Exagen: Sustained Test Volume Growth and Solid Cash Runway Support Outperform Rating Despite Mixed Quarter

William Blair analyst Andrew Brackmann has maintained their bullish stance on XGN stock, giving a Buy rating yesterday.

Andrew Brackmann has given his Buy rating due to a combination of factors that, in his view, support Exagen’s long‑term value proposition despite a mixed quarter. He notes that while preliminary fourth-quarter revenue only roughly matched consensus and fell short of the midpoint of prior guidance, test volumes—particularly for AVISE CTD—continued to show strong double-digit growth, reinforcing confidence in underlying demand. Although average selling prices for AVISE CTD only edged up modestly and are likely to disappoint investors hoping for a sharper increase, they did at least meet expectations for the year. Brackmann also points out that Exagen’s cash position appears adequate to carry the company toward its profitability goals without immediate balance-sheet stress.

At the stock level, Brackmann regards the update as mixed but not thesis-breaking: meeting consensus on revenue, volume, and ASP should help prevent a major reset in valuation. He emphasizes that sustained volume momentum is a key positive, even as the timing and magnitude of ASP improvement remain an area of scrutiny and follow-up with management. Importantly, he continues to believe the company has the necessary elements in place to achieve durable, profitable growth over time. When coupled with what he views as an undemanding valuation of about 2x projected 2026 sales, these factors underpin his Outperform (Buy) rating on Exagen’s shares, while acknowledging ongoing risks around reimbursement, ASP uplift, capital needs, and early-stage pipeline initiatives.

In another report released yesterday, TD Cowen also reiterated a Buy rating on the stock with a $13.00 price target.

Based on the recent corporate insider activity of 6 insiders, corporate insider sentiment is negative on the stock. This means that over the past quarter there has been an increase of insiders selling their shares of XGN in relation to earlier this year.