20/20 Biolabs (NASDAQ:AIDX – Get Free Report) and Billiontoone (NASDAQ:BLLN – Get Free Report) are both healthcare companies, but which is the better investment? We will compare the two businesses based on the strength of their institutional ownership, profitability, analyst recommendations, dividends, valuation, earnings and risk.
Profitability
This table compares 20/20 Biolabs and Billiontoone’s net margins, return on equity and return on assets.
| Net Margins | Return on Equity | Return on Assets | |
| 20/20 Biolabs | N/A | N/A | N/A |
| Billiontoone | 8.04% | 9.96% | 5.35% |
Analyst Ratings
This is a summary of recent ratings for 20/20 Biolabs and Billiontoone, as reported by MarketBeat.com.
| Sell Ratings | Hold Ratings | Buy Ratings | Strong Buy Ratings | Rating Score | |
| 20/20 Biolabs | 1 | 0 | 1 | 0 | 2.00 |
| Billiontoone | 1 | 3 | 7 | 0 | 2.55 |
Earnings & Valuation
This table compares 20/20 Biolabs and Billiontoone”s gross revenue, earnings per share and valuation.
| Gross Revenue | Price/Sales Ratio | Net Income | Earnings Per Share | Price/Earnings Ratio | |
| 20/20 Biolabs | $2.05 million | 2.36 | -$3.74 million | ($0.54) | -0.70 |
| Billiontoone | $397.41 million | 11.33 | $7.45 million | $0.70 | 136.30 |
Billiontoone has higher revenue and earnings than 20/20 Biolabs. 20/20 Biolabs is trading at a lower price-to-earnings ratio than Billiontoone, indicating that it is currently the more affordable of the two stocks.
Summary
Billiontoone beats 20/20 Biolabs on 10 of the 11 factors compared between the two stocks.
About 20/20 Biolabs
We develop and commercialize AI-powered, laboratory-based blood tests for the early detection and prevention of cancers and chronic diseases. We offer two families of lab tests, both under our OneTest brand: (i) OneTest for Cancer, a multi-cancer early detection, or MCED, blood test which has been our primary commercial focus and source of revenues since we wound down our COVID-19 testing business, and (ii) OneTest for Longevity, which measures inflammatory biomarkers, that we expect to launch in the first half of 2026. Both tests are run in our CAP (College of American Pathologists) accredited, CLIA (Clinical Laboratory Improvement Amendments) licensed laboratory in Gaithersburg, MD. That laboratory also hosts our Clinical Laboratory Innovation Accelerator, or CLIAx, which we believe is the country’s first shared CLIA laboratory for overseas diagnostics start-ups seeking to launch novel lab tests in the U.S. without the expense of establishing and operating their own, independent lab. As noted above, during the COVID-19 pandemic, we also provided COVID-19 viral testing using polymerase chain reaction, or PCR, analytical equipment in our clinical laboratory. Our legacy business also includes a pioneering field test kit for screening suspicious powders for bioterror agents known as BioCheck. As of the date of this prospectus, we generate revenue from three sources: OneTest for Cancer (primarily as a lab test in the U.S. but we also license our algorithms to overseas labs), BioCheck and from our CLIAx. For each of the nine months ended September 30, 2025 and 2024, sales of OneTest for Cancer accounted for approximately 87% of our revenues, sales of BioCheck accounted for approximately 9% of our revenues, and our CLIAx accounted for approximately 4% of our revenues. For the years ended December 31, 2024 and 2023, sales of OneTest for Cancer accounted for approximately 85% and 65% of our revenues, respectively, sales of BioCheck accounted for approximately 10% and 13% of our revenues, respectively, our CLIAx accounted for approximately 5% and 4% of our revenues, respectively, and COVID-19 testing accounted for approximately 0% and 18% of our revenues, respectively. Our principal executive offices are located in Gaithersburg, MD.
