Tearsheet

Castle Biosciences (CSTL)


Market Price (3/15/2026): $25.54 | Market Cap: $749.3 Mil
Sector: Health Care | Industry: Life Sciences Tools & Services

Castle Biosciences (CSTL)


Market Price (3/15/2026): $25.54
Market Cap: $749.3 Mil
Sector: Health Care
Industry: Life Sciences Tools & Services

Investment Highlights Why It Matters Detailed financial logic regarding cash flow yields vs trend-riding momentum.

0 Cash is significant % of market cap
Net D/ENet Debt/Equity. Debt net of cash. Negative indicates net cash. Equity is taken as the Market Capitalization is -35%
Weak multi-year price returns
2Y Excs Rtn is -9.3%, 3Y Excs Rtn is -52%
Not profitable at operating income level
Op Inc LTMOperating Income, Last Twelve Months is -43 Mil, Op Mgn LTMOperating Margin = Operating Income / Revenue Reflects profitability before taxes and before impact of capital structure (interest payments). is -12%
1 Attractive cash flow generation
CFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 19%
  Significant share based compensation
SBC/Rev LTMShare Based Compensation / Revenue (Sales), Last Twelve Months (LTM) is 13%
2 Megatrend and thematic drivers
Megatrends include Biotechnology & Genomics, and Precision Medicine. Themes include Advanced Diagnostics, and Personalized Diagnostics.
  Yield minus risk free rate is negative
ERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -7.2%
3   Key risks
CSTL key risks include [1] its demonstrated challenge in achieving profitability, Show more.
0 Cash is significant % of market cap
Net D/ENet Debt/Equity. Debt net of cash. Negative indicates net cash. Equity is taken as the Market Capitalization is -35%
1 Attractive cash flow generation
CFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 19%
2 Megatrend and thematic drivers
Megatrends include Biotechnology & Genomics, and Precision Medicine. Themes include Advanced Diagnostics, and Personalized Diagnostics.
3 Weak multi-year price returns
2Y Excs Rtn is -9.3%, 3Y Excs Rtn is -52%
4 Not profitable at operating income level
Op Inc LTMOperating Income, Last Twelve Months is -43 Mil, Op Mgn LTMOperating Margin = Operating Income / Revenue Reflects profitability before taxes and before impact of capital structure (interest payments). is -12%
5 Significant share based compensation
SBC/Rev LTMShare Based Compensation / Revenue (Sales), Last Twelve Months (LTM) is 13%
6 Yield minus risk free rate is negative
ERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -7.2%
7 Key risks
CSTL key risks include [1] its demonstrated challenge in achieving profitability, Show more.

Valuation, Metrics & Events

Price Chart

Why The Stock Moved

Qualitative Assessment

AI Analysis | Feedback

Castle Biosciences (CSTL) stock has lost about 35% since 11/30/2025 because of the following key factors:

1. Impact of Changes in Medicare Coverage and Product Discontinuation for Key Tests.

Castle Biosciences experienced a decline in its stock due to the adverse effects of changes in Medicare coverage for its DecisionDx-SCC test, which became effective on April 24, 2025. This, along with the discontinuation of the IDgenetix test in May 2025, affected the company's fourth-quarter 2025 revenue and test report volume for DecisionDx-SCC. Despite the company reporting overall full-year 2025 revenue of $344.2 million, exceeding prior guidance, these specific product challenges contributed to investor concerns regarding future growth prospects for these particular tests.

2. Decline in Adjusted EBITDA Despite Revenue Beat.

While Castle Biosciences surpassed revenue and earnings per share estimates for the fourth quarter of 2025, reporting $87.0 million in revenue and a loss of $0.08 per share, its Adjusted EBITDA for the quarter significantly decreased. Adjusted EBITDA fell to $11.5 million in Q4 2025, a substantial drop from $21.3 million in Q4 2024. This notable reduction in profitability, despite strong top-line performance, likely raised concerns among investors about the company's operational efficiency and long-term earnings potential.

