital, Castle Biosciences (CSTL) leads (Castle Biosciences (CSTL) -5.8%, Natera (NTRA) -9.9%).

Which stock has performed better?

Over the past year Natera (NTRA) returned the most: Castle Biosciences (CSTL) +1.9%, Natera (NTRA) +82.0%, Grail (GRAL) +40.7%. Over five years, Natera (NTRA) compounded fastest (Castle Biosciences (CSTL) -10.5%/yr, Natera (NTRA) +25.7%/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) 55.5%, Natera (NTRA) 49.6%, Grail (GRAL) 113.0%). 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 8. 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.