Management's Discussion and Analysis of Financial Condition and Results of Operations
    
    
      The following Management's Discussion and Analysis of Financial Condition and Results of Operations should be read in conjunction with the unaudited Condensed Consolidated Financial Statements and the related notes thereto included in this Quarterly Report on Form 10-Q and the audited Consolidated Financial Statements and related notes thereto and Management's Discussion and Analysis of Financial Condition and Results of Operations for the year ended December 31, 2024 included in our Annual Report on Form 10-K filed with the Securities and Exchange Commission, or SEC, on February 28, 2025.
    
    
      "We," "us," "our," "Myriad" and the "Company" as used in this Quarterly Report on Form 10-Q refer to Myriad Genetics, Inc., a Delaware corporation, and its subsidiaries.
    
    
      Myriad, the Myriad logo, BRACAnalysis, BRACAnalysis CDx, Colaris, MyRisk, Myriad myRisk, MyRisk Hereditary Cancer, myChoice, Tumor BRACAnalysis CDx, MyChoice CDx, Prequel, Prequel with Amplify, Amplify, Foresight, Foresight Universal Plus, Precise Tumor, Precise Oncology Solutions, Precise Liquid, Precise MRD, FirstGene, SneakPeek, SneakPeek Early Gender DNA Test, SneakPeek Snap, Urosuite, Mygenehistory, Health.Illuminated., RiskScore, Prolaris, and GeneSight are registered trademarks or trademarks of Myriad. Solely for convenience, trademarks, trade names and service marks referred to in this Quarterly Report on Form 10-Q may appear without the ®, ™ or SMsymbols, but such references are not intended to indicate, in any way, that we will not assert, to the fullest extent under applicable law, our rights or the right of the applicable licensor to these trademarks, trade names and service marks.
    
    
      Cautionary Statement Regarding Forward-Looking Statements
    
    
      The SEC encourages companies to disclose forward-looking information so that investors can better understand a company's future prospects and make informed investment decisions. This Quarterly Report on Form 10-Q contains such "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995.
    
    
      Words such as "may," "anticipate," "estimate," "expects," "projects," "intends," "plans," "believes," "seek," "could," "continue," "likely," "will," "strategy," and "goal" and words and terms of similar substance used in connection with any discussion of future operating or financial performance identify forward-looking statements. All forward-looking statements are management's present expectations of future events as of the date hereof and are subject to a number of known and unknown risks and uncertainties that could cause actual results, conditions, and events to differ materially and adversely from those anticipated. These risks include, but are not limited to:
    
    
      •the risk that sales and profit margins of our existing tests may decline;
    
    
      •the risk that we may not be able to operate our business on a profitable basis;
    
    
      •risks related to our ability to achieve certain revenue growth targets and generate sufficient revenue from our existing product portfolio or in launching and commercializing new tests to be profitable;
    
    
      •risks related to recent changes in the our senior management team and the successful implantation of the company's strategic plan;
    
    
      •risks related to changes in governmental or private insurers' coverage and reimbursement levels for our tests or our ability to obtain reimbursement for our new tests at comparable levels to our existing tests, including with respect to UnitedHealthcare's coverage decisions not to provide coverage for certain multi-gene panel pharmacogenetic tests, including our GeneSight test;
    
    
      •risks related to increased competition and the development of new competing tests;
    
    
      •the risk that we may be unable to develop or achieve commercial success for additional tests in a timely manner, or at all;
    
    
      •the risk that we may not successfully develop new markets or channels for our tests;
    
    
      •the risk that we are not able to secure additional financing to fund our business, if needed, in a timely manner or on favorable terms, if it all;
    
    
      •the risk that licenses to the technology underlying our tests and any future tests are terminated or cannot be maintained on satisfactory terms;
    
    
      •risks related to delays or other problems with operating our laboratory testing facilities;
    
    
      •risks related to public concern over genetic testing in general or our tests in particular;
    
    
      •risks related to regulatory requirements or enforcement in the United States and foreign countries and changes in the structure of the healthcare system or healthcare payment systems;
    
    
      •risks related to our ability to obtain new corporate collaborations or licenses and acquire or develop new technologies or businesses on satisfactory terms, if at all;
    
    
      •risks related to our ability to successfully integrate and derive benefits from any technologies or businesses that we license, acquire, or develop;
    
    
      •risks related to our projections or estimates about the potential market opportunity for our current and future products;
    
    
      •the risk that we or our licensors may be unable to protect or that third parties will infringe the proprietary technologies underlying our tests;
    
    
      •the risk of patent-infringement claims or challenges to the validity of our patents;
    
    
      •risks related to changes in intellectual property laws covering our tests, or patents or enforcement, in the United States and foreign countries;
    
    
      •risks related to security breaches, loss of data and other disruptions, including from cyberattacks and other cybersecurity incidents;
    
    
      •risks of new, changing and competitive technologies in the United States and internationally, and that we may not be able to keep pace with the rapid technology changes in our industry, or properly leverage new technologies to achieve or sustain competitive advantages in our products;
    
