Natera (NTRA)
Applies personalized molecular testing across reproductive health, oncology, and organ health.
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Natera runs a laboratory that reads DNA floating in a tube of blood, then sends the bill to a health insurer. The older, steadier part of it is pregnancy screening, where prices settled long ago and growth means winning clinics from rivals. About half the money now comes from cancer testing, led by Signatera, which watches for a tumor returning after surgery. Persuading insurers to pay for more tests is the whole game.
Item facts: H1 FY2026 · six months ended June 30, 2026, from filings, earnings calls and company pages.
Judgment weights, not filed revenue
The band summarizes business focus and direction. ~ marks estimates.
7 in detail · 12 more below
Signatera
The blood test that watches for cancer returning after surgery, and close to half of all sales. Clinical volume hit 283,000 tests in the June quarter, up 56% in a year; the number to watch is what insurers actually pay — about $1,275 per test against a $2,000 goal.
Competes with Haystack MRD (Quest Diagnostics) · Guardant Reveal (Guardant Health) · Oncodetect (Exact Sciences)
In plain English
When a surgeon takes out a tumor, the question is whether any of it is still hiding. Natera sequences the removed tumor, builds a set of genetic markers unique to that one patient, and then looks for those same markers in ordinary blood draws over the months that follow.
An oncologist orders the test; a health plan pays for it. Medicare alone covered about a quarter of Natera's revenue last year, so government coverage rules are the biggest lever on what each test collects. Every additional cancer type that coverage programmes and treatment guidelines accept turns the same lab work into more money.
Empower
Inherited cancer-risk test read from blood or spit, ordered by both women's health and cancer doctors — a small, steady slice of sales. It went unmentioned across the last eight earnings calls: mature, price-competitive, and second to Myriad's panel.
Competes with MyRisk Hereditary Cancer (Myriad Genetics) · Germline panels (Ambry Genetics) · Invitae-derived germline menu (LabCorp)
In plain English
Some cancers run in families. This test reads a person's own inherited DNA, from blood or spit, and reports back in about two weeks whether they carry gene variants that raise their risk.
That answer changes what happens next: extra screening, preventive surgery, a different treatment plan after a diagnosis, or testing the patient's relatives. An OB/GYN seeing a healthy woman and an oncologist working up a new case can both order it, so it rides along on sales calls Natera is already making. Insurers pay when national testing criteria say the patient qualifies — which caps how many orders can be written at all.
Signatera Biopharma Services
Drug companies pay Natera directly to run Signatera inside their own clinical trials — no insurer involved, and only about a hundredth of sales. Many small partners, none of them large. The real value is seeding: trial users become clinic orderers.
Competes with Biopharma services (Guardant Health) · FoundationOne CDx partnerships (Roche)
In plain English
The part of Signatera that no insurer ever sees. A drug company running a cancer trial writes the test into its protocol and pays Natera's invoice itself, patient by patient, the way a builder pays for surveys on a site.
The cheques are small and the partner list is long and thin — Merck, Angiex and a string of smaller names, none big enough to matter on its own. The payoff sits downstream instead: the oncologists who used the test inside a trial are the ones writing orders for it in the clinic afterwards, where a health plan picks up the bill.
Panorama
The prenatal blood screen for Down syndrome and other chromosome conditions — roughly a fifth of sales. A rebuilt version in May 2026 cut inconclusive results from about one in fifty to one in two hundred, winning new accounts. US births are flat, so growth has to come from rivals.
Competes with QNatal Advanced (Quest Diagnostics) · UNITY (BillionToOne) · Harmony (Roche)
In plain English
A pregnant woman's blood carries traces of her baby's DNA. Panorama reads those traces to estimate the chance of conditions such as Down syndrome, without anything being put into the womb, and it can also tell whether twins are identical.
The OB/GYN orders it at a routine visit and a commercial plan or Medicaid pays. Prices here were settled years ago, so the line only grows by taking practices off the big reference labs. That is what the May 2026 rebuild was for: far fewer tests coming back as "we could not tell", which is the complaint that loses an account.
Horizon
Carrier screening — does a would-be parent carry a gene for cystic fibrosis or similar? About an eighth of sales, ordered at the same visit as Panorama and from the same blood draw. Prices are mature, so the line grows purely by attaching to more visits.
