CSTL vs TEM vs GRAL Stock Comparison

Castle Biosciences, Tempus AI and Grail Prices as of Oct 27, 2026 Peers: Industry group
CSTL Castle Biosciences Inc
$34.51 -3.6% 1M +44.0% 1Y
Market cap
$1.11B
P/E
–
Revenue (TTM)
$357.28M
Div. yield
–
Diagnostic Labs Healthcare
4 wins
TEM Tempus AI, Inc.
$72.15 -15.1% 1M -21.2% 1Y
Market cap
$13.72B
P/E
–
Revenue (TTM)
$1.43B
Div. yield
–
Diagnostic Labs Healthcare
2 wins
GRAL GRAIL, Inc.
$150.61 +18.7% 1M +77.2% 1Y
Market cap
$6.81B
P/E
–
Revenue (TTM)
$157.21M
Div. yield
–
Diagnostic Labs Healthcare
1 win

Head to Head

7 decided of 12

Castle Biosciences leads on 4 of the 12 questions below (Castle Biosciences 4, Tempus AI 2, Grail 1). Which ones matter depends on what you are buying for; a cheap multiple and slow growth often come together.

QuestionCSTLTEMGRALLeader
Larger companyMarket capitalisation $1.11B $13.72B $6.81B TEM
Cheaper on earningsLower P/E, profitable companies only -57.3x -53.9x -17.4x –
Cheaper on forward earningsLower price / next fiscal year consensus EPS — — — –
Faster revenue growthRevenue growth, trailing twelve months +3.2% +50.4% +17.1% TEM
More profitableNet margin, trailing twelve months -5.4% -17.8% -249.1% CSTL
Better return on capitalReturn on invested capital -6.7% -52.0% — CSTL
Less leveragedLower net debt / EBITDA 15.5x — — –
Higher dividend yieldTrailing dividend yield 0.00% 0.00% 0.00% –
Better 1-year returnPrice return, last 12 months +44.0% -21.2% +77.2% GRAL
Better 5-year returnAnnualised price return, 5 years -11.6%/yr — — –
Less volatileAnnualised volatility, 1 year 58.3% 76.8% 111.3% CSTL
Higher overall scoreMean of the five percentile scores vs peers 50/100 26/100 43/100 CSTL

Percentile Scorecard

CSTLTEMGRAL

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

AxisCSTLTEMGRAL
Valuation 47 #49 of 92 9 #84 of 92 8 #85 of 92
Growth 52 #42 of 87 27 #64 of 87 58 #37 of 87
Profitability 39 #53 of 86 11 #77 of 86 6 #81 of 86
Financial Health 92 #9 of 97 57 #42 of 97 99 #2 of 97
Shareholder Returns 20 #45 of 56 – –
Overall 50 26 43
  • CSTL ranked among 102 companies in Healthcare Providers
  • TEM 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

PeriodCSTLTEMGRALSPY
1 month -3.6%-15.1%+18.7% -0.2%
3 months +44.5%+68.2%+133.8% +3.9%
6 months +39.8%+41.2%+188.5% +8.2%
Year to date -11.3%+22.2%+76.0% +12.9%
1 year +44.0%-21.2%+77.2% +12.3%
3 years +164.2%—— +87.4%
3 years, per year +38.3%—— +23.3%
5 years -46.0%—— +67.9%
5 years, per year -11.6%—— +10.9%

Risk

MeasureCSTLTEMGRALSPY
Volatility, 1Y 58.3%76.8%111.3% 12.7%
Downside volatility, 1Y 61.4%66.8%126.1% 12.7%
Beta vs S&P 500, 1Y 0.962.562.69 1.00
Return / volatility, 1Y 0.76-0.280.69 0.97
Max drawdown, 5Y -82.1%-59.8%-62.9% -25.4%
From 52-week high -19.8%-21.2%-2.3% -1.2%
52-week high $43.04$91.58$154.08 $779.14
52-week low $18.15$41.55$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.

MultipleCSTLTEMGRAL
P/E now vs peer median -54.0xmedian 24.6x -51.0xmedian 24.6x -16.6xmedian 24.6x
P/S now vs peer median 2.9xmedian 1.6x 8.8xmedian 1.6x 42.8xmedian 1.6x
EV/EBITDA now vs peer median -48.2xmedian 14.6x —median 14.6x -14.5xmedian 14.6x
P/FCF now vs peer median -2,153xmedian 21.6x -48.0xmedian 21.6x -22.7xmedian 21.6x
P/B now vs peer median 2.2xmedian 3.2x 28.4xmedian 3.2x 2.6xmedian 3.2x
PEG now vs peer median -1.28median 0.66 —median 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 monthsCSTLTEMGRAL
Revenue $357.28M $1.43B $157.21M
Gross profit $276.03M $916.19M $75.51M
Operating income -$32.11M -$283.03M -$559.25M
Net income -$19.42M -$254.43M -$391.59M
Free cash flow -$489.00K -$263.22M -$296.16M
R&D $55.45M $196.31M $190.72M
EPS (diluted) $-0.64 $-1.39 $-9.08
Cash & equivalents $62.12M $599.61M $55.65M
Total debt $10.08M – –
Shares (diluted) 30.40M 182.40M 43.11M
Enterprise value -$2.58M $10.75B $3.68B