    
      •the risk that we may be unable to comply with financial or operating covenants under our credit or lending agreements;
    
    
      •the risk that we may not be able to maintain effective disclosure controls and procedures and internal control over financial reporting;
    
    
      •risks related to current and future investigations, claims or lawsuits, including derivative claims, product or professional liability claims, and risks related to the amount of our insurance coverage limits and scope of insurance coverage with respect thereto; and
    
    
      •other factors discussed under the heading "Risk Factors" contained in Part I, Item 1A of our Annual Report on Form 10-K filed with the SEC on February 28, 2025 as updated under the heading "Risk Factors" in Part II, Item 1A of our Quarterly Report on Form 10-Q filed with the SEC on May 7, 2025 and August 6, 2025, and this Quarterly Report on Form 10-Q, and subsequent filings we make with the SEC.
    
    
      In light of these assumptions, risks and uncertainties, the results and events discussed in the forward-looking statements contained in this Quarterly Report on Form 10-Q, or in any document incorporated by reference might not occur. Stockholders are cautioned not to place undue reliance on the forward-looking statements, which speak only as of the date of this Quarterly Report on Form 10-Q. We are not under any obligation, and we expressly disclaim any obligation, to update or alter any forward-looking statements, whether as a result of new information, future events or otherwise except as required by applicable law. All forward-looking statements in this Quarterly Report on Form 10-Q attributable to us or to any person acting on our behalf are expressly qualified in their entirety by the cautionary statements contained or referred to in this section.
    
    
      General
    
    
      We are a leading molecular diagnostic testing and precision company dedicated to advancing health and well-being for all. We develop and offer molecular tests that help assess the risk of developing disease or disease progression and guide treatment decisions across medical specialties where molecular insights can significantly improve patient care and lower health care costs. Our molecular tests provide insights that help people take control of their health and enable healthcare providers to better detect, treat, and prevent disease.
    
    
      We believe there are significant growth opportunities in addressing urgent healthcare needs through innovative molecular diagnostic and precision testing services. Our strategy is focused on three strategic pillars. First, we plan to drive accelerated growth and profitability by focusing on the Cancer Care Continuum, or CCC, market. We plan to do so by increasing investment in research and development and enhancing our commercial capabilities and customer digital experience to better serve the CCC market. We also plan to leverage strategic partnerships and biopharma services to unlock new growth drivers and expand our portfolio of testing solutions to other high-growth cancer segments such as molecular residual disease (MRD). Second, we aim to grow our Prenatal Health and Mental Health revenues at or above market growth by leveraging our expanded prenatal offerings, including FirstGene Multiple Prenatal Screen, to drive increased volume. We also plan to focus on high value GeneSight accounts and leverage state biomarker laws to improve our reimbursement rates. Third, we plan to complement the revenue growth drivers outlined above with an enhanced focus and commitment on delivering sustained, profitable growth. By maintaining financial discipline, growing revenue faster than operating expenses, and strengthening our planning and execution capabilities, we believe we can increase our profitability while delivering sustained revenue growth.
    
    
      Business Updates
    
    
      Our recent significant business updates include the following:
    
    
      •In October 2025, we announced the addition of two genes, F8 and FXN, to the Foresight Carrier Screen Universal Plus Panel.
    
    
      •In September 2025, we announced a strategic collaboration with SOPHiA Genetics, Inc. to develop and provide pharmaceutical companies with an innovative global liquid biopsy companion diagnostic (CDx) test.
    
    
      •In September 2025, we announced the publication of a new meta-analysis of six prospective controlled studies that included 3,532 adults with major depressive disorder (MDD). The meta-analysis showed that when GeneSight Psychotropic test results were available to treating clinicians, there were significant improvements in response and remission rates for patients with MDD, compared to treatment as usual.
    
    
      •Effective August 16, 2025, Benjamin R. Wheeler was appointed Chief Financial Officer.
    
    
      Results of Operations for the Three Months Ended September 30, 2025 and 2024
    
    
      The results of operations for the three months ended September 30, 2025 and 2024 are discussed below.
    
    
      Revenue
    
    
      The following table summarizes year-over-year revenue changes in our core product categories:
    
    
      
        
          | 
           | 
          
           | 
          
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           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Three months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
             
