NTRANatera, Inc.
Industry Diagnostics Updated 28 Sep 2026 Price 23 Oct 2026
If management hits its targets, one share in 12 months
$404 → $452
Promises vs. what happened
16 claims · 8 decksEvery target management put in a slide deck, and whether they hit it, missed it, or quietly dropped it.
| Promise | Made in | What happened | |
|---|---|---|---|
| 2024 revenue, margin and cash (third raise) | Q3 '24 | beat all three | Held |
| 2025 revenue $1.87-1.95B | Q4 '24 | $2,306M, after three raises | Held |
| 2025 gross margin 60-64% | Q4 '24 | 64.7%, above the top | Held |
| 2025 cash flow positive, then $100M | Q4 '24 | $107.6M | Held |
| Latitude launch in CRC, mid-2025 | Q4 '24 | launched; folded into the MRD count | Held |
| 20-gene Fetal Focus panel in Q4 '25 | Q3 '25 | shipped as 21 genes; ~200K orders a year | Held |
| PROCEED readout on >100 AA, 500 controls | Q2 '25 | on time, on 92 and 366 | Late |
| ~$200M of AI efficiency | Q2 '25 | said once, never measured again | Dropped |
| 2026 revenue $2.62-2.70B | Q4 '25 | raised to $2.85-2.91B; H1 $1,449M | Open |
| 2026 gross margin 63-65%, ex true-ups | Q4 '25 | raised to 64-66% and the exclusion dropped | Open |
| 2026 SG&A roughly flat | Q4 '25 | H1 annualises above the range | Open |
| 2026 cash flow positive | Q4 '25 | the quarterly cash figure stopped being reported | Open |
| FIND-CRC enrolled in 18 months | Q3 '25 | target widened; completion moved to Q3 '26 | Open |
| Japan approval in '26, launch by year-end | Q1 '26 | approved June '26; launch not yet reported | Open |
| MolDX coverage on more tumour types (~$250-300M) | Q2 '25 | seven submissions ready; none reported covered | Open |
| 2025 opex flat despite the $80M raise | Q2 '25 | SG&A and R&D both raised three months later | Missed |
What they’re pitching
the headline page, deck by deckThe headline from each quarterly results deck over two years, so you can see what they want you to focus on, and when it changes.
'24Q4
'24Q1
'25Q2
'25Q3
'25Q4
'25Q1
'26Q2
'26
RaisesPage one since Q3 '24
UnitsPage one since Q3 '24
MarginFirst seen Q3 '24
CashOff page one Q1 '26
EvidenceOff page one Q4 '25
ApprovalsOff page one Q1 '25
ScreeningOff page one Q4 '25
Women's healthOff page one Q4 '25
on the headline page further in the deck not in the deck▲ onto page one▼ off page one● first mentionTap a mark for the quote.
Raising the annual outlook
“Raising outlook: revenue of $1.61 – $1.64B; gross margin of 58% – 61%; and $50– $75 million in cash2.”
Deck Investor presentation — Q3 2024 Earnings Call · p. 3 ·
Raising the annual outlook
“Establishing 2025 financial outlook: revenue of $1.87B – $1.95B (pro-forma revenue growth of 24%);”
Deck Q4’2024 Earnings Presentation · p. 3 ·
Raising the annual outlook
“Increasing 2025 financial outlook: revenue of $1.94B – $2.02B (pro-forma revenue growth of ~26%);”
Deck Q1’2025 Earnings Presentation · p. 3 ·
Raising the annual outlook
“Increasing 2025 financial outlook by $80M for revenue: revenue of $2.02B – $2.1B; gross margin1 of 61% – 64%;”
Deck Q2’2025 Earnings Presentation · p. 3 ·
Raising the annual outlook
“Increasing 2025 financial outlook by $160M for revenue: Outlook includes revenue of $2.18B – $2.26B; gross margin1 of 62% – 64%; and $100M in cash flow generation2.”
Deck Q3’2025 Earnings Presentation · p. 3 ·
Raising the annual outlook
“Establishing 2026 financial outlook: revenue of $2.62B-$2.70B; gross margin of 63%-65%; and positive cash inflow2.”
Deck Q4’2025 Earnings Presentation · p. 3 ·
Raising the annual outlook
“Raising 2026 outlook, $120M increase in revenue at the midpoint ($2.74B-$2.82B); gross margin1 increased to 64%-66%.”
Deck Q1’2026 Earnings Presentation · p. 3 ·
Raising the annual outlook
“Raising 2026 outlook, $100M increase in revenue at the midpoint.”