Competes with Foresight Carrier Screen (Myriad Genetics) · UNITY Screen (BillionToOne) · In-house carrier panels (LabCorp)
In plain English
Before or early in a pregnancy, parents can ask a simpler question than whether anything is wrong with this baby — namely, do we carry anything that could be passed on? Horizon checks for inherited conditions such as cystic fibrosis and spinal muscular atrophy.
It is almost always ordered at the same appointment as the prenatal screen, from the same blood draw, through the same sales relationship. That is the whole economic point: one visit, two tests. Natera reports the pair as a single core women's health number and they move together, which also means a lost practice costs it twice.
Prospera
Blood test that flags a transplanted kidney, heart or lung being rejected, in place of cutting out a tissue sample. About a tenth of sales. A July 2026 Medicare rule raised how many tests it pays for per patient — the number that sets this line's size.
Competes with AlloSure Kidney (CareDx) · Viracor TRAC dd-cfDNA (Eurofins)
In plain English
A transplanted organ can be rejected by the body that received it, and the classic way to check is to cut out a tiny piece and examine it under a microscope. Prospera measures how much of the donor's DNA is drifting in the recipient's bloodstream instead, so a blood draw stands in for a biopsy.
Transplant centres order on a fixed schedule, which makes revenue close to arithmetic: patients times tests paid for per year. Medicare dominates this group, and in July 2026 it widened the allowance to six tests in the first year after a kidney transplant and twelve for heart and lung.
Early Cancer Detection (FIND-CRC)
A blood test meant to catch colon cancer in healthy adults, aimed at the pre-cancerous growths that rival blood tests are worst at spotting. It earns nothing and costs roughly $100 million this year. About 24,000 people are enrolled; results land in 2027.
Competes with Shield (Guardant Health) · Cologuard (Exact Sciences) · Freenome CRC blood test (Exact Sciences)
In plain English
The expensive bet at the back of the lab. Colon cancer starts as a growth that has not yet turned cancerous, and the standard way to find those is a colonoscopy. Natera is building a blood test that hunts for them instead; its early study spotted about a fifth of them, where the published figures for Guardant's and Freenome's tests are lower.
None of this earns a cent today. It costs roughly $100 million this year, funded out of the profits Signatera throws off, and even a good trial result is followed by regulatory review, guideline committees and pricing decisions before a single test is paid for.
SignateraThe blood test that watches for cancer returning after surgery, and close to half of all sales. Clinical volume hit 283,000 tests in the June quarter, up 56% in a year; the number to watch is what insurers actually pay — about $1,275 per test against a $2,000 goal.The blood test that watches for cancer returning after surgery, and close to half of all sales. Clinical volume hit 283,000 tests in the June quarter, up 56% in a year; the number to watch is what insurers actually pay — about $1,275 per test against a $2,000 goal.
In plain English
When a surgeon takes out a tumor, the question is whether any of it is still hiding. Natera sequences the removed tumor, builds a set of genetic markers unique to that one patient, and then looks for those same markers in ordinary blood draws over the months that follow.
An oncologist orders the test; a health plan pays for it. Medicare alone covered about a quarter of Natera's revenue last year, so government coverage rules are the biggest lever on what each test collects. Every additional cancer type that coverage programmes and treatment guidelines accept turns the same lab work into more money.
Competes with Haystack MRD (Quest Diagnostics) · Guardant Reveal (Guardant Health) · Oncodetect (Exact Sciences)
EmpowerInherited cancer-risk test read from blood or spit, ordered by both women's health and cancer doctors — a small, steady slice of sales. It went unmentioned across the last eight earnings calls: mature, price-competitive, and second to Myriad's panel.Inherited cancer-risk test read from blood or spit, ordered by both women's health and cancer doctors — a small, steady slice of sales. It went unmentioned across the last eight earnings calls: mature, price-competitive, and second to Myriad's panel.
In plain English
Some cancers run in families. This test reads a person's own inherited DNA, from blood or spit, and reports back in about two weeks whether they carry gene variants that raise their risk.
That answer changes what happens next: extra screening, preventive surgery, a different treatment plan after a diagnosis, or testing the patient's relatives. An OB/GYN seeing a healthy woman and an oncologist working up a new case can both order it, so it rides along on sales calls Natera is already making. Insurers pay when national testing criteria say the patient qualifies — which caps how many orders can be written at all.