              % of Total Revenue
             
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
        
        
          | 
            Hereditary Cancer
           | 
          
            $
           | 
          
            93.0  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            90.5  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            2.5  
           | 
          
           | 
          
           | 
          
            45%
           | 
          
           | 
          
           | 
          
            43%
           | 
        
        
          | 
            Tumor Profiling
           | 
          
            29.5  
           | 
          
           | 
          
           | 
          
           | 
          
            31.6  
           | 
          
           | 
          
           | 
          
            (2.1)
           | 
          
           | 
          
           | 
          
            14%
           | 
          
           | 
          
           | 
          
            15%
           | 
        
        
          | 
            Prenatal
           | 
          
            44.5  
           | 
          
           | 
          
           | 
          
           | 
          
            43.5  
           | 
          
           | 
          
           | 
          
            1.0  
           | 
          
           | 
          
           | 
          
            22%
           | 
          
           | 
          
           | 
          
            20%
           | 
        
        
          | 
            Pharmacogenomics
           | 
          
            38.7  
           | 
          
           | 
          
           | 
          
           | 
          
            47.7  
           | 
          
           | 
          
           | 
          
            (9.0)
           | 
          
           | 
          
           | 
          
            19%
           | 
          
           | 
          
           | 
          
            22%
           | 
        
        
          | 
            Total revenue
           | 
          
            $
           | 
          
            205.7  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            213.3  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (7.6)
           | 
          
           | 
          
           | 
          
            100%
           | 
          
           | 
          
           | 
          
            100%
           | 
        
      
     
    
      The following table summarizes volume changes in our core product categories:
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Three months ended September 30,
           | 
          
           | 
          
           | 
        
        
          | 
            (in thousands)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            % Change
           | 
        
        
          | 
             
              Volume:
             
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            Hereditary Cancer
           | 
          
            82  
           | 
          
           | 
          
           | 
          
           | 
          
            74  
           | 
          
           | 
          
           | 
          
            11  
           | 
          
            %
           | 
        
        
          | 
            Tumor Profiling
           | 
          
            12  
           | 
          
           | 
          
           | 
          
           | 
          
            13  
           | 
          
           | 
          
           | 
          
            (8)
           | 
          
            %
           | 
        
        
          | 
            Prenatal
           | 
          
            155  
           | 
          
           | 
          
           | 
          
           | 
          
            162  
           | 
          
           | 
          
           | 
          
            (4)
           | 
          
            %
           | 
        
        
          | 
            Pharmacogenomics
           | 
          
            137  
           | 
          
           | 
          
           | 
          
           | 
          
            127  
           | 
          
           | 
          
           | 
          
            8  
           | 
          
            %
           | 
        
        
          | 
             
              Total
             
           | 
          
            386  
           | 
          
           | 
          
           | 
          
           | 
          
            376  
           | 
          
           | 
          
           | 
          
            3  
           | 
          
            %
           | 
        
      
     
    
      Revenues decreased $7.6 million for the three months ended September 30, 2025 compared to the same period in the prior year primarily due to $8.6 million of revenue recognized during the three months ended September 30, 2024 for tests in which the performance obligation was met in a prior period. For the three months ended September 30, 2025, revenue for tests in which the performance obligation was met in a prior period was immaterial.
    
    
      Pharmacogenomics revenues decreased $9.0 million for the three months ended September 30, 2025 compared to the same period in the prior year due to a 25% year-over-year decrease in average revenue per test, due to revenue recognized for the three months ended September 30, 2024 for tests in which the performance obligation was met in a prior period and UnitedHealthcare's change in GeneSight test coverage under its commercial, individual exchange, and certain managed Medicaid benefit plans. We expect this coverage decision will continue to negatively affect Pharmacogenomics revenue in future periods.
    
    
      Cost of Revenue
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Three months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
             
              % Change
             
           | 
        
        
          | 
             
              Cost of revenue
             
           | 
          
            $
           | 
          
            61.9  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            63.5  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (1.6)
           | 
          
           | 
          
            (3)
           | 
          
            %
           | 
        
        
          | 
             
              Cost of revenue as a % of total revenue
             
           | 
          
            30.1  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            29.8  
           | 
          
            %
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
      
     
    
      Cost of revenue for the three months ended September 30, 2025 decreased $1.6 million compared to the same period in the prior year primarily due to a reduction in the cost per test for the current period driven by reductions in the cost of laboratory reagents and supplies.
    
    
      Operating Expenses
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
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           | 
          
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          | 
           | 
          
            Three months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
            % Change
           | 
        
        
          | 
             
              Research and development expense
             
           | 
          
            $
           | 
          
            28.2  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            28.5  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (0.3)
           | 
          
           | 
          
           | 
          
            (1)
           | 
          
            %
           | 
        
        
          | 
            Sales and marketing expense
           | 
          
            $
           | 
          
            71.0  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            69.9  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            1.1  
           | 
          
           | 
          
           | 
          
            2  
           | 
          
            %
           | 
        
        
          | 
             
              General and administrative expense
             
           | 
          
            $
           | 
          
            67.9  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            69.2  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (1.3)
           | 
          
           | 
          
           | 
          
            (2)
           | 
          
            %
           | 
        
        
          | 
             
              Total operating expenses
             
           | 
          
            $
           | 
          
            167.1  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            167.6  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (0.5)
           | 
          
           | 
          
           | 
          
            -  
           | 
          
            %
           | 
        
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
             
              Research and development expense as a % of total revenue
             
           | 
          
            13.7  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            13.4  
           | 
          
            %
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            Sales and marketing expense as a % of total revenue
           | 
          
            34.5  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            32.8  
           | 
          
            %
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
             
              General and administrative expense as a % of total revenue
             
           | 
          
            33.0  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            32.4  
           | 
          
            %
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
             
              Total operating expenses as a % of total revenue
             
           | 
          
            81.2  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            78.6  
           | 
          
            %
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
      
     
    
      For the three months ended September 30, 2025, operating expenses were relatively consistent with the expenses incurred in the same period of the prior year, reflecting stable operating activities across the business. We remain committed to disciplined cost management while maintaining investments in key strategic areas, such as research and development.
    
