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Exagen
(NASDAQ:XGN)
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Rating:55Neutral
Price Target:
$8.00
▲(5.26% Upside)
Action:Reiterated
Date:10/17/26
The score is driven most by improving fundamentals and upbeat execution signals from the latest earnings call (raised revenue guidance, record operating metrics, better collections, and near-breakeven adjusted EBITDA). These positives are tempered by still-material net losses and negative free cash flow, plus only mixed near-term technical momentum and limited valuation support given the negative P/E.
Positive Factors
Growing Test Adoption
Rising test volume and clinician adoption strengthen Exagen’s recurring laboratory-services model and indicate broader clinical use of AVISE. Continued penetration among rheumatologists can support durable revenue growth, improve laboratory utilization, and expand the platform’s commercial foundation.
Negative Factors
Persistent Cash Burn
Negative operating and free cash flow show that Exagen has not yet become self-funding despite improving performance. Continued cash burn can limit investment flexibility and require external funding or balance-sheet resources until operating profitability and collections improve further.
Read all positive and negative factors
Positive Factors
Negative Factors
Growing Test Adoption
Rising test volume and clinician adoption strengthen Exagen’s recurring laboratory-services model and indicate broader clinical use of AVISE. Continued penetration among rheumatologists can support durable revenue growth, improve laboratory utilization, and expand the platform’s commercial foundation.
Read all positive factors
Exagen Key Performance Indicators (KPIs)
Any
Revenue by Customer Category
Breaks down revenue across customer types (e.g., clinical labs and hospitals, commercial lab partners and distributors, direct-to-patient testing, and research or licensing agreements). For Exagen (XGN), this reveals whether growth is driven by broad consumer demand or concentrated partner contracts, highlights margin and cash-flow differences between channels, and flags concentration or reimbursement risks that could quickly affect results. Points to which channels are scalable and where management should focus sales, pricing, and payer negotiations.
Breaks down revenue across customer types (e.g., clinical labs and hospitals, commercial lab partners and distributors, direct-to-patient testing, and research or licensing agreements). For Exagen (XGN), this reveals whether growth is driven by broad consumer demand or concentrated partner contracts, highlights margin and cash-flow differences between channels, and flags concentration or reimbursement risks that could quickly affect results. Points to which channels are scalable and where management should focus sales, pricing, and payer negotiations.
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The Fly
The FlyExagen (XGN) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$176.12M
Dividend YieldN/A
Average Volume (3M)342.86K
Price to Earnings (P/E)―
Beta (1Y)1.76
Revenue Growth20.83%
EPS Growth9.70%
CountryUS
Employees216
SectorHealthcare
Sector Strength45
IndustryMedical - Diagnostics & Research
Share Statistics
EPS (TTM)-0.82
Shares Outstanding24,225,340
10 Day Avg. Volume426,871
30 Day Avg. Volume342,861
Financial Highlights & Ratios
PEG Ratio-0.54
Price to Book (P/B)7.51
Price to Sales (P/S)1.97
P/FCF Ratio-9.19
Enterprise Value/Market Cap0.66
Enterprise Value/Revenue1.62
Enterprise Value/Gross Profit2.77
Enterprise Value/Ebitda-10.20
Forecast
1Y Price Target
$10.80Price Target Upside42.11% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering5
EPS Forecast (FY)-0.65
Revenue Forecast (FY)$73.89M
Exagen Business Overview & Revenue Model
Company Description
Exagen Inc. develops and commercializes diagnostic testing solutions, leveraging its proprietary cell-bound complement activation products (CB-CAPs) technology under the AVISE brand throughout the United States. The company's mission is to equip r...
How the Company Makes Money
Exagen makes money primarily by performing proprietary autoimmune diagnostic tests in its own laboratory and billing for those tests. Its core revenue stream is clinical testing revenue generated when physicians order Exagen’s AVISE-branded panels...
Exagen Earnings Call Summary
Earnings Call Date:Aug 04, 2026
(Q2-2026)
| % Change Since: |
Next Earnings Date:Nov 16, 2026
Earnings Call Sentiment Positive
The call conveyed strong operational and financial momentum: record revenue, record AVISE test volume, consecutive ASP growth (13 quarters), significant pharma services expansion, meaningful improvements in cash collections and near-breakeven adjusted EBITDA. Management raised full-year guidance and reiterated pipeline progress (myositis launch early 2027) and long-term ASP targets. Key risks include reimbursement uncertainty (pending MolDX LCD), seasonality and variability in collections and revenue recognition, and the remaining runway to achieve sustained adjusted EBITDA positivity around an $80M revenue run rate. Overall, positives — including multiple record metrics, improved margins and clear execution on RCM and commercial initiatives — materially outweigh the remaining operational and reimbursement headwinds.Positive Updates
Record Quarterly Revenue
Reported revenue of $19.9 million in Q2 2026, up 16% year-over-year and the highest quarterly revenue in company history.
