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Exagen Inc (XGN)
NASDAQ:XGN

Exagen (XGN) AI Stock Analysis

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XGN

Exagen

(NASDAQ:XGN)

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Neutral 44 (OpenAI - 5.2)
Rating:44Neutral
Price Target:
$3.00
▲(1.01% Upside)
Action:ReiteratedDate:04/09/26
Overall score is held down primarily by weak financial performance driven by continued operating losses and negative free cash flow. Technicals also remain unfavorable with the stock below key moving averages and negative MACD. Offsetting these, a positive corporate update showing record revenue and improved cash supports the outlook, but not enough to outweigh current profitability and cash-generation risks.
Positive Factors
Record revenue and rising test volumes
Sustained top-line growth with higher volumes and quarter-to-quarter momentum signals durable clinical adoption of the AVISE franchise. Higher throughput supports scale economics and expanding gross profit dollars, strengthening the core revenue engine over the medium term.
Negative Factors
Persistent negative operating cash flow
Ongoing cash burn means the company remains reliant on financing or balance-sheet resources to operate. Absent sustained positive operating cash flow, liquidity and the ability to self-fund scaling or absorb reimbursement setbacks are constrained, raising medium-term execution risk.
Read all positive and negative factors
Positive Factors
Negative Factors
Record revenue and rising test volumes
Sustained top-line growth with higher volumes and quarter-to-quarter momentum signals durable clinical adoption of the AVISE franchise. Higher throughput supports scale economics and expanding gross profit dollars, strengthening the core revenue engine over the medium term.
Read all positive factors

Exagen (XGN) vs. SPDR S&P 500 ETF (SPY)

Exagen Business Overview & Revenue Model

Company Description
Exagen Inc. develops and commercializes various testing products based on its cell-bound complement activation products technology under the AVISE brand in the United States. It enables rheumatologists to care for patients through the diagnosis, p...
How the Company Makes Money
Exagen makes money primarily by performing its proprietary autoimmune diagnostic tests as a clinical laboratory service and recognizing revenue when those tests are ordered by healthcare providers and processed by Exagen. The core revenue stream i...

Exagen Key Performance Indicators (KPIs)

Any
Any
Revenue by Customer Category
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.
Chart InsightsCommercial revenue has rebounded strongly since 2022 and now drives growth, with recent quarters showing clear acceleration; Client Direct Bill is also ramping, suggesting successful push into direct channels. Government looks like a less reliable contributor after an isolated spike, and Janssen revenue has disappeared—indicative of a lost/ended contract that raises customer‑concentration risk. The company is shifting toward scalable commercial/direct revenue, which boosts growth potential but increases dependence on retaining and expanding commercial relationships.
Data provided by:The Fly

Exagen Earnings Call Summary

Earnings Call Date:Nov 04, 2025
(Q3-2025)
|
% Change Since: |
Next Earnings Date:May 12, 2026
Earnings Call Sentiment Neutral
The earnings call highlighted strong revenue and volume growth, the successful launch of new products, and increased pharma services revenue. However, challenges such as the loss of a high ASP account, slower ASP gains, and increased expenses indicate areas of concern. While the company shows positive operational momentum, financial challenges balance the sentiment.
Positive Updates
Record Quarter Revenue
Fourth quarter revenue of $17.2 million was the highest quarter in Exagen's history, marking a nearly 40% increase over the third quarter of 2024, even considering over $1 million in downside revenue adjustments in Q3 of last year.
Negative Updates
Loss of High ASP Direct Bill Account
A large high ASP direct bill account was lost, impacting ASP as the business converted to a standard commercial insurance payer mix.
Read all updates
Q3-2025 Updates
Negative
Record Quarter Revenue
Fourth quarter revenue of $17.2 million was the highest quarter in Exagen's history, marking a nearly 40% increase over the third quarter of 2024, even considering over $1 million in downside revenue adjustments in Q3 of last year.
Read all positive updates
Company Guidance
During Exagen Inc.'s Q3 2025 earnings call, the company reported a robust 19% year-to-date revenue growth, attributed to an 8% increase in testing volume and a 9% rise in average selling price (ASP). The company launched anti-PAD4 antibodies, its second rheumatoid arthritis biomarker set for the year, although its immediate revenue impact is expected to be modest. Exagen is on track to achieve $65 million to $70 million in revenue for 2025, with the potential to be cash flow positive at the high end of this range, though sustained cash flow positivity might be delayed until 2026 due to ASP challenges. The company also highlighted a significant revenue increase in its Pharma Services business, generating $780,000 this quarter, and continues to see a strong order backlog of $3.5 million. Despite losing a high ASP direct bill account, Exagen's revenue has benefited from volume growth, and the company continues to work on ASP expansion through revenue cycle management, appeals, and payer education efforts.