    
      Goodwill and Long-lived Asset Impairment Charges
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
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           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Three months ended September 30,
           | 
          
           | 
          
            Change
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
           | 
          
             
              % Change
             
           | 
        
        
          | 
            Goodwill and long-lived asset impairment charges
           | 
          
            $
           | 
          
            -  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            2.2  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (2.2)
           | 
          
           | 
          
           | 
          
            (100)
           | 
          
            %
           | 
        
        
          | 
            Goodwill and long-lived asset impairment charges as a % of total revenue
           | 
          
            -  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            1.0  
           | 
          
            %
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
      
     
    
      There were no goodwill and long-lived asset impairment charges in the three months ended September 30, 2025. In the prior year, we recognized $2.2 million of losses in connection with the sale of the EndoPredict business.
    
    
      Other Income (Expense), Net
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Three months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
             
              % Change
             
           | 
        
        
          | 
            Other income (expense), net
           | 
          
            $
           | 
          
            (2.9)
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (1.2)
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (1.7)
           | 
          
           | 
          
            141.7  
           | 
          
            %
           | 
        
      
     
    
      Other expense, net for the three months ended September 30, 2025 increased $1.7 million as compared to the same period in the prior year primarily due to an increase in interest expense related to our new $125 million term loan secured in July 2025.
    
    
      Income Tax Expense
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Three months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
             
              % Change
             
           | 
        
        
          | 
             
              Income tax expense
             
           | 
          
            $
           | 
          
            1.2  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            0.9  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            0.3
           | 
          
           | 
          
            33.3  
           | 
          
            %
           | 
        
        
          | 
            Effective tax rate
           | 
          
            (4.6)
           | 
          
            %
           | 
          
           | 
          
           | 
          
            (4.2)
           | 
          
            %
           | 
          
           | 
          
            
           | 
          
           | 
          
           | 
        
      
     
    
      Our tax rate is the product of a U.S. federal effective rate of 21.0% and a blended state income tax rate of approximately 3.4%. Certain significant or unusual items are separately recognized during the period in which they occur and can be a source of variability in the effective tax rates from period to period.
    
    
      For the three months ended September 30, 2025, there was $1.2 million income tax expense and our effective tax rate was (4.6)%. For the three months ended September 30, 2024, there was $0.9 million income tax expense and our effective tax rate was (4.2)%. For the three months ended September 30, 2025 and 2024, our effective tax rate differs from the U.S. federal statutory rate primarily due to the recognition of valuation allowances. Due to our cumulative loss and the exhaustion of future taxable income from the reversal of taxable temporary differences, our estimated annual effective tax rate for the current year period includes a valuation allowance against the majority of the current year increase in deferred tax assets.
    
    
      Results of Operations for the Nine Months Ended September 30, 2025 and 2024
    
    
      The results of operations for the nine months ended September 30, 2025 and 2024 are discussed below.
    
    
      Revenue
    
    
      The following table summarizes revenue changes in our core product categories:
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Nine months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
            % of Total Revenue
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
        
        
          | 
            Hereditary Cancer
           | 
          
            $
           | 
          
            275.6  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            270.1  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            5.5  
           | 
          
           | 
          
           | 
          
            45%
           | 
          
           | 
          
           | 
          
            43%
           | 
        
        
          | 
            Tumor Profiling
           | 
          
            90.2  
           | 
          
           | 
          
           | 
          
           | 
          
            95.1  
           | 
          
           | 
          
           | 
          
            (4.9)
           | 
          
           | 
          
           | 
          
            15%
           | 
          
           | 
          
           | 
          
            15%
           | 
        
        
          | 
            Prenatal
           | 
          
            141.4  
           | 
          
           | 
          
           | 
          
           | 
          
            132.2  
           | 
          
           | 
          
           | 
          
            9.2  
           | 
          
           | 
          
           | 
          
            23%
           | 
          
           | 
          
           | 
          
            21%
           | 
        
        
          | 
            Pharmacogenomics
           | 
          
            107.5  
           | 
          
           | 
          
           | 
          
           | 
          
            129.6  
           | 
          
           | 
          
           | 
          
            (22.1)
           | 
          
           | 
          
           | 
          
            17%
           | 
          
           | 
          
           | 
          
            21%
           | 
        
        
          | 
            Total revenue
           | 
          
            $
           | 
          
            614.7  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            627.0  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (12.3)
           | 
          
           | 
          
           | 
          
            100%
           | 
          
           | 
          
           | 
          
            100%
           | 
        
      
     