Show more

Stock Movement Drivers

Fundamental Drivers

The -36.0% change in CSTL stock from 11/30/2025 to 3/14/2026 was primarily driven by a -35.6% change in the company's P/S Multiple.
(LTM values as of)113020253142026Change
Stock Price ($)39.9525.56-36.0%
Change Contribution By: 
Total Revenues ($ Mil)3443440.2%
P/S Multiple3.42.2-35.6%
Shares Outstanding (Mil)2929-0.9%
Cumulative Contribution-36.0%

LTM = Last Twelve Months as of date shown

Market Drivers

11/30/2025 to 3/14/2026
ReturnCorrelation
CSTL-36.0% 
Market (SPY)-3.1%22.0%
Sector (XLV)-5.0%16.6%

Fundamental Drivers

The 6.5% change in CSTL stock from 8/31/2025 to 3/14/2026 was primarily driven by a 8.7% change in the company's P/S Multiple.
(LTM values as of)83120253142026Change
Stock Price ($)24.0125.566.5%
Change Contribution By: 
Total Revenues ($ Mil)346344-0.6%
P/S Multiple2.02.28.7%
Shares Outstanding (Mil)2929-1.5%
Cumulative Contribution6.5%

LTM = Last Twelve Months as of date shown

Market Drivers

8/31/2025 to 3/14/2026
ReturnCorrelation
CSTL6.5% 
Market (SPY)3.0%12.5%
Sector (XLV)9.5%25.4%

Fundamental Drivers

The 17.9% change in CSTL stock from 2/28/2025 to 3/14/2026 was primarily driven by a 18.6% change in the company's P/S Multiple.
(LTM values as of)22820253142026Change
Stock Price ($)21.6825.5617.9%
Change Contribution By: 
Total Revenues ($ Mil)3323443.7%
P/S Multiple1.82.218.6%
Shares Outstanding (Mil)2829-4.1%
Cumulative Contribution17.9%

LTM = Last Twelve Months as of date shown

Market Drivers

2/28/2025 to 3/14/2026
ReturnCorrelation
CSTL17.9% 
Market (SPY)12.4%23.4%
Sector (XLV)1.9%29.0%

Fundamental Drivers

The 1.5% change in CSTL stock from 2/28/2023 to 3/14/2026 was primarily driven by a 151.2% change in the company's Total Revenues ($ Mil).
(LTM values as of)22820233142026Change
Stock Price ($)25.1825.561.5%
Change Contribution By: 
Total Revenues ($ Mil)137344151.2%
P/S Multiple4.92.2-55.1%
Shares Outstanding (Mil)2629-10.0%
Cumulative Contribution1.5%

LTM = Last Twelve Months as of date shown

Market Drivers

2/28/2023 to 3/14/2026
ReturnCorrelation
CSTL1.5% 
Market (SPY)73.4%20.9%
Sector (XLV)23.3%18.0%

Return vs. Risk

Price Returns Compared

 202120222023202420252026Total [1]
Returns
CSTL Return-36%-45%-8%23%46%-33%-61%
Peers Return-12%-51%46%29%10%-16%-26%
S&P 500 Return27%-19%24%23%16%-1%80%

Monthly Win Rates [3]
CSTL Win Rate42%42%50%50%50%33% 
Peers Win Rate45%30%55%52%50%40% 
S&P 500 Win Rate75%42%67%75%67%33% 

Max Drawdowns [4]
CSTL Max Drawdown-42%-63%-50%-19%-45%-33% 
Peers Max Drawdown-27%-64%-7%-26%-46%-19% 
S&P 500 Max Drawdown-1%-25%-1%-2%-15%-2% 


[1] Cumulative total returns since the beginning of 2021
[2] Peers: NEO, VCYT, MYGN, EXAS, NTRA. See CSTL Returns vs. Peers.
[3] Win Rate = % of calendar months in which monthly returns were positive
[4] Max drawdown represents maximum peak-to-trough decline within a year
[5] 2026 data is for the year up to 3/13/2026 (YTD)