Exagen Financial Statement Overview

Summary
Financial profile is constrained by ongoing losses and persistent cash burn. While revenue growth and narrowing losses versus 2022 are positives and the balance sheet improved with sharply reduced debt and higher equity, operating cash flow and free cash flow remain negative each year, keeping risk elevated until profitability and cash generation improve.
Income Statement
34
Negative
Balance Sheet
52
Neutral
Cash Flow
28
Negative
BreakdownDec 2025Dec 2024Dec 2023Dec 2022Dec 2021
Income Statement
Total Revenue66.58M55.64M52.55M45.56M48.30M
Gross Profit38.80M33.11M29.46M21.35M27.71M
EBITDA-11.95M-11.14M-19.15M-43.66M-23.10M
Net Income-19.95M-15.12M-23.69M-47.39M-26.85M
Balance Sheet
Total Assets58.02M44.69M56.94M86.22M123.44M
Cash, Cash Equivalents and Short-Term Investments32.22M22.04M36.49M62.39M99.44M
Total Debt5.40M23.00M23.23M35.20M28.07M
Total Liabilities40.57M35.15M34.25M43.76M38.51M
Stockholders Equity17.45M9.54M22.69M42.46M84.94M
Cash Flow
Free Cash Flow-14.27M-13.79M-15.29M-36.46M-22.64M
Operating Cash Flow-13.63M-13.28M-14.46M-32.14M-20.27M
Investing Cash Flow-626.00K-515.00K-804.00K-4.32M-2.42M
Financing Cash Flow24.43M-663.00K-10.63M-489.00K64.68M

Exagen Technical Analysis

Technical Analysis Sentiment
Negative
Last Price2.97
Price Trends
50DMA
3.24
Negative
100DMA
4.80
Negative
200DMA
7.15
Negative
Market Momentum
MACD
-0.10
Negative
RSI
44.10
Neutral
STOCH
63.05
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For XGN, the sentiment is Negative. The current price of 2.97 is above the 20-day moving average (MA) of 2.95, below the 50-day MA of 3.24, and below the 200-day MA of 7.15, indicating a neutral trend. The MACD of -0.10 indicates Negative momentum. The RSI at 44.10 is Neutral, neither overbought nor oversold. The STOCH value of 63.05 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Negative sentiment for XGN.

Exagen Risk Analysis

Exagen disclosed 72 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

Overall Rating
UnderperformOutperform
Sector (51)
Financial Indicators
Name
Overall Rating
Market Cap
P/E Ratio
ROE
Dividend Yield
Revenue Growth
EPS Growth
61
Neutral
$298.37M-36.02%159.45%8.59%
52
Neutral
$487.20M-4.66-52.04%-41.87%-165.76%
51
Neutral
$7.86B-0.30-43.30%2.27%22.53%-2.21%
48
Neutral
$77.11M-4.68-47.69%1.06%22.41%
45
Neutral
$93.52M-2.33-138.87%78.62%32.39%
44
Neutral
$72.88M-6.57-126.62%14.08%1.34%
43
Neutral
$104.78M-5.33516.59%21.68%58.30%
* Healthcare Sector Average
Performance Comparison
Ticker
Company Name
Price
Change
% Change
XGN
Exagen
3.04
-1.37
-31.07%
ACRS
Aclaris Therapeutics
3.92
2.80
250.00%
MDXH
MDxHealth
2.27
0.67
41.87%
STIM
Neuronetics
1.43
-2.34
-62.07%
PRE
Prenetics Group
18.01
14.20
372.70%
SERA
Sera Prognostics
2.14
-1.16
-35.15%

Exagen Corporate Events

Business Operations and StrategyFinancial Disclosures
Exagen Announces Record 2025 Revenue and Strong Cash Position
Positive
Jan 12, 2026
On January 11, 2026, Exagen Inc. reported select preliminary unaudited results for the fourth quarter and full year ended December 31, 2025, indicating record annual revenue of $66 million to $67 million, up 19% to 20% year over year, with fourth-...
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.Date of analysis: Apr 09, 2026