    
      The following table summarizes volume changes in our core product categories:
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Nine months ended September 30,
           | 
          
           | 
          
           | 
        
        
          | 
            (in thousands)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            % Change
           | 
        
        
          | 
             
              Volume:
             
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            Hereditary Cancer
           | 
          
            233  
           | 
          
           | 
          
           | 
          
           | 
          
            219  
           | 
          
           | 
          
           | 
          
            6%
           | 
        
        
          | 
            Tumor Profiling
           | 
          
            36  
           | 
          
           | 
          
           | 
          
           | 
          
            41  
           | 
          
           | 
          
           | 
          
            (12)%
           | 
        
        
          | 
            Prenatal
           | 
          
            487  
           | 
          
           | 
          
           | 
          
           | 
          
            506  
           | 
          
           | 
          
           | 
          
            (4)%
           | 
        
        
          | 
            Pharmacogenomics
           | 
          
            399  
           | 
          
           | 
          
           | 
          
           | 
          
            380  
           | 
          
           | 
          
           | 
          
            5%
           | 
        
        
          | 
             
              Total
             
           | 
          
            1,155  
           | 
          
           | 
          
           | 
          
           | 
          
            1,146  
           | 
          
           | 
          
           | 
          
            1%
           | 
        
      
     
    
      Revenue decreased $12.3 million for the nine months ended September 30, 2025 compared to the same period in the prior year. For the nine months ended September 30, 2024, we recognized $20.3 million of revenue for tests in which the performance obligation was met in a prior period, including $3.0 million in revenue due to a retroactive coverage change by a payor for one of our prenatal products. For the nine months ended September 30, 2025, revenue for tests in which the performance obligation was met in a prior period was immaterial. This decrease in revenue was partially offset by increased revenue resulting from higher volumes for Hereditary Cancer.
    
    
      Pharmacogenomics revenue decreased $22.1 million for the nine months ended September 30, 2025 compared to the same period in the prior year primarily due to a 21% decrease in the average revenue per test due to revenue recognized in the nine months ended September 30, 2024, for tests in which the performance obligation had been satisfied in a prior period and UnitedHealthcare's change in GeneSight test coverage under its commercial, individual exchange, and certain managed Medicaid benefit plans. We expect this coverage decision will continue to negatively affect Pharmacogenomics revenue in future periods. Tumor Profiling revenue decreased $4.9 million for the nine months ended September 30, 2025 compared to the same period in the prior year primarily due to the sale of our EndoPredict business in August 2024. These decreases in revenue were partially offset by growth in Prenatal and Hereditary Cancer revenues. Prenatal revenue increased $9.2 million for the nine months ended September 30, 2025 compared to the same period in the prior year due to a 11% increase in average revenue per test, partially offset by a 4% decrease in volume primarily driven by decline in SneakPeek volume. Hereditary Cancer revenue increased $5.5 million for the nine months ended September 30, 2025 compared to the same period in the prior year due to a 6% increase in volume, partially offset by a 4% decrease in average revenue per test.
    
    
      Cost of Revenue
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Nine months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
            % Change
           | 
        
        
          | 
             
              Cost of revenue
             
           | 
          
            $
           | 
          
            184.9  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            192.5  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (7.6)
           | 
          
           | 
          
            (4)
           | 
          
            %
           | 
        
        
          | 
             
              Cost of revenue as a % of total revenue
             
           | 
          
            30.1  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            30.7  
           | 
          
            %
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
      
     
    
      Cost of revenue for the nine months ended September 30, 2025 decreased $7.6 million compared to the same period in the prior year primarily due to a reduction in the cost per test for the current period driven by reduction in the cost of laboratory reagents and supplies.
    
    
      Research and Development Expense
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Nine months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
             
              % Change
             
           | 
        
        
          | 
            Research and development expense
           | 
          
            $
           | 
          
            81.3  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            81.2  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            0.1  
           | 
          
           | 
          
           | 
          
            -  
           | 
          
            %
           | 
        
        
          | 
            Research and development expense as a % of total revenue
           | 
          
            13.2  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            13.0  
           | 
          
            %
           | 
          
           | 
          
            
           | 
          
           | 
          
           | 
        
      
     
    
      Research and development expense for the nine months ended September 30, 2025 were relatively consistent with the expenses incurred in the same period of the prior year, reflecting stable operating activities across the business.
    
    
      Sales and Marketing Expense
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Nine months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
            % Change
           | 
        
        
          | 
            Sales and marketing expense
           | 
          
            $
           | 
          
            212.1  
           | 
          
           | 
          
           | 
          
           | 
          
            212.1  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            -  
           | 
          
           | 
          
           | 
          
            -  
           | 
          
            %
           | 
        
        
          | 
            Sales and marketing expense as a % of total revenue
           | 
          
            34.5  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            33.8  
           | 
          
            %
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
      
     
    
      Sales and marketing expense for the nine months ended September 30, 2025 were relatively consistent with the expenses incurred in the same period of the prior year, reflecting stable operating activities across the business.
    