How Low Can It Go

Unique KeyEventCSTLS&P 500
2022 Inflation Shock2022 Inflation Shock  
2022 Inflation Shock% Loss% Loss-88.0%-25.4%
2022 Inflation Shock% Gain to Breakeven% Gain to Breakeven734.7%34.1%
2022 Inflation ShockTime to BreakevenTime to BreakevenNot Fully Recovered days464 days
2020 Covid Pandemic2020 Covid Pandemic  
2020 Covid Pandemic% Loss% Loss-35.0%-33.9%
2020 Covid Pandemic% Gain to Breakeven% Gain to Breakeven53.9%51.3%
2020 Covid PandemicTime to BreakevenTime to Breakeven57 days148 days

Compare to NEO, VCYT, MYGN, EXAS, NTRA

In The Past

Castle Biosciences's stock fell -88.0% during the 2022 Inflation Shock from a high on 2/9/2021. A -88.0% loss requires a 734.7% gain to breakeven.

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About Castle Biosciences (CSTL)

Castle Biosciences, Inc., a commercial-stage diagnostics company, focuses to provide diagnostic and prognostic testing services for dermatological cancers. Its lead product is DecisionDx-Melanoma, a multi-gene expression profile (GEP) test to identify the risk of metastasis for patients diagnosed with invasive cutaneous melanoma. The company also offers DecisionDx-UM test, a proprietary GEP test that predicts the risk of metastasis for patients with uveal melanoma, a rare eye cancer; DecisionDx-SCC, a proprietary 40-gene expression profile test that uses an individual patient's tumor biology to predict individual risk of squamous cell carcinoma metastasis for patients with one or more risk factors; and DecisionDx DiffDx-Melanoma and myPath Melanoma, a proprietary GEP test to diagnose suspicious pigmented lesions. It offers test services through physicians and their patients. The company was founded in 2007 and is headquartered in Friendswood, Texas.

AI Analysis | Feedback

Here are a few brief analogies for Castle Biosciences (CSTL):

  • A Foundation Medicine for predicting the spread of skin and eye cancers.
  • Like an Invitae or Natera, but specializing in gene expression tests to forecast metastasis risk in skin and eye cancers.

AI Analysis | Feedback

  • DecisionDx-Melanoma: A multi-gene expression profile (GEP) test designed to identify the risk of metastasis for patients with invasive cutaneous melanoma.
  • DecisionDx-UM: A proprietary GEP test used to predict the risk of metastasis for patients diagnosed with uveal melanoma.
  • DecisionDx-SCC: A proprietary 40-gene expression profile test that predicts the individual risk of squamous cell carcinoma metastasis for patients with specific risk factors.
  • DecisionDx DiffDx-Melanoma and myPath Melanoma: Proprietary GEP tests utilized for the diagnosis of suspicious pigmented lesions.

AI Analysis | Feedback

Castle Biosciences (CSTL) primarily offers its diagnostic and prognostic testing services to healthcare providers who, in turn, utilize these services for their patients. Therefore, its major customers are not individual consumers, but rather medical professionals and the institutions they represent. Here are the primary categories of customers Castle Biosciences serves:
  • Dermatologists and Dermatology Practices: These are key customers as the company's lead products, DecisionDx-Melanoma, DecisionDx-SCC, DecisionDx DiffDx-Melanoma, and myPath Melanoma, focus on diagnosing and predicting the risk of metastasis for dermatological cancers like cutaneous melanoma and squamous cell carcinoma. Dermatologists are typically the first point of contact for patients with suspicious lesions and make decisions regarding further testing.
  • Ophthalmologists and Ocular Oncology Practices: For its DecisionDx-UM test, which predicts the risk of metastasis for patients with uveal melanoma (a rare eye cancer), ophthalmologists, particularly those specializing in ocular oncology, are crucial customers who order these specialized tests.
  • Oncologists and Hospitals/Integrated Healthcare Systems: Oncologists, particularly those specializing in melanoma or skin cancers, may utilize Castle Biosciences' tests for risk stratification and management of high-risk patients. Additionally, hospitals and larger integrated healthcare systems encompassing dermatology, ophthalmology, and oncology departments are significant customers, as they provide comprehensive care and often have established pathways for ordering specialized diagnostic tests.