About Billiontoone
BillionToOne is transforming healthcare by redefining molecular diagnostics. Our revolutionary single molecule NGS (smNGS) platform achieves what was once thought impossible – detecting and precisely quantifying genetic targets with single-molecule sensitivity. At the heart of this technological breakthrough lies our patented QCTs, enabling measurements at the physical limit of detection – the single DNA molecule. This leap forward addresses a fundamental limitation in healthcare – the inability to detect sparse but clinically crucial disease signals in cfDNA. Our superior technology platform(1) has enabled us to build category-defining prenatal and oncology products. Our products reveal actionable insights from a simple blood draw that are fundamentally changing how diseases are diagnosed and treated, leading to a paradigm shift in personalized medicine. We believe our novel smNGS platform technologies combined with our AI-enhanced integrated workflow, allows us to push the technology frontier forward and deliver on the full promise of non-invasive liquid biopsy, which we estimate has an annual market opportunity of over $100 billion in the United States alone(2). Founded with the mission to remove the fear of the unknown through powerful and accessible smNGS-based diagnostics, we have swiftly transitioned from a research and development (R&D) focused company to a proven commercial organization. In 2019, we launched our first prenatal product, UNITY. UNITY is the first non-invasive prenatal test (NIPT) that uses cfDNA to provide fetal risk assessment for recessive conditions such as sickle cell disease (SCD) and cystic fibrosis (CF) without requiring a paternal sample or invasive procedures such as amniocentesis. Since then, we have established ourselves as a leader in the prenatal testing market and expanded our UNITY offering to cover comprehensive prenatal genetic needs from a single maternal blood draw. While we know of competitors working to develop and launch competing NIPTs for recessive conditions, we believe the differentiation of our smNGS technology and five years of accumulated data and publications will allow us to maintain our competitive advantage as this type of testing becomes the standard of care and significantly improves patient outcomes(3). In the oncology setting, ultrasensitive tests with real-time insights are required to effectively detect, diagnose, and treat patients with a diverse range of mutations and solid tumor types across the cancer care continuum. In 2023, we successfully leveraged our smNGS platform to launch two complementary pan-cancer liquid biopsy tests – Northstar Select and Northstar Response. Our Northstar Select test is used to guide therapy selection and has been shown to detect over 50% more actionable solid tumor mutations than conventional liquid biopsies(4),(5). Based on our knowledge of all widely available tests, Northstar Response is the only methylation-based assay that quantifies the amount of cancer (tumor burden) at the single molecule level without requiring a tissue biopsy, enabling real-time monitoring of patient response to therapy with unprecedented precision. Our Northstar tests give physicians extraordinary visibility into cancer profile and treatment response, enabling more informed and earlier treatment decisions that can fundamentally alter patient outcomes. Our business momentum is evidenced by our rapidly scaling commercial success and improving operational efficiency. Of approximately one million smNGS-based tests that we have processed since our initial launch, over 50% of them, or approximately 508,000 tests, were processed within the last 12 months ended June 30, 2025. For the year ended December 31, 2024, we generated revenue of $152.6 million, representing 113% year-over-year growth, with a gross margin of 53% and net loss of $41.6 million. We have incurred losses since inception, including a net loss of $41.6 million and $4.2 million for the year ended December 31, 2024 and six months ended June 30, 2025, respectively, and we had an accumulated deficit of $286.4 million as of June 30, 2025. Our loss from operations for the six months ended June 30, 2024 and 2025 was $22.8 million and $3.9 million, respectively. Our business model has demonstrated improving operational leverage, which has enabled us to reach, on a non-GAAP income from operations basis, positive operating income after adjusting for stock-based compensation expense for the six months ended June 30, 2025. During this period, we generated revenue of $125.5 million, representing 82% year-over-year revenue growth as compared to the six months ended June 30, 2024, with a gross margin of 65%. This translated to a non-GAAP income from operations of $1.2 million for the six months ended June 30, 2025 compared to a non-GAAP loss from operations of $18.9 million for the six months ended June 30, 2024, which represented an improvement of approximately $20.1 million. Backed by our commitment to continued innovation and high-quality execution, we aim to lead the next wave of advancements in precision diagnostics, delivering profound benefits to patients, providers, and the broader healthcare system. (1) Our smNGS platform overcomes the technical noise that restrains the traditional NGS testing methods used by other diagnostic companies. (2) Half of this addressable market includes early detection, an area in which we have not yet begun specific product development or commercial sales, but we believe will be strongly enabled by our existing technology platform. (3) This is based on (i) our six months ended June 30, 2025 prenatal testing revenue as compared to the publicly disclosed prenatal testing revenue of Myriad Genetics, one of the largest laboratories for prenatal diagnostic testing, and (ii) recent ACOG practice advisory changes for RhD and fetal antigen NIPT have specifically cited our publications, resulting in changes to the standard of care. (4) Bower, X., Wignall, J., Varga, M. G., Zhu, J., O’Sullivan, M., Searle, N. E., Hong, L. K., Dogruluk, T., Li, Z., Farmer, T. E., Rosas-Linhard, E., Luong, J., Lin, E., Simon, M. E., Tsao, D. S., Bosch, J. R. T., Palmer, G., Gajra, A., Huynh, C., & Zhou, W. (2025). Validation of a liquid biopsy assay with increased sensitivity for clinical comprehensive genomic profiling. The Journal of Liquid Biopsy, 100322. (5) More than 50% more actionable/reportable mutations when compared to the comparator products in the aggregate. Actual percentages may vary depending on the individual comparator test. Our principal executive offices are located in Menlo Park, CA.
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