Deck Q2’2026 Earnings Presentation · p. 3 ·
Signatera / clinical MRD unit growth
“~137K oncology tests in Q3 2024 vs ~89K in Q3 2023; year-over-year growth of 54%. Signatera clinical units grew ~11.4K units over Q2 2024, and grew a record ~48K vs Q3 2023.”
Deck Investor presentation — Q3 2024 Earnings Call · p. 3 ·
Signatera / clinical MRD unit growth
“151K oncology tests in Q4 2024 vs 98K in Q4 2023; year-over-year growth of 55%.”
Deck Q4’2024 Earnings Presentation · p. 3 ·
Signatera / clinical MRD unit growth
“Clinical oncology units grew 16.5K units over Q4 2024, a new record for sequential quarter growth.”
Deck Q1’2025 Earnings Presentation · p. 3 ·
Signatera / clinical MRD unit growth
“Clinical oncology grew ~20K units over Q1 2025.”
Deck Q2’2025 Earnings Presentation · p. 3 ·
Signatera / clinical MRD unit growth
“Clinical MRD tests grew ~21.5K units over Q2 2025.”
Deck Q3’2025 Earnings Presentation · p. 3 ·
Signatera / clinical MRD unit growth
“Clinical MRD tests grew ~23K units over Q3 2025.”
Deck Q4’2025 Earnings Presentation · p. 3 ·
Signatera / clinical MRD unit growth
“249K clinical oncology tests in Q1 2026 vs 161K in Q1 2025; year-over-year growth of ~55%. Clinical oncology units grew 24K units over Q4 2025, a new record for sequential quarter growth.”
Deck Q1’2026 Earnings Presentation · p. 3 ·
Signatera / clinical MRD unit growth
“○ Clinical MRD oncology1 units grew ~34K units over Q1 2026, the largest sequential increase to-date.”
Deck Q2’2026 Earnings Presentation · p. 3 ·
Gross margin and ASP step-ups
“Significant sequential step up in ASPs”
Deck Investor presentation — Q3 2024 Earnings Call · p. 7 ·
Gross margin and ASP step-ups
“Continued sequential step up in ASPs”
Deck Q4’2024 Earnings Presentation · p. 7 ·
Gross margin and ASP step-ups
“Continued sequential step up in ASPs”
Deck Q1’2025 Earnings Presentation · p. 7 ·
Gross margin and ASP step-ups
“Sequential ASP improvement in Signatera”
Deck Q2’2025 Earnings Presentation · p. 7 ·
Gross margin and ASP step-ups
“Continued sequential step up in ASPs”
Deck Q3’2025 Earnings Presentation · p. 7 ·
Gross margin and ASP step-ups
“Continued sequential step up in ASPs.”
Deck Q4’2025 Earnings Presentation · p. 7 ·
Gross margin and ASP step-ups
“Gross margins1,2 at 64.7% despite ~2% transient impacts:”
Deck Q1’2026 Earnings Presentation · p. 9 ·
Gross margin and ASP step-ups
“Ex-true ups, ~50 bps sequential increase vs. Q1.”
Deck Q2’2026 Earnings Presentation · p. 7 ·
Cash generation
“Generated ~$34.5M in cash inflow2 in Q3 2024.”
Deck Investor presentation — Q3 2024 Earnings Call · p. 3 ·
Cash generation
“Gross margin1 of 63% in Q4 2024 vs 51% in Q4 2023; generated ~$46M in cash inflow2 in Q4 2024.”
Deck Q4’2024 Earnings Presentation · p. 3 ·
Cash generation
“Gross margin1 of 63% in Q1 2025 vs 57% in Q1 2024; generated ~$23M in cash inflow2 in Q1 2025.”
Deck Q1’2025 Earnings Presentation · p. 3 ·
Cash generation
“Gross margin1 of ~63% in Q2 2025 vs ~59% in Q2 2024; generated ~$24M in cash inflow2 in Q2 2025.”
Deck Q2’2025 Earnings Presentation · p. 3 ·
Cash generation
“Gross margin1 of ~65% in Q3 2025; generated ~$26M in cash inflow2 in Q3 2025.”
Deck Q3’2025 Earnings Presentation · p. 3 ·
Cash generation
“Generated ~$107.6M in cash inflow2 in 2025.”
Deck Q4’2025 Earnings Presentation · p. 3 ·
Clinical evidence and trial readouts
“ESMO presentation and concurrent Nature Medicine publication demonstrate Signatera’s ability to predict overall survival and chemotherapy benefit in colorectal cancer.”