AI Analysis | Feedback

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Derek J. Maetzold, President and Chief Executive Officer

Derek J. Maetzold founded Castle Biosciences in September 2007, initiating operations in late 2008 with co-founders Toby Juvenal and Kristen Oelschlager. Before founding Castle Biosciences, he accumulated 24 years of experience in pharmaceutical development and commercialization, focusing on new product development through business licensing and commercial oversight of pre-approved therapies. Immediately prior to starting Castle, he prepared a public biotechnology company for its first commercial product launch, and this company was subsequently sold. His pharmaceutical career involved leadership roles at companies such as Encysive Pharmaceuticals, Schering-Plough Corporation (now Merck), Integrated Communications, Amylin Pharmaceuticals, and Sandoz Pharmaceuticals (now a division of Novartis). Mr. Maetzold has contributed to the discovery, development, and commercialization of five diagnostic and prognostic tests in cancers and is a co-inventor of multiple technologies at Castle Biosciences and Encysive Pharmaceuticals.

Frank Stokes, Chief Financial Officer

Frank Stokes has served as Castle Biosciences' Chief Financial Officer since December 2017. Prior to joining Castle Biosciences, he was the Chief Financial Officer of Hammock Pharmaceuticals, a specialty pharmaceutical company, where he was involved in the company's initial capitalization and the acquisition of its foundational drug delivery technology. Mr. Stokes also had a distinguished career as a senior investment banker at firms including Leerink Partners (now SVB Leerink), Robert W. Baird, and Wachovia Securities (now Wells Fargo Securities). In these roles, he led life sciences, tools, and diagnostics sector investment banking efforts, and managed various financings, and mergers and acquisitions transactions. He successfully stewarded Castle through its IPO in 2019, a move he had actively anticipated and pursued a relationship with Castle for during his banking career.

Kristen M. Oelschlager, Chief Operating Officer

Kristen M. Oelschlager joined Castle Biosciences in October 2008 as one of the company's three initial employees, serving as the Executive Director of Operations. She has held the position of Chief Operating Officer since April 2021, and her previous roles at Castle Biosciences include Chief Operations Officer (August 2020 to April 2021), Senior Vice President, Clinical Operations (January 2018 to August 2020), and Vice President, Clinical Operations (2013 to 2018). Ms. Oelschlager brings over 15 years of experience in clinical nursing, clinical operations services, and clinical research to her role.

Tobin W. Juvenal, Chief Commercial Officer

Tobin W. Juvenal was one of the three initial employees at Castle Biosciences, joining in October 2008 as the Executive Director, Sales and Marketing. He has served as Chief Commercial Officer since September 2020. His prior roles at the company include Senior Vice President, Sales (January 2018 to August 2020), and Vice President of Sales (2013 to 2018).

AI Analysis | Feedback

Here are the key risks to Castle Biosciences (CSTL):