    
      General and Administrative Expense
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Nine months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
            % Change
           | 
        
        
          | 
            General and administrative expense
           | 
          
            $
           | 
          
            201.2  
           | 
          
           | 
          
           | 
          
           | 
          
            211.9  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (10.7)
           | 
          
           | 
          
           | 
          
            (5)
           | 
          
            %
           | 
        
        
          | 
            General and administrative expense as a % of total revenue
           | 
          
            32.7  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            33.8  
           | 
          
            %
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
      
     
    
      General and administrative expense decreased by $10.7 million for the nine months ended September 30, 2025 compared to the prior year primarily due to a $6.8 million decrease in amortization for previously impaired intangible assets, and a decrease of $3.4 million in consulting fees.
    
    
      Goodwill and Long-lived Asset Impairment Charges
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Nine months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
             
              Change
             
           | 
          
           | 
          
            % Change
           | 
        
        
          | 
             
              Goodwill and long-lived asset impairment charges
             
           | 
          
            $
           | 
          
            316.7  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            13.8  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            302.9  
           | 
          
           | 
          
           | 
          
            2195  
           | 
          
            %
           | 
        
        
          | 
             
              Goodwill and long-lived asset impairment charges as a % of total revenue
             
           | 
          
            51.5  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            2.2  
           | 
          
            %
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
      
     
    
      Goodwill and long-lived asset impairment charges in the nine months ended September 30, 2025 included goodwill impairment charges of $234.7 million and intangible asset impairment charges of $82.0 million related to our Women's Health and Pharmacogenomics reporting units. In the prior year, we recognized $13.8 million of losses in connection with the sale of the EndoPredict business.
    
    
      Other Income (Expense), Net
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Nine months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
            % Change
           | 
        
        
          | 
            Other income (expense), net
           | 
          
            $
           | 
          
            (4.7)
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            0.1  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (4.8)
           | 
          
           | 
          
            (4800)%
           | 
        
      
     
    
      Other income (expense), net for the nine months ended September 30, 2025 increased $4.8 million as compared to the same period in the prior year primarily due to an increase in interest expense for the current period related to our new $125 million term loan secured in July 2025.
    
    
      Income Tax (Benefit) Expense
    
    
      
        
          | 
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
           | 
          
            Nine months ended September 30,
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
        
          | 
            (in millions)
           | 
          
            2025
           | 
          
           | 
          
           | 
          
            2024
           | 
          
           | 
          
            Change
           | 
          
           | 
          
            % Change
           | 
        
        
          | 
             
              Income tax (benefit) expense
             
           | 
          
            $
           | 
          
            (28.2)
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            0.4  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            (28.6)
           | 
          
           | 
          
            (7150)%
           | 
        
        
          | 
            Effective tax rate
           | 
          
            7.3  
           | 
          
            %
           | 
          
           | 
          
           | 
          
            (0.5)
           | 
          
            %
           | 
          
           | 
          
           | 
          
           | 
          
           | 
        
      
     
    
      Our tax rate is the product of a blended U.S. statutory federal income tax rate of 21.0% and a blended state income tax rate of approximately 3.4%. Certain significant or unusual items are separately recognized during the period in which they occur and can be a source of variability in the effective tax rates from period to period.
    
    
      Income tax benefit for the nine months ended September 30, 2025 was $28.2 million and our effective tax rate was 7.3%. Income tax expense for the nine months ended September 30, 2024was $0.4 million and our effective tax rate was (0.5)%. For the nine months ended September 30, 2025and 2024, our recognized effective tax rate differs from the U.S. federal statutory rate primarily due to the release of unrecognized tax benefits and the recognition of valuation allowances. The unrecognized tax benefits released were primarily related to tax refund claims following the Coronavirus Aid, Relief, and Economic Security Act, or the CARES Act. Following the success of these claims, we remeasured or released the unrecognized benefits resulting in a discrete tax benefit of $29.6 million during the nine months ended September 30, 2025. Due to our cumulative loss and the exhaustion of future taxable income from the reversal of taxable temporary differences, our estimated annual effective tax rate for the current year includes a valuation allowance against the majority of the current year increase in deferred tax assets, including any tax-deductible loss from the $316.7 million of goodwill and long-lived impairment charges recorded for the nine months ended September 30, 2025. 
    
    
      Liquidity and Capital Resources
    
    
      Our primary sources of liquidity are our cash and cash equivalents, our expected cash flows from operations, and, in certain circumstances, amounts available for borrowing under our new credit facility discussed below. Our capital deployment strategy focuses on use of resources in the key areas of research and development, technology, and collaborations. We believe that investing organically through research and development and new product development or collaborations to support our business strategy provides the best return on invested capital.
    