Deck Investor presentation — Q3 2024 Earnings Call · p. 3 ·
Clinical evidence and trial readouts
“Clinical readouts in oncology, kidney/heart transplantation, and fetal RhD NIPT.”
Deck Q4’2024 Earnings Presentation · p. 3 ·
Clinical evidence and trial readouts
“Proliferation of Signatera”
Deck Q1’2025 Earnings Presentation · p. 3 ·
Clinical evidence and trial readouts
“Furthered MRD leadership in breast and GI cancers with recent clinical trial data and activations.”
Deck Q2’2025 Earnings Presentation · p. 3 ·
Clinical evidence and trial readouts
“Furthered MRD leadership and SignateraTM differentiation in landmark ESMO presentations.”
Deck Q3’2025 Earnings Presentation · p. 3 ·
Clinical evidence and trial readouts
“Positive readout of interventional SINERGY trial in R/M HNSCC”
Deck Q4’2025 Earnings Presentation · p. 13 ·
Clinical evidence and trial readouts
“3 datasets: Signatera may enable patients to avoid surgery”
Deck Q1’2026 Earnings Presentation · p. 10 ·
Clinical evidence and trial readouts
“12 3rd NCCN guideline update for ctDNA-MRD 1st Category 1 recommendation in bladder cancer”
Deck Q2’2026 Earnings Presentation · p. 12 ·
Coverage, reimbursement and regulatory approvals
“Medicare coverage of Signatera for lung cancer patients in surveillance.”
Deck Q4’2024 Earnings Presentation · p. 3 ·
Coverage, reimbursement and regulatory approvals
“Coverage for additonal non-covered tumor types”
Deck Q2’2025 Earnings Presentation · p. 8 ·
Coverage, reimbursement and regulatory approvals
“Signatera data generation: 7 new MolDx submissions ready”
Deck Q3’2025 Earnings Presentation · p. 8 ·
Coverage, reimbursement and regulatory approvals
“Medicare Coverage: Signatera Genome”
Deck Q4’2025 Earnings Presentation · p. 4 ·
Coverage, reimbursement and regulatory approvals
“PMDA approval expected in 2026, with commercial launch by end of year”
Deck Q1’2026 Earnings Presentation · p. 17 ·
Coverage, reimbursement and regulatory approvals
“MAY 2026 1st FDA-approved companion diagnostic in blood-based MRD”
Deck Q2’2026 Earnings Presentation · p. 10 ·
Early cancer detection
“Promising initial readout from early cancer detection 127 CRC Cases”
Deck Q4’2024 Earnings Presentation · p. 17 ·
Early cancer detection
“Disciplined spend and phase-gated approach to launch”
Deck Q2’2025 Earnings Presentation · p. 17 ·
Early cancer detection
“Announced strong new data in early cancer detection for advanced adenomas.”
Deck Q3’2025 Earnings Presentation · p. 3 ·
Early cancer detection
“Readout: AA Data from PROCEED Trial”
Deck Q4’2025 Earnings Presentation · p. 4 ·
Early cancer detection
“FIND-CRC1: initiated in 2025, enrolling significantly ahead of schedule 1. NCT: NCT07046585”
Deck Q1’2026 Earnings Presentation · p. 16 ·
Early cancer detection
“Continued progress in early cancer detection”
Deck Q2’2026 Earnings Presentation · p. 15 ·
Women's health launches
“Ongoing support for Natera’s fetal RhD NIPT”
Deck Q4’2024 Earnings Presentation · p. 10 ·
Women's health launches
“Major product launch in women’s health and new data published on PEDAL clinical trial in organ health.”
Deck Q2’2025 Earnings Presentation · p. 3 ·
Women's health launches
“Announced expansion of gene panel for Fetal FocusTM single-gene NIPT.”
Deck Q3’2025 Earnings Presentation · p. 3 ·
Women's health launches
“Strong reception to 21-gene Fetal Focus single-gene NIPT”
Deck Q4’2025 Earnings Presentation · p. 8 ·
Women's health launches
“Record quarter for Women’s Health, second fastest growth since 2019”
Deck Q1’2026 Earnings Presentation · p. 5 ·
Women's health launches
“Enhanced Panorama: reduces no-call rates by ~80%”
Deck Q2’2026 Earnings Presentation · p. 8 ·
What they keep talking about · 10
The themes that show up deck after deck, and the ones that disappear.
- Raises
- The first bullet of all eight decks. 2024 went up three times, 2025 three times, 2026 twice — and every landed year beat the last range, not just the first.