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
MetricCSTLTEMGRAL
P/E -54.0x -51.0x -16.6x
P/FCF -2,153x -48.0x -22.7x
P/Operating cash flow 24.7x -53.2x -22.8x
P/S 2.9x 8.8x 42.8x
P/B 2.2x 28.4x 2.6x
P/Tangible book 2.2x 95.4x 8.8x
EV/EBITDA -48.2x – -14.5x
EV/EBIT -24.8x -41.8x -10.5x
EV/Revenue 2.2x 8.3x 37.3x
EV/FCF -1,628x -44.9x -19.8x
EV/Operating cash flow 18.7x -49.8x -19.9x
PEG (3Y EPS CAGR) -1.28 – –

Growth

14 metrics
MetricCSTLTEMGRAL
Revenue growth (1Y) 3.2% 50.4% 17.1%
Revenue CAGR (3Y) 28.7% – –
Gross profit growth (1Y) -1.6% 58.5% 30.2%
Gross profit CAGR (3Y) 29.2% – –
Operating income growth (1Y) -39.3% -20.6% 11.6%
Operating income CAGR (3Y) 30.8% – –
Net income growth (1Y) -105.1% -27.4% 11.6%
Net income CAGR (3Y) 39.8% – –
EPS growth (1Y) -99.3% -21.1% 26.6%
EPS CAGR (3Y) 42.3% – –
Operating cash flow growth (1Y) -31.8% -356.2% 20.3%
Operating cash flow CAGR (3Y) 45.1% – –
Free cash flow growth (1Y) -101.4% -278.0% 20.3%
Free cash flow CAGR (3Y) 78.8% – –

Profitability

14 metrics
MetricCSTLTEMGRAL
Gross margin 77.3% 64.0% 48.0%
EBITDA margin -4.6% – -257.6%
Operating margin -9.0% -19.8% -355.7%
Pretax margin -5.4% -17.6% -336.8%
Net margin -5.4% -17.8% -249.1%
FCF margin -0.1% -18.4% -188.4%
Operating cash flow margin 11.9% -16.6% -187.5%
Return on equity -4.2% -57.3% -15.5%
Return on assets -3.5% -11.0% -13.9%
Return on invested capital -6.7% -52.0% –
Return on capital employed -6.4% -15.2% -20.4%
Asset turnover 0.6x 0.6x 0.1x
Cash conversion (OCF / net income) -2.2x 0.9x 0.8x
Stock comp / revenue 12.6% 13.0% 40.9%

Financial Health

11 metrics
MetricCSTLTEMGRAL
Debt / assets 1.8% – –
Debt / equity 0.0x – –
Net debt / EBITDA 15.5x – –
Debt / FCF -20.6x – –
Liabilities / assets 16.2% 81.2% 10.6%
Equity / assets 83.8% 18.8% 89.4%
Interest coverage -85.6x -5.1x –
Current ratio 6.0x 3.3x 10.9x
Quick ratio 5.6x 3.1x 10.6x
Cash ratio 4.7x 2.1x 10.3x
Altman Z-score 7.39 3.13 8.04

Shareholder Returns

7 metrics
MetricCSTLTEMGRAL
Dividend yield – – –
Net buyback yield -0.5% – –
Shareholder yield -0.5% 0.0% –
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.

ConsensusCSTLTEMGRAL
EPS, next fiscal year $-1.31FY2026 $-0.21FY2026 $-9.05FY2026
Revenue, next fiscal year $385.85MFY2026 $1.64BFY2026 $169.78MFY2026
Revenue growth, next FY +12.1%FY2026 +29.0%FY2026 +15.4%FY2026
Revenue growth, the year after +2.3% +24.1% +38.2%

Institutional Ownership

13F filings, quarter ended Jun 30, 2026
HoldersCSTLTEMGRAL
Held by institutions 89.6% 63.0% 85.4%
Institutions holding 177 483 372
Change in shares held, QoQ -1.0% +5.0% +8.4%
Institutions buying 104 284 182
Institutions selling 55 118 100
Buyers to sellers 1.89 2.41 1.82

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.

CSTLTEMGRAL
CSTL 1.00 0.49 0.37
TEM 0.49 1.00 0.41
GRAL 0.37 0.41 1.00

Add a Peer

Largest companies in the same industry

Related Comparisons

Frequently Asked Questions

Which is bigger, CSTL, TEM and GRAL?

Tempus AI (TEM) is the largest by market capitalisation: Castle Biosciences (CSTL) $1.11B, Tempus AI (TEM) $13.72B, Grail (GRAL) $6.81B.

Which company is growing faster?

Tempus AI (TEM) grew revenue fastest over the trailing twelve months: Castle Biosciences (CSTL) +3.2%, Tempus AI (TEM) +50.4%, Grail (GRAL) +17.1%.

Which company is more profitable?

Castle Biosciences (CSTL) has the highest net margin (Castle Biosciences (CSTL) -5.4%, Tempus AI (TEM) -17.8%, Grail (GRAL) -249.1%). On return on invested capital, Castle Biosciences (CSTL) leads (Castle Biosciences (CSTL) -6.7%, Tempus AI (TEM) -52.0%).

Which stock has performed better?

Over the past year Grail (GRAL) returned the most: Castle Biosciences (CSTL) +44.0%, Tempus AI (TEM) -21.2%, Grail (GRAL) +77.2%. Returns are price only, before dividends.

Which stock is riskier?

By one-year price volatility, Castle Biosciences (CSTL) has been the steadiest (Castle Biosciences (CSTL) 58.3%, Tempus AI (TEM) 76.8%, Grail (GRAL) 111.3%). Volatility measures how widely the price swings, not the risk of the business.

Which is the better stock, CSTL, TEM 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, Castle Biosciences (CSTL) leads on 4. 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.