    
      On July 31, 2025 (the "Closing Date"), we entered into a Credit Agreement (the "Credit Agreement") with the lenders from time to time party thereto, and OrbiMed Royalty & Credit Opportunities IV, LP., as administrative agent (the "Administrative Agent") and as initial lender. The Credit Agreement consists of a $200.0 millionterm loan credit facility with an initial term loan of $125.0 million(the "Initial Loan"), which amount was funded on the Closing Date, and delayed draw term loans (the "Delayed Draw Loans" and together with the Initial Loan, the "Loans"), at our election on or prior to June 30, 2027, in a maximum principal amount of $75.0 million(the "Credit Facility"). We incurred debt discounts and issuance costs totaling $9.4 million. These costs are being amortized using the effective interest method.
    
    
      The proceeds of theCredit Facility were or will be used for our working capital needs and general corporate purposes. Concurrent with the new Credit Facility, we used $60.2 million of the proceeds to repay our previous debt facility, an asset-based revolving credit facility (the "ABL Facility"), in full and terminated the ABL Facility agreement.
    
    
      The Credit Facility matures on July 31, 2030 (the "Maturity Date"). Loans outstanding under the Credit Facility bear interest at a rate per annum equal to (x) the greater of the one-month Secured Overnight Financing Rate (SOFR) Rate and 2.5%plus (y) an applicable margin of 6.5%. All repayments are subject to the accrued exit fee. Commencing on September 30, 2029, and on the last business day of each fiscal quarter thereafter, we are required to make a scheduled principal payment equal to 2.5%of the unpaid principal amount of the loans outstanding on the fourth anniversary of the Closing Date, together with any applicable exit fee. We may elect to prepay all or a portion of the amounts owed prior to the Maturity Date subject to a repayment premium, in addition to the exit fee. Any undrawn amount of the Delayed Draw Loans bears an fee of 0.5%based on the amount that remains undrawn through June 30, 2027. The interest rate for borrowings under the Credit Agreement as of September 30, 2025 was 10.8%.
    
    
      The Credit Facility is also subject to customary mandatory prepayments with the proceeds of indebtedness and certain asset sales and casualty events. In addition to the exit fee and repayment premium referenced above, voluntary and mandatory prepayments and all other payments of the Credit Facility must also be accompanied by payment of accrued interest on the principal amount repaid or prepaid. The Credit Facility is also subject to other customary fee arrangements.
    
    
      Our obligations are guaranteed by certain of our material subsidiaries (the "Credit Facility Guarantors") pursuant to a Guarantee. Our obligations and the Credit Facility Guarantors under the Credit Agreement and Guarantee are secured by substantially all of our assets and the Credit Facility Guarantors under a Pledge and Security Agreement entered into with the Administrative Agent.
    
    
      The Credit Facility requires us and our subsidiaries, on a consolidated basis, to comply with a minimum trailing twelve-month revenue test as of the end of each month, commencing with the month ending December 31, 2025 at $615.0 million and increasing quarterly to $974.0 million beginning on December 31, 2029 and thereafter. In addition, the Credit Facilitycontains customary representations and warranties and affirmative and negative covenants, including covenants that limit or restrict us and our subsidiaries' ability to incur liens, incur indebtedness, dispose of assets, make investments, make certain restricted payments, merge or consolidate and enter into certain speculative hedging arrangements. The Credit Facilityincludes a number of customary events of default, including, among other things, nonpayment defaults, covenant defaults, cross-defaults to other material indebtedness, bankruptcy and insolvency defaults, material judgment defaults and the occurrence of a change of control. If any event of default occurs (subject, in certain instances, to specified grace periods), the principal, premium, if any, interest and any other monetary obligations on all the then outstanding amounts under the Credit Facility may become due and payable immediately. As of September 30, 2025, we were in compliance with all covenants under the Credit Agreement.
    
    
      We believe that our existing capital resources will be sufficient to meet our projected operating requirements for at least the next 12 months. Our available capital resources, however, may be consumed more rapidly than currently expected, or may be insufficient for our business needs for many reasons, including as a result of our operational cash needs or capital expenditures. Our available cash from operations has been and may continue to be impacted by delays in the timing of the payment of receivables due to claims review, audit and appeal processes. In addition, we are subject to covenants under our Credit Facilitywhich could limit our ability to incur additional indebtedness or impact our ability to pursue other financing. If we do not generate sufficient cash from operations, if our capital resources are consumed more rapidly than expected, or if we no longer have access to additional funds under our Credit Facilityand we are unable to secure additional funds on acceptable terms, or at all, we may be forced to delay, scale back or eliminate some of our sales and marketing efforts, research and development activities, or other operations; or delay development of our tests in an effort to provide sufficient funds to continue our operations. If any of these events occur, our ability to achieve our development and commercialization goals could be adversely affected.
    
    
      From time to time, we enter into purchase commitments or other agreements that may materially impact our liquidity position in future periods.
    