  1. Reimbursement Uncertainty and Challenges: Castle Biosciences faces significant risk from ongoing uncertainties and potential changes in reimbursement policies for its diagnostic tests. Management has acknowledged uncertainty, particularly for AdvanceAD-Tx and DecisionDx-SCC. Notably, a Medicare contractor, Novitas, finalized a decision for non-coverage of the DecisionDx-SCC test, which became effective in February 2025. This non-coverage is considered a "material risk to one of CSTL's highest-growth assets," potentially eliminating Medicare reimbursement for a key product. The company's financial outlook and ability to translate test volumes into sustainable earnings are highly dependent on favorable reimbursement decisions and payer coverage.
  2. Concentration Risk on Key Products: While Castle Biosciences is expanding its portfolio, a substantial portion of its revenue is expected to continue coming from its core DecisionDx-Melanoma franchise and related dermatologic tests for the foreseeable future. This reliance on a limited number of products exposes the company to significant risk if new competitors emerge, reimbursement rates are cut for these specific tests, or new clinical guidelines reduce their utility or adoption.
  3. Persistent Net Losses and Challenges to Profitability: Despite experiencing strong top-line revenue growth and increasing test volumes, Castle Biosciences has consistently reported net losses. The company recorded a net loss of $24.2 million for the full year 2025. High operating expenses, which are growing faster than revenue, contribute to operational inefficiencies and a challenging path to sustained profitability. While the company maintains a strong gross margin, its negative earnings per share and net margin highlight ongoing difficulties in translating revenue into positive net income.

AI Analysis | Feedback

The emergence of artificial intelligence (AI) and machine learning (ML) powered digital pathology solutions that can analyze routine histology slides to predict metastatic risk for dermatological cancers. Such solutions could provide prognostic information directly from existing tissue biopsies (e.g., H&E stained slides), potentially offering a faster, more cost-effective, and integrated alternative to specialized multi-gene expression profile (GEP) tests like those offered by Castle Biosciences, thereby reducing the demand for their proprietary testing services.

AI Analysis | Feedback

Castle Biosciences addresses significant markets with its diagnostic and prognostic tests for dermatological cancers:

  • DecisionDx-Melanoma: The estimated addressable market for DecisionDx-Melanoma in the U.S. is approximately 130,000 eligible patients diagnosed with invasive cutaneous melanoma annually. The broader U.S. melanoma diagnostics and therapeutics market was valued at an estimated USD 3.45 billion in 2025 and is projected to reach USD 5.21 billion by 2030. Globally, the melanoma cancer diagnostics market was valued at USD 4.95 billion in 2024 and is expected to grow to USD 8.64 billion by 2032.
  • DecisionDx-UM: The global uveal melanoma market was valued at USD 1.5 billion in 2024 and is projected to grow to USD 2.5 billion by 2034. Another report estimates the global uveal melanoma market at USD 402.5 million in 2024, expected to reach USD 609.7 million by 2030. North America, particularly the U.S., dominates this market, with about 2,500 individuals diagnosed annually in the U.S. The uveal melanoma treatment market in North America held the largest revenue share of 44.2% in 2024.
  • DecisionDx-SCC: The estimated total addressable market for DecisionDx-SCC in the U.S. is approximately 200,000 patients diagnosed annually with high-risk squamous cell carcinoma. The squamous cell carcinoma market across the top 7 major markets (U.S., EU4, U.K., and Japan) was valued at USD 739.1 million in 2024 and is projected to reach USD 1,469.0 million by 2035. The global cutaneous squamous cell carcinoma treatment market size is estimated at USD 13.69 billion in 2024 and is projected to reach approximately USD 27.54 billion by 2034. The United States accounts for the largest market size in Cutaneous Squamous Cell Carcinoma.
  • DecisionDx DiffDx-Melanoma and myPath Melanoma: These tests, combined as Castle's Diagnostic GEP offering for difficult-to-diagnose melanocytic lesions, represent an estimated U.S. total addressable market of $600 million. The clinical offering of DiffDx-Melanoma was suspended in February 2023, with myPath Melanoma continuing.

AI Analysis | Feedback

Castle Biosciences (CSTL) is expected to drive future revenue growth over the next 2-3 years through several key initiatives:

  1. Increased Adoption and Penetration of Core Dermatology Tests: Continued growth is anticipated from the company's flagship dermatological tests, particularly DecisionDx-Melanoma. In 2025, DecisionDx-Melanoma delivered 39,083 test reports, showing a 9% year-over-year increase, and achieved approximately 31% patient penetration with nearly 17,000 ordering clinicians. The company is also working on a de novo 510(k) submission to support commercial reimbursement.