Competes with MyRisk Hereditary Cancer (Myriad Genetics) · Germline panels (Ambry Genetics) · Invitae-derived germline menu (LabCorp)
Signatera Biopharma ServicesDrug companies pay Natera directly to run Signatera inside their own clinical trials — no insurer involved, and only about a hundredth of sales. Many small partners, none of them large. The real value is seeding: trial users become clinic orderers.Drug companies pay Natera directly to run Signatera inside their own clinical trials — no insurer involved, and only about a hundredth of sales. Many small partners, none of them large. The real value is seeding: trial users become clinic orderers.
In plain English
The part of Signatera that no insurer ever sees. A drug company running a cancer trial writes the test into its protocol and pays Natera's invoice itself, patient by patient, the way a builder pays for surveys on a site.
The cheques are small and the partner list is long and thin — Merck, Angiex and a string of smaller names, none big enough to matter on its own. The payoff sits downstream instead: the oncologists who used the test inside a trial are the ones writing orders for it in the clinic afterwards, where a health plan picks up the bill.
Competes with Biopharma services (Guardant Health) · FoundationOne CDx partnerships (Roche)
PanoramaThe prenatal blood screen for Down syndrome and other chromosome conditions — roughly a fifth of sales. A rebuilt version in May 2026 cut inconclusive results from about one in fifty to one in two hundred, winning new accounts. US births are flat, so growth has to come from rivals.The prenatal blood screen for Down syndrome and other chromosome conditions — roughly a fifth of sales. A rebuilt version in May 2026 cut inconclusive results from about one in fifty to one in two hundred, winning new accounts. US births are flat, so growth has to come from rivals.
In plain English
A pregnant woman's blood carries traces of her baby's DNA. Panorama reads those traces to estimate the chance of conditions such as Down syndrome, without anything being put into the womb, and it can also tell whether twins are identical.
The OB/GYN orders it at a routine visit and a commercial plan or Medicaid pays. Prices here were settled years ago, so the line only grows by taking practices off the big reference labs. That is what the May 2026 rebuild was for: far fewer tests coming back as "we could not tell", which is the complaint that loses an account.
Competes with QNatal Advanced (Quest Diagnostics) · UNITY (BillionToOne) · Harmony (Roche)
HorizonCarrier screening — does a would-be parent carry a gene for cystic fibrosis or similar? About an eighth of sales, ordered at the same visit as Panorama and from the same blood draw. Prices are mature, so the line grows purely by attaching to more visits.Carrier screening — does a would-be parent carry a gene for cystic fibrosis or similar? About an eighth of sales, ordered at the same visit as Panorama and from the same blood draw. Prices are mature, so the line grows purely by attaching to more visits.
In plain English
Before or early in a pregnancy, parents can ask a simpler question than whether anything is wrong with this baby — namely, do we carry anything that could be passed on? Horizon checks for inherited conditions such as cystic fibrosis and spinal muscular atrophy.
It is almost always ordered at the same appointment as the prenatal screen, from the same blood draw, through the same sales relationship. That is the whole economic point: one visit, two tests. Natera reports the pair as a single core women's health number and they move together, which also means a lost practice costs it twice.
Competes with Foresight Carrier Screen (Myriad Genetics) · UNITY Screen (BillionToOne) · In-house carrier panels (LabCorp)
ProsperaBlood test that flags a transplanted kidney, heart or lung being rejected, in place of cutting out a tissue sample. About a tenth of sales. A July 2026 Medicare rule raised how many tests it pays for per patient — the number that sets this line's size.Blood test that flags a transplanted kidney, heart or lung being rejected, in place of cutting out a tissue sample. About a tenth of sales. A July 2026 Medicare rule raised how many tests it pays for per patient — the number that sets this line's size.
In plain English
A transplanted organ can be rejected by the body that received it, and the classic way to check is to cut out a tiny piece and examine it under a microscope. Prospera measures how much of the donor's DNA is drifting in the recipient's bloodstream instead, so a blood draw stands in for a biopsy.
Transplant centres order on a fixed schedule, which makes revenue close to arithmetic: patients times tests paid for per year. Medicare dominates this group, and in July 2026 it widened the allowance to six tests in the first year after a kidney transplant and twelve for heart and lung.
Competes with AlloSure Kidney (CareDx) · Viracor TRAC dd-cfDNA (Eurofins)
Early Cancer Detection (FIND-CRC)A blood test meant to catch colon cancer in healthy adults, aimed at the pre-cancerous growths that rival blood tests are worst at spotting. It earns nothing and costs roughly $100 million this year. About 24,000 people are enrolled; results land in 2027.A blood test meant to catch colon cancer in healthy adults, aimed at the pre-cancerous growths that rival blood tests are worst at spotting. It earns nothing and costs roughly $100 million this year. About 24,000 people are enrolled; results land in 2027.