Negative Updates
Reimbursement and LCD Uncertainty
Local Coverage Determination (MolDX) request has been pending since summer 2022 with no update; Medicare reimbursement remains stable but the LCD process is opaque and timing/ outcome uncertain, representing downside risk.
Read all updates
Q2-2026 Updates
Positive
Negative
Record Quarterly Revenue
Reported revenue of $19.9 million in Q2 2026, up 16% year-over-year and the highest quarterly revenue in company history.
Read all positive updates
Company Guidance
Exagen raised 2026 revenue guidance to $72–$75 million (up from $70–$73M) based on Q2 revenue of $19.9M and first‑half strength; the updated outlook assumes high‑single‑digit volume growth for the year and mid‑single‑digit trailing‑12‑month ASP growth versus Q4‑2025 exit (current TTM ASP $446, +4% Y/Y), while noting typical second‑half seasonality. Management reiterated a longer‑term ASP target of ~$600–$650 (≈50% of Medicare), said gross margin should progress into the mid‑60s (now tracking to ~60%+ by year‑end), and reiterated that adjusted‑EBITDA breakeven is expected around an ~$80M revenue run‑rate. The guide also reflects revenue‑cycle momentum (Q2 included >$1M collected on claims >360 days; H1 collections were $9M higher than H1‑2025) and contribution from pharma services (Q2 pharma revenue >$1M; backlog >$6M).Exagen Financial Statement Overview
Summary
Income Statement
34
Negative
Balance Sheet
55
Neutral
Cash Flow
28
Negative
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 71.12M | 66.58M | 55.64M | 52.55M | 45.56M | 48.30M |
| Gross Profit | 41.70M | 38.80M | 33.11M | 29.46M | 21.35M | 27.71M |
| EBITDA | -11.32M | -13.46M | -11.14M | -19.15M | -43.66M | -23.10M |
| Net Income | -18.92M | -19.95M | -15.12M | -23.69M | -47.39M | -26.85M |
Balance Sheet | ||||||
| Total Assets | 51.94M | 58.02M | 44.69M | 56.94M | 86.22M | 123.44M |
| Cash, Cash Equivalents and Short-Term Investments | 24.59M | 32.22M | 22.04M | 36.49M | 62.39M | 99.44M |
| Total Debt | 25.55M | 25.71M | 23.21M | 23.23M | 35.20M | 28.07M |
| Total Liabilities | 39.72M | 40.57M | 35.15M | 34.25M | 43.76M | 38.51M |
| Stockholders Equity | 12.22M | 17.45M | 9.54M | 22.69M | 42.46M | 84.94M |
Cash Flow | ||||||
| Free Cash Flow | -7.59M | -14.27M | -13.79M | -15.29M | -36.46M | -22.64M |
| Operating Cash Flow | -6.50M | -13.63M | -13.28M | -14.46M | -32.14M | -20.27M |
| Investing Cash Flow | -1.08M | -626.00K | -515.00K | -804.00K | -4.32M | -2.42M |
| Financing Cash Flow | 2.13M | 24.43M | -663.00K | -10.63M | -489.00K | 64.68M |
Exagen Technical Analysis
Neutral
7.60
Price Trends
7.81
Negative
6.33
Positive
4.96
Positive
Market Momentum
-0.08
Positive
40.55
Neutral
15.59
Positive
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For XGN, the sentiment is Neutral. The current price of 7.6 is below the 20-day moving average (MA) of 8.07, below the 50-day MA of 7.81, and above the 200-day MA of 4.96, indicating a neutral trend. The MACD of -0.08 indicates Positive momentum. The RSI at 40.55 is Neutral, neither overbought nor oversold. The STOCH value of 15.59 is Positive, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Neutral sentiment for XGN.
Exagen Risk Analysis
Exagen disclosed 73 risk factors in its most recent earnings report. Exagen reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Exagen Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
55 Neutral | $176.12M | -8.87 | -121.62% | ― | 20.83% | 9.70% | |
55 Neutral | $293.87M | -4.17 | -49.17% | 2.46% | 182.05% | -5.43% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
49 Neutral | $80.08M | -3.03 | -46.71% | ― | -35.19% | 21.75% | |
46 Neutral | $160.78M | -4.91 | -150.56% | ― | 39.59% | 61.06% | |
45 Neutral | $552.00M | -6.47 | -61.65% | ― | -51.05% | 57.25% | |
43 Neutral | $17.49M | -0.31 | 142.63% | ― | 12.75% | 16.23% |
* Healthcare Sector Average
XGN
Exagen
7.27
-4.64
-38.96%
ACRS
Aclaris Therapeutics
3.75
1.41
60.26%
MDXH
MDxHealth
0.18
-4.61
-96.18%
STIM
Neuronetics
2.11
-0.98
-31.72%
PRE
Prenetics Group
17.35
4.27
32.65%
SERA
Sera Prognostics
2.03
-1.71
-45.72%
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.