  2. Expansion of TissueCypher Barrett's Esophagus Test: The TissueCypher test, which identifies the risk of progression for patients with Barrett's esophagus, is a significant growth driver. Its test volume grew 86% to 39,014 reports in 2025, with management noting only about 11% patient penetration, indicating substantial room for future expansion. The test's inclusion in the AGA Barrett's esophagus guideline further supports its adoption.

  3. Commercialization of AdvanceAD-Tx for Atopic Dermatitis: Castle Biosciences launched AdvanceAD-Tx, a gene expression profile test for moderate-to-severe atopic dermatitis, on a limited-access basis in November 2025. Early results showed strong interest, with over half of the initial 150 dermatological accounts ordering the test within the first five weeks. This new product is expected to materially expand the company's total addressable market, with significant revenue contributions anticipated in 2027 or 2028 as reimbursement pathways are established and availability expands.

  4. Strategic Commercial Team Expansion and Market Penetration: The company plans to enhance its commercial efforts, including potential expansion of its sales force, to drive broader adoption by both clinicians and payers for its existing and newly launched products. This strategic focus aims to capitalize on unmet clinical needs and significant market opportunities through robust clinical evidence and targeted penetration.

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Share Issuance

  • Castle Biosciences' common shares issued and outstanding have steadily increased over the last few years, reflecting ongoing share issuances.
  • As of December 31, 2020, there were 24,812,487 shares issued and outstanding, increasing to 25,054,513 shares by March 31, 2021.
  • The number of shares issued and outstanding further grew to 26,553,681 by December 31, 2022, and approximately 30 million shares by the fourth quarter of 2025.

Capital Expenditures

  • Capital expenditures totaled $31.0 million in 2025 and $9.3 million in 2024.
  • The capital expenditures in 2024 and 2025 were primarily related to a development project for a new building.
  • The company anticipates that capital expenditures will decline in 2026.

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7.1%7.1%-3.0%

Recent Active Movers

Peer Comparisons

Peers to compare with:

Financials

CSTLNEOVCYTMYGNEXASNTRAMedian
NameCastle B.NeoGenom.Veracyte Myriad G.Exact Sc.Natera  
Mkt Price25.567.8832.134.66103.57187.8528.84
Mkt Cap0.71.02.50.419.726.01.8
Rev LTM3447275178243,2472,306776
Op Inc LTM-43-8878-68-199-310-78
FCF LTM28-22127-263577652
FCF 3Y Avg15-2975-83154-50-7
CFO LTM6451362491215100
CFO 3Y Avg41385-392863538

Growth & Margins

CSTLNEOVCYTMYGNEXASNTRAMedian
NameCastle B.NeoGenom.Veracyte Myriad G.Exact Sc.Natera  
Rev Chg LTM3.7%10.1%16.0%-1.6%17.7%35.9%13.1%
Rev Chg 3Y Avg38.4%12.6%20.4%6.9%16.0%41.5%18.2%
Rev Chg Q0.8%10.6%18.5%-0.4%23.1%39.8%14.6%
QoQ Delta Rev Chg LTM0.2%2.6%4.4%-0.1%5.4%8.9%3.5%
Op Mgn LTM-12.4%-12.1%15.2%-8.2%-6.1%-13.4%-10.2%
Op Mgn 3Y Avg-13.6%-13.8%5.0%-12.6%-7.1%-22.6%-13.1%
QoQ Delta Op Mgn LTM-2.3%0.9%6.2%1.7%-1.1%3.2%1.3%
CFO/Rev LTM18.7%0.7%26.4%0.2%15.1%9.3%12.2%
CFO/Rev 3Y Avg11.9%0.5%18.5%-5.2%9.7%-1.8%5.1%
FCF/Rev LTM8.2%-3.0%24.5%-3.1%11.0%3.3%5.8%
FCF/Rev 3Y Avg3.5%-4.4%16.1%-10.7%5.0%-6.6%-0.5%