- Units
- The lead volume figure in every deck, and the label keeps moving: Signatera clinical, then oncology, then clinical oncology, then clinical MRD once Latitude was folded in. The sequential gain went 11K, 16.5K, 20K, 21.5K, 23K, 24K, 34K.
- Margin
- "Continued sequential step up in ASPs" in six of eight decks, and not one ASP figure in any of them. From Q1 '26 the slide shows the margin instead, footnoted to include a ~3% true-up benefit.
- Cash
- A quarterly cash-inflow figure on the highlights slide through Q4 '25 — $34.5M, $46M, $23M, $24M, $26M, then $107.6M for the year. Both 2026 decks drop it while still guiding "cash flow positive".
- Evidence
- On the highlights slide in all five decks to Q3 '25 — ESMO, Nature Medicine, a first NEJM paper — then off it from Q4 '25, when the highlights became financial only.
- Approvals
- US Medicare coverage through 2025 ("7 new MolDx submissions ready"), replaced in 2026 by regulatory firsts: the first FDA-approved blood-based MRD companion diagnostic in May, PMDA approval in June, EU IVDR.
- Screening
- A back-of-the-deck story that keeps getting a slide: 127 CRC cases, then 22.5% advanced-adenoma sensitivity on 92 cases, then FIND-CRC enrolling "significantly ahead of schedule" with the readout in 2027.
- Women's health
- Fetal RhD, then the Fetal Focus single-gene test launched at 21 genes, then "Record quarter" in Q1 '26 and an enhanced Panorama cutting no-call rates ~80%.
- New
- Q2 '26: the first ex-true-up gross margins Natera has ever printed, 61.3% and 61.8% — below the floor of the range the 2026 guide was first set on.
- Quiet
- The quarterly cash inflow, the growth rate excluding true-ups and the product/licensing split all stopped in 2026. Two of the three are the ones that showed how much of the revenue was collected on earlier work.
Every quarterly report we’ve saved · 8
The press releases and shareholder letters behind this page.
- Q2 2026 release · 8-K 6 Aug 2026
- Q1 2026 release · 8-K 7 May 2026
- Q4 2025 release · 8-K 12 Jan 2026
- Q3 2025 release · 8-K 6 Nov 2025
- Q2 2025 release · 8-K 7 Aug 2025
- Q1 2025 release · 8-K 8 May 2025
- Q4 2024 release · 8-K 13 Jan 2025
- Q3 2024 release · 8-K 12 Nov 2024
Archived as text; the links open the copies filed on EDGAR or the investor-relations site.
What analysts asked them
8 calls · Q3 24 – Q2 26The last eight earnings calls: what analysts kept asking about, which questions got dodged, and how much the CEO did the talking.
Share of questions by topic, call by call. A topic that suddenly dominates is usually the problem. The last row is how much of the answering the CEO did, rather than the CFO or others.
| Share of questions about… | Q3 24 | Q4 24 | Q1 25 | Q2 25 | Q3 25 | Q4 25 | Q1 26 | Q2 26 |
|---|---|---|---|---|---|---|---|---|
| Demand & customers | · | 5% | 6% | · | · | · | 8% | 17% |
| Growth & sales | 37% | 24% | 44% | 31% | 11% | 54% | 25% | 33% |
| Pricing & margins | 26% | 14% | 25% | 15% | 33% | 15% | 25% | 42% |
| Guidance & outlook | 47% | 29% | 19% | 31% | 22% | 23% | 33% | 17% |
| Capacity & supply | · | · | · | · | · | 15% | · | · |
| Capital & financing | 5% | · | · | · | · | 8% | 8% | · |
| Competition | 5% | · | 6% | 8% | 11% | 15% | 8% | 17% |
| Products & technology | 21% | 14% | 19% | 31% | 22% | 38% | 33% | 17% |
| Other | 16% | 43% | 25% | 23% | 33% | 15% | 33% | 17% |
| Questions | 19 | 21 | 16 | 13 | 9 | 13 | 12 | 12 |
| How much the CEO talked | 31% | 41% | 57% | 48% | 41% | 60% | 49% | 54% |
Who’s in charge, who’s selling
read from the filings · 1 Oct 2026Shareholder votes against the board and pay, plus which executives have been selling their own shares.
Tier 1 · live
A $292.5m judgment is final and on appeal, with no reserve disclosed
A November 2024 jury award to Guardant Health was largely upheld in July 2025, final judgment was entered in June 2026, and Natera is appealing to the Ninth Circuit. A second Guardant suit (trade secrets, February 2025) and a certified securities class action in the Western District of Texas are both live. The legal note read discloses no reserve amount for any of them. The judgment alone is about 27% of the $1,091.5m of cash.
