BillionToOne Inc (NASDAQ: BLLN) is a molecular diagnostics company that develops and commercializes single-molecule next-generation sequencing (smNGS) tests for prenatal and oncology markets. Revenue comes from test reimbursements billed to payors, including insurance and Medicare, for its UNITY prenatal tests and Northstar oncology tests. The company operates a direct sales force of 231 representatives as of December 31, 2025, split between 177 in prenatal and 54 in oncology, up from 137 total representatives at year-end 2024. BillionToOne's smNGS platform is built around patented quantitative counting templates (QCTs) that enable detection of genetic targets from cell-free DNA (cfDNA) at single-molecule sensitivity. The company generated net income of $7.5 million and operating cash flow of $24.6 million for the year ended December 31, 2025, compared to a net loss of $41.6 million and operating cash outflow of $41.4 million for the year ended December 31, 2024. BillionToOne completed its IPO on November 5, 2025 and is listed on NASDAQ.

Revenue model

Fee-for-service laboratory testing billed to third-party payors (insurance and Medicare) for UNITY prenatal tests and Northstar oncology tests. Revenue is transactional, tied to test volume. Accounts receivable increased $16.9 million in FY2025, consistent with volume-driven billing growth.

Products and services

UNITY: prenatal cell-free DNA screening tests. Northstar Response: a circulating tumor DNA (ctDNA) liquid biopsy test for monitoring cancer treatment response in solid tumor patients. Northstar Select: a liquid biopsy test for somatic mutation detection including SNVs and CNVs, with peer-reviewed head-to-head data published August 2025 showing superiority versus on-market assays. All tests are built on the company's smNGS platform using patented QCT technology.

Customers and end markets

Physicians in the prenatal and oncology markets in the United States. Prenatal market served through 177 sales representatives as of December 31, 2025. Oncology market served through 54 sales representatives as of December 31, 2025. Payors (insurers, Medicare) are the primary billing counterparties.

Value-chain role

Laboratory test developer and operator. BillionToOne performs sample processing and sequencing in its own laboratory, generates diagnostic reports delivered to ordering physicians, and handles payor billing and reimbursement appeals internally. The company is a CLIA-regulated laboratory and healthcare provider subject to HIPAA.

Geographic exposure

United States only, based on disclosed commercial operations and sales force deployment as of December 31, 2025.

Source: SEC 10-K, filed 2026-03-11

Industry: Services-Medical Laboratories