In plain English
The expensive bet at the back of the lab. Colon cancer starts as a growth that has not yet turned cancerous, and the standard way to find those is a colonoscopy. Natera is building a blood test that hunts for them instead; its early study spotted about a fifth of them, where the published figures for Guardant's and Freenome's tests are lower.
None of this earns a cent today. It costs roughly $100 million this year, funded out of the profits Signatera throws off, and even a good trial result is followed by regulatory review, guideline committees and pricing decisions before a single test is paid for.
Competes with Shield (Guardant Health) · Cologuard (Exact Sciences) · Freenome CRC blood test (Exact Sciences)
Named in filings, launches and programs
- Fetal FocusProduct · RampingNewer prenatal test reading the baby's own DNA for single-gene conditions; orders neared 200,000 a year by May 2026, but insurers mostly do not cover it yet.
- LatitudeProduct · RampingTissue-free version of Signatera for patients with no usable tumor sample; still a small number of tests, with a Medicare coverage application in flight.
- AlteraProductReads a tumor's tissue sample for treatment-guiding mutations — the profiling test ordered at diagnosis. Meets Roche's FoundationOne CDx and Tempus xT head-on.
- RenasightProductGene panel that looks for inherited causes of kidney disease, sold into the same kidney and transplant doctors Prospera reaches.
- AnoraProductAnalyses tissue after a miscarriage to help explain why it happened — a small line inside the women's health roster.
- VistaraProductEarlier single-gene prenatal test covering 25 conditions; Fetal Focus is the next generation of it.
- Fetal RhD NIPTProductLaunched in 2024 during a shortage of the Rho(D) injection; demand kept climbing after the shortage eased.
- Signatera GenomeProductWhole-genome version of the cancer-monitoring test, launched in 2025; the exome version still carries the vast majority of volume.
- PhasED-SeqPlatformDetection chemistry from the Foresight deal, folded into Signatera in December 2025; finds tumor DNA below one part in ten million.
- Foresight DiagnosticsBrandBought in December 2025, all in stock, for $424.5M including earnouts; brought the phased-variant chemistry and a lymphoma franchise.
- Licensing and otherServiceThe odds and ends outside testing — $10.3M in 2025, four tenths of one percent of sales, and smaller every year since 2022.
- SIGNAL-ER101Product · AnnouncedNatera's first trial of its own: stepping up breast-cancer treatment only for patients whose blood test turns positive. Open as of August 2026.
Fetal FocusProduct · Ramping
Newer prenatal test reading the baby's own DNA for single-gene conditions; orders neared 200,000 a year by May 2026, but insurers mostly do not cover it yet.
LatitudeProduct · Ramping
Tissue-free version of Signatera for patients with no usable tumor sample; still a small number of tests, with a Medicare coverage application in flight.
AlteraProduct
Reads a tumor's tissue sample for treatment-guiding mutations — the profiling test ordered at diagnosis. Meets Roche's FoundationOne CDx and Tempus xT head-on.
RenasightProduct
Gene panel that looks for inherited causes of kidney disease, sold into the same kidney and transplant doctors Prospera reaches.
AnoraProduct
Analyses tissue after a miscarriage to help explain why it happened — a small line inside the women's health roster.
VistaraProduct
Earlier single-gene prenatal test covering 25 conditions; Fetal Focus is the next generation of it.
Fetal RhD NIPTProduct
Launched in 2024 during a shortage of the Rho(D) injection; demand kept climbing after the shortage eased.
Signatera GenomeProduct
Whole-genome version of the cancer-monitoring test, launched in 2025; the exome version still carries the vast majority of volume.
PhasED-SeqPlatform
Detection chemistry from the Foresight deal, folded into Signatera in December 2025; finds tumor DNA below one part in ten million.
Foresight DiagnosticsBrand
Bought in December 2025, all in stock, for $424.5M including earnouts; brought the phased-variant chemistry and a lymphoma franchise.
Licensing and otherService
The odds and ends outside testing — $10.3M in 2025, four tenths of one percent of sales, and smaller every year since 2022.
SIGNAL-ER101Product · Announced
Natera's first trial of its own: stepping up breast-cancer treatment only for patients whose blood test turns positive. Open as of August 2026.