Tier 1 · worsening
The pay is weighted to revenue, and the revenue carries collections the decks stopped breaking out
The cash bonus runs 55% on revenue, 35% on product gross margin and 10% on operating cash flow, and the performance shares on three-year cumulative revenue. That revenue included $194m of collections on earlier-period tests in 2025, 8.4% of the year. Across eight decks three measures stopped being reported and two of them are the ones that strip the effect out; February's margin guide said it excluded true-ups and May's raise dropped the sentence. The only ex-true-up margins printed, 61.3% and 61.8%, sit below the floor of the range as first defined. The 2025 target was 11% growth and paid 131%.
Tier 2 · worsening
451 sales, no purchases, on a share count up 51% in four years
$320.8m sold by twelve insiders in the year to June 2026, 84% under pre-set plans, and not one open-market purchase by anyone — the executive chairman, the chief executive, the lead independent director, both co-founders, the chief financial officer and the chief legal officer among the sellers. Diluted shares went 90.6m to 136.7m in four years and 144.1m by July 2026, on $1,284m of cumulative share-based pay and no buyback ever. An automatic shelf has been live since December 2025.
Tier 2 · stable
Natera keeps investing in a private company its executive chairman founded and chairs
About $16.7m into MyOme — $4m in 2021, $2.7m in 2024, $10m in January 2026 — plus milestone warrants, for about 19.1% fully diluted. Matthew Rabinowitz is MyOme's founder and chairman and holds about 19.4%; co-founder and director Jonathan Sheena is a stockholder and MyOme director; the chief legal officer is a stockholder; and the lead independent director's firm invested in the same round. An independent board committee oversees it.
Tier 2 · stable
A classified board, elected by plurality, where a 29% protest changes nothing
Three staggered classes, so at most four of eleven seats stand in a year, and directors are elected by plurality — the proxy states that withheld votes "will not be counted in such nominee's favor", so they cannot defeat an unopposed candidate. 29.2% of the vote was withheld from Gail Marcus in 2025; she remains a director and chairs the nominating committee. The board also grew itself from ten to twelve during 2026 without a shareholder vote.
Where shareholders voted no
At each annual meeting shareholders vote on who sits on the board, what the executives are paid and whether the company may create more shares. These are the votes that drew the most "no"s at the last two meetings: the shares voted against (or withheld) each year, then what share of all votes cast that was. Under each one, what the vote was about and what a no means.
| 2025 | 2026 | Share 2026 | |
|---|---|---|---|
| Amend the 2015 Equity Incentive PlanStock to pay staff and executives. Lets the company create new shares to hand out as pay. Every new share makes each existing share a slightly smaller slice of the company, so a no says shareholders think the dilution is too much. | 29.1M | 26.9M | 21.9% |
| Say on pay (advisory)Executive pay. Shareholders say whether they accept what the top executives were paid. The vote is advisory: the board can ignore it, but a large no is a public rebuke and boards usually change the pay plan after one. | 4.6M | 2.5M | 2.0% |
| Ratify Ernst & YoungThe auditor. Keeping the outside accounting firm that checks the company's books. This almost always passes; a sizeable no means shareholders doubt the audit or think the firm has been in place too long. | 0.7M | 0.8M | 0.7% |
| Gail Marcus (Class I, 2025 only)A board seat. Shareholders vote to keep this person on the board, the group that hires, pays and can fire the CEO. A no, or a withheld vote, says they want this director out, often because of the committee they sit on or a decision they signed off. | 32.8M | — | 29.2% |
| Herm Rosenman (Class II, 2026 only)A board seat. | — | 18.8M | 15.3% |
| Eric Rubin (Class I, 2026 only)A board seat. | — | 2.1M | 1.7% |
Insiders who sold the most stock
Reported sales by executives and directors, biggest first.
| SEC insider data sets, Jul '25-Jun '26; names from the 175-filing Form 4 sweep | Sold | Note |
|---|---|---|
| All insiders | $320.8M | 451 sales by 12 people, and not one purchase; 84% pre-planned |
| Matthew Rabinowitz, exec chairman | $124.1M | 515,157 shares, all under 10b5-1 plans; still holds 3.39% |
| Steven Chapman, chief executive | $94.0M | 437,258 shares on a plan; he is left with 32,401 shares |
| Roelof Botha, lead independent dir. | $34.9M | 153,000 shares, with no plan footnote on the rows read |