BillionToOne Q2 2026 Earnings: Revenue Rises 64% as Gross Margin Expands

BillionToOne (NASDAQ: BLLN) reported Q2 2026 revenue of $109.4 million, up 64% from $66.6 million a year earlier, while diluted EPS improved to $0.15 from a loss of $0.02. Growth came from both a 35% increase in tests delivered and a 21% rise in overall average selling price, helping gross margin reach 70% and operating income turn positive. The quarter ended June 30, 2026, and the company reiterated its full-year revenue guidance.

Core earnings data

The main financial shift was improved operating leverage. Gross profit increased faster than operating expenses, which rose 59%, allowing BillionToOne to move from an operating loss to a profit while continuing to invest in research, sales, and administration.

Quarterly operating cash flow and free cash flow also improved from the prior year. The figures below are GAAP except for adjusted EBITDA and free cash flow.

Business and operating performance

Prenatal testing remained BillionToOne’s largest source of revenue, while oncology produced the highest growth rate. Both businesses recorded year-over-year test-volume growth, although the company did not disclose separate test counts for each segment.

The combination of higher test volume and higher average selling price explains why total revenue grew substantially faster than the number of tests delivered. Oncology remained much smaller than prenatal testing in absolute revenue but contributed disproportionately to incremental growth.

Higher pricing outweighed the cost of a faster-growing oncology mix

Gross margin expanded by five percentage points even though overall cost per test increased slightly. BillionToOne said cost per test improved for its prenatal products and both oncology products, but those savings were offset by faster growth in oncology tests, which carry higher costs per test.

The 21% increase in overall average selling price more than compensated for that mix effect. As a result, gross profit rose about 77%, faster than both revenue and operating expenses. This relationship is important because continued oncology growth could affect consolidated unit costs even if the individual products become more efficient.

Profitability, cash flow, and balance sheet

Operating expenses reached $71.6 million, compared with $45.1 million a year earlier. Research and development expense increased to $17.3 million from $11.8 million, while selling, general, and administrative expense rose to $54.3 million from $33.3 million. Because revenue grew slightly faster than total operating expenses, the company generated a 5% operating margin.

Net income exceeded operating income partly because BillionToOne recorded $2.0 million of net other income. That included $4.7 million of interest income, partly offset by a $3.0 million loss from the change in fair value of its term loan. The quarter also included a $0.5 million income-tax benefit.

For Q2 alone, operating cash flow was $9.1 million and capital expenditures were $4.0 million, producing $5.1 million of free cash flow. For the first six months of 2026, operating cash flow was $24.6 million and free cash flow was $16.0 million; these year-to-date figures should not be confused with the quarterly amounts.

Cash and cash equivalents were $548.6 million at June 30, up from $496.0 million at the end of 2025. The increase was not solely generated by operations: first-half financing cash flow totaled $36.6 million and included $30.0 million from debt issuance. Long-term debt consequently increased to $91.0 million from $57.2 million.

Accounts receivable rose to $74.9 million from $41.6 million at year-end and represented the largest first-half operating working-capital use. Inventory also increased to $21.1 million from $17.5 million.

Earnings guidance

BillionToOne reiterated its full-year 2026 revenue range rather than raising or lowering it. Management also expects profitability to remain similar to current levels despite significant continued investment, but it did not provide a quantified profitability target.

With first-half revenue of $217.8 million, the full-year range implies approximately $232.2 million to $247.2 million of revenue in the second half.

Management viewpoint

Co-founder and CEO Oguzhan Atay attributed the quarter’s growth and profitability to the company’s technology platform, product portfolio, and operating execution. Management’s stated priority remains continued investment alongside profitability near current levels.

The company also outlined two near-term product additions. A 130-gene expansion of the Unity Fetal Risk Screen was scheduled for commercial availability on August 17, 2026, while Northstar Origin, a tissue-of-origin add-on for Northstar Select, was scheduled for September 1, 2026. BillionToOne also cited peer-reviewed data indicating that Northstar Response was a stronger predictor of survival than standard imaging in the studied advanced solid-tumor patients receiving immunotherapy or combination therapy.

Recent insider transactions

The 10 most recent insider records provided were dated July 6 through July 16, 2026, after the end of the reported quarter. They included six sales and four derivative-security exercises; these transactions do not by themselves establish insiders’ views of the company’s prospects.

Risks investors should monitor

• Revenue growth depends on volume and average selling price. Q2 revenue growth reflected both 35% more tests delivered and a 21% higher overall selling price. Slower progress in either factor would make the reiterated full-year range more difficult to achieve.
• Oncology mix can pressure consolidated testing costs. Oncology revenue grew 176%, but the company said oncology products have higher costs per test. Faster oncology growth could offset product-level cost reductions unless selling prices or other efficiencies provide sufficient support.
• Investment spending remains elevated. Operating expenses rose 59%, including higher research and development and administrative spending. Management intends to continue significant investments while maintaining profitability near current levels, making expense discipline an important variable.
• Working capital and debt can affect cash conversion. Accounts receivable increased by $33.3 million from year-end, while long-term debt rose by about $33.8 million. Continued increases could absorb operating cash or raise financing obligations despite the company’s large cash balance.

Summary

BillionToOne’s Q2 2026 results combined higher testing volume and selling prices with an expanded gross margin, positive operating income, and positive free cash flow. Prenatal testing remained the revenue base, while oncology provided the fastest growth but also introduced a higher-cost mix. The main points to monitor are the second-half revenue needed to reach guidance, the balance between oncology growth and gross margin, and whether continued investment can coexist with profitability and cash generation near current levels.