Valuation

CSTLNEOVCYTMYGNEXASNTRAMedian
NameCastle B.NeoGenom.Veracyte Myriad G.Exact Sc.Natera  
Mkt Cap0.71.02.50.419.726.01.8
P/S2.21.44.90.56.111.33.5
P/EBIT-25.5-9.541.1-1.1-107.8-98.4-17.5
P/E-31.0-9.438.3-1.2-94.5-124.8-20.2
P/CFO11.7193.818.7242.140.0120.780.3
Total Yield-3.2%-10.7%2.6%-84.0%-1.1%-0.8%-2.1%
Dividend Yield0.0%0.0%0.0%0.0%0.0%0.0%0.0%
FCF Yield 3Y Avg1.4%-1.5%2.5%-6.2%0.9%-1.1%-0.1%
D/E0.00.40.00.50.10.00.1
Net D/E-0.40.2-0.10.10.1-0.00.0

Returns

CSTLNEOVCYTMYGNEXASNTRAMedian
NameCastle B.NeoGenom.Veracyte Myriad G.Exact Sc.Natera  
1M Rtn-19.9%-29.5%-8.6%2.9%0.3%-9.6%-9.1%
3M Rtn-33.8%-33.5%-25.0%-35.4%2.0%-19.0%-29.3%
6M Rtn19.3%-1.0%4.0%-35.6%92.0%11.5%7.8%
12M Rtn32.5%-19.8%2.0%-53.7%130.2%26.7%14.4%
3Y Rtn12.8%-57.7%40.2%-80.0%60.9%229.3%26.5%
1M Excs Rtn-18.6%-28.8%-8.3%-1.5%2.5%-9.2%-8.8%
3M Excs Rtn-31.2%-32.7%-24.2%-33.9%3.9%-17.8%-27.7%
6M Excs Rtn9.5%-8.4%-2.0%-42.2%82.1%5.2%1.6%
12M Excs Rtn9.2%-44.0%-17.2%-76.2%102.4%9.0%-4.1%
3Y Excs Rtn-51.9%-126.0%-34.6%-148.4%-10.4%155.7%-43.2%

Comparison Analyses

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Financials

Segment Financials

Revenue by Segment
$ Mil20252024202320222021
Delivery of test reports for our molecular diagnostic tests332220   
Dermatologic  1258658
Non-Dermatologic  1285
Total3322201379463


Net Income by Segment
$ Mil20252024202320222021
Delivery of test reports for our molecular diagnostic tests18-57   
Total18-57   


Price Behavior

Price Behavior
Market Price$25.56 
Market Cap ($ Bil)0.7 
First Trading Date07/25/2019 
Distance from 52W High-40.6% 
   50 Days200 Days
DMA Price$34.72$27.37
DMA Trendupdown
Distance from DMA-26.4%-6.6%
 3M1YR
Volatility48.2%59.8%
Downside Capture271.7371.92
Upside Capture56.9088.47
Correlation (SPY)23.0%22.7%
CSTL Betas & Captures as of 2/28/2026

 1M2M3M6M1Y3Y
Beta1.721.060.800.440.651.03
Up Beta-0.38-0.080.341.000.641.03
Down Beta0.99-0.66-0.74-1.230.640.96
Up Capture73%104%66%140%62%106%
Bmk +ve Days9203170142431
Stock +ve Days10212968132372
Down Capture405%307%238%93%77%105%
Bmk -ve Days12213054109320
Stock -ve Days11203256117373

[1] Upside and downside betas calculated using positive and negative benchmark daily returns respectively
Based On 1-Year Data
Annualized
Return
Annualized
Volatility
Sharpe
Ratio
Correlation
with CSTL
CSTL34.0%59.9%0.70-
Sector ETF (XLV)5.0%17.5%0.1230.0%
Equity (SPY)19.6%18.9%0.8122.9%
Gold (GLD)71.9%26.3%2.05-1.6%
Commodities (DBC)19.3%17.3%0.89-2.3%
Real Estate (VNQ)6.2%16.3%0.1921.1%
Bitcoin (BTCUSD)-15.3%44.2%-0.259.7%