    
      Third-party payors, including state and federal health care programs such as Medicare, managed care organizations, and other private health insurers, are increasingly attempting to contain health care costs by limiting or denying coverage for certain tests and reducing reimbursement rates for both new and existing tests. We have experienced and may continue to experience coverage limitations or denials for many of our products. For example, UnitedHealthcare updated its medical policies for pharmacogenetic testing to no longer provide coverage for certain multi-gene panel pharmacogenetic tests, including our GeneSight test, under its commercial, individual exchange, and certain managed Medicaid benefit plans, effective during 2025. The change in UnitedHealthcare coverage has negatively impacted our Pharmacogenomics revenue, profitability, and cash flow in 2025 and we expect that these negative impacts will continue into future periods.
    
    
      The following table represents the balances of cash and cash equivalents as of the dates set forth in the table below: 
    
    
      
        
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            (in millions)
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            September 30, 
            2025
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           | 
          
           | 
          
            December 31, 
            2024
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            Change
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            Cash and cash equivalents
           | 
          
            $
           | 
          
            145.4  
           | 
          
           | 
          
           | 
          
           | 
          
            $
           | 
          
            102.4  
           | 
          
           | 
          
           | 
          
            $
           | 
          
            43.0  
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      The increase in cash and cash equivalents as of September 30, 2025 as compared to December 31, 2024 was primarily driven by a net increase in cash proceeds from borrowings of $76.1 million under our new Credit Facility partially offset by $21.4 million in cash used for capital expenditures including the capitalization of internal-use software and $8.8 million in cash used for operating activities.
    
    
      The following table represents the Condensed Consolidated Cash Flow Statement:
    
    
      
        
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           | 
          
            Nine Months Ended September 30,
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            (in millions)
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            2025
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            2024
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            Change
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            Cash flows used in operating activities
           | 
          
            $
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            (8.8)
           | 
          
           | 
          
           | 
          
           | 
          
            $
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            (15.3)
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           | 
          
           | 
          
            $
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            6.5  
           | 
          
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            Cash flows used in investing activities
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            (21.4)
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           | 
          
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            (6.0)
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           | 
          
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            (15.4)
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            Cash flows provided by (used in) financing activities
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            72.4  
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            (9.5)
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            81.9  
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            Effect of foreign exchange rates on cash, cash equivalents, and restricted cash
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            0.7  
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            (0.3)
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            1.0  
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              Net increase (decrease) in cash, cash equivalents, and restricted cash
             
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            42.9  
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            (31.1)
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           | 
          
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            74.0  
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            Cash, cash equivalents, and restricted cash at the beginning of the period
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            111.9  
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           | 
          
           | 
          
           | 
          
            140.9  
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            (29.0)
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            Cash, cash equivalents, and restricted cash at the end of the period
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            $
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            154.8  
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            $
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            109.8  
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            $
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            45.0  
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      Cash Flows from Operating Activities
    
    
      We used $6.5 million less cash for operating activities for the nine months ended September 30, 2025 compared to the same period in the prior year. The decrease in cash used for operating activities was primarily driven by changes in working capital.
    
    
      Cash Flows from Investing Activities
    
    
      We used $15.4 million more cash for investing activities for the nine months ended September 30, 2025 compared to the same period in the prior year. In fiscal year 2024, we had cash inflows from the maturities of investments and the sale of our EndoPredict business, which did not occur in 2025.
    
    
      Cash Flows from Financing Activities
    
    
      Cash flows from financing activities increased $81.9 million for the nine months ended September 30, 2025 compared to the same period in the prior year, primarily due to an increase of cash proceeds from our new Credit Facility of $76.1 million, net of the repayment of our prior ABL Facility and debt issuance costs related to the term loan.
    
    
      Effects of Inflation
    
    
      While inflation returned to more moderate levels in 2024 and 2025, inflation has had, and may continue to have, an impact on the labor costs we incur to attract and retain qualified personnel, costs to generate sales and produce testing results, and costs of laboratory supplies. If inflation were to increase, it may negatively impact our profitability and may adversely affect our business, financial condition and results of operations. In addition, increased inflation has had, and may continue to have, an effect on interest rates. An increase in interest rates in the future may adversely affect our borrowing rate and our ability to obtain, or the terms under which we can obtain, additional funding. Furthermore, to the extent tariffs imposed by the United States affect our costs, we may not be able to pass on any portion of the cost increase to our customers.
    
    
      Critical Accounting Estimates
    
    
      Critical accounting estimates are those estimates made in accordance with generally accepted accounting principles that involve a significant level of estimation uncertainty and have had or are reasonably likely to have a material impact on a company's financial condition or results of operations. For a further discussion of our critical accounting estimates, see our Annual Report on Form 10-K filed with the SEC on February 28, 2025 and our Quarterly Report on Form 10-Q filed with the SEC on August 6, 2025. No significant changes to our critical accounting estimates took place during the three months ended September 30, 2025.