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Based On 5-Year Data
Annualized
Return
Annualized
Volatility
Sharpe
Ratio
Correlation
with CSTL
CSTL-16.9%74.2%0.08-
Sector ETF (XLV)7.5%14.5%0.3326.0%
Equity (SPY)13.1%17.0%0.6133.1%
Gold (GLD)24.1%17.3%1.143.9%
Commodities (DBC)11.2%19.0%0.474.7%
Real Estate (VNQ)4.8%18.8%0.1631.1%
Bitcoin (BTCUSD)6.3%56.7%0.3322.2%

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Based On 10-Year Data
Annualized
Return
Annualized
Volatility
Sharpe
Ratio
Correlation
with CSTL
CSTL2.1%74.6%0.38-
Sector ETF (XLV)10.1%16.5%0.5025.0%
Equity (SPY)14.5%17.9%0.7029.2%
Gold (GLD)14.4%15.6%0.776.8%
Commodities (DBC)8.6%17.6%0.405.9%
Real Estate (VNQ)5.6%20.7%0.2324.4%
Bitcoin (BTCUSD)67.4%66.8%1.0721.6%

Smart multi-asset allocation framework can stack odds in your favor. Learn How

Short Interest

Short Interest: As Of Date2272026
Short Interest: Shares Quantity1.4 Mil
Short Interest: % Change Since 21520262.6%
Average Daily Volume0.5 Mil
Days-to-Cover Short Interest2.9 days
Basic Shares Quantity29.3 Mil
Short % of Basic Shares4.8%

Earnings Returns History

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 Forward Returns
Earnings Date1D Returns5D Returns21D Returns
1/13/2026-0.1%3.0%-18.5%
11/3/202521.7%33.7%52.4%
8/4/202532.8%25.1%51.4%
5/5/2025-11.4%-9.1%-9.2%
1/13/2025-13.6%-17.6%-7.0%
11/4/2024-7.4%0.4%-5.2%
8/5/202414.0%22.4%32.3%
5/2/20246.5%6.9%2.5%
...
SUMMARY STATS   
# Positive111213
# Negative1098
Median Positive7.9%5.2%18.7%
Median Negative-6.7%-10.2%-8.1%
Max Positive32.8%33.7%52.4%
Max Negative-13.6%-27.0%-25.6%

SEC Filings

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Report DateFiling DateFiling
12/31/202502/26/202610-K
09/30/202511/03/202510-Q
06/30/202508/04/202510-Q
03/31/202505/05/202510-Q
12/31/202402/27/202510-K
09/30/202411/04/202410-Q
06/30/202408/05/202410-Q
03/31/202405/02/202410-Q
12/31/202302/28/202410-K
09/30/202311/02/202310-Q
06/30/202308/02/202310-Q
03/31/202305/03/202310-Q
12/31/202202/28/202310-K
09/30/202211/02/202210-Q
06/30/202208/08/202210-Q
03/31/202205/09/202210-Q

Insider Activity

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#OwnerTitleHoldingActionFiling DatePriceSharesTransacted
Value
Value of
Held Shares
Form
1Maetzold, Derek JPres. & Chief Exec. OfficerDirectSell1229202540.3583033,4901,352,936Form
2Maetzold, Derek JPres. & Chief Exec. OfficerDirectSell1219202540.0450920,3801,375,774Form
3Oelschlager, Kristen MChief Operating OfficerDirectSell1219202539.3114,888585,292484,454Form
4Maetzold, Derek JPres. & Chief Exec. OfficerDirectSell1217202538.7819,525757,0991,849,221Form
5Maetzold, Derek JPres. & Chief Exec. OfficerDirectSell1217202538.5512,821494,3011,344,339Form