EXACT SCIENCES CORP, 10-Q filed on 11/3/2025
Quarterly Report
v3.25.3
Cover Page - shares
 9 Months Ended
Sep. 30, 2025
Oct. 31, 2025
Cover [Abstract]    
Document Type 10-Q  
Document Quarterly Report true  
Document Period End Date Sep. 30, 2025  
Document Transition Report false  
Entity File Number 001-35092  
Entity Registrant Name EXACT SCIENCES CORPORATION  
Entity Incorporation, State or Country Code DE  
Entity Tax Identification Number 02-0478229  
Entity Address, Address Line One 5505 Endeavor Lane  
Entity Address, City or Town Madison  
Entity Address, State or Province WI  
Entity Address, Postal Zip Code 53719  
City Area Code 608  
Local Phone Number 284-5700  
Title of 12(b) Security Common Stock, $0.01 par value per share  
Trading Symbol EXAS  
Security Exchange Name NASDAQ  
Entity Current Reporting Status Yes  
Entity Interactive Data Current Yes  
Entity Filer Category Large Accelerated Filer  
Entity Small Business false  
Entity Emerging Growth Company false  
Entity Shell Company false  
Entity Common Stock, Shares Outstanding   189,471,298
Document Fiscal Year Focus 2025  
Document Fiscal Period Focus Q3  
Entity Central Index Key 0001124140  
Amendment Flag false  
Current Fiscal Year End Date --12-31  
v3.25.3
Condensed Consolidated Balance Sheets - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Current assets:    
Cash and cash equivalents $ 789,037 $ 600,889
Marketable securities 214,058 437,137
Accounts receivable, net 306,051 248,968
Inventory 164,784 162,383
Prepaid expenses and other current assets 116,796 122,046
Total current assets 1,590,726 1,571,423
Property, plant and equipment, net 704,065 693,673
Long-term Assets:    
Operating lease right-of-use assets 121,114 116,952
Goodwill 2,368,028 2,366,676
Intangible assets, net 941,200 1,009,693
Other long-term assets, net 174,876 169,722
Total assets 5,900,009 5,928,139
Current liabilities:    
Accounts payable 129,356 89,572
Accrued liabilities 408,774 328,292
Operating lease liabilities, current portion 31,851 27,405
Convertible Notes Payable, Current 0 249,153
Other current liabilities 14,279 37,765
Total current liabilities 584,260 732,187
Long-term liabilities:    
Convertible notes, net, less current portion 2,325,637 2,321,067
Other long-term liabilities 324,807 315,503
Operating lease liabilities, less current portion 163,886 157,133
Total liabilities 3,398,590 3,525,890
Commitments and contingencies (Note 13)
Stockholders’ equity:    
Preferred stock, $0.01 par value Authorized—5,000,000; shares issued and outstanding—no shares at September 30, 2025 and December 31, 2024 0 0
Common stock, $0.01 par value Authorized—400,000,000; shares issued and outstanding—189,452,459 and 185,616,438 shares at September 30, 2025 and December 31, 2024 1,896 1,857
Additional paid-in capital 7,116,306 6,899,368
Accumulated other comprehensive income (loss) 3,243 (944)
Accumulated deficit (4,620,026) (4,498,032)
Total stockholders’ equity 2,501,419 2,402,249
Total liabilities and stockholders’ equity $ 5,900,009 $ 5,928,139
v3.25.3
Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares
Sep. 30, 2025
Dec. 31, 2024
Statement of Financial Position [Abstract]    
Preferred stock, par value (in dollars per share) $ 0.01 $ 0.01
Preferred stock, authorized (in shares) 5,000,000 5,000,000
Preferred stock, issued (in shares) 0 0
Preferred stock, outstanding (in shares) 0 0
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
Common stock, authorized (in shares) 400,000,000 400,000,000
Common stock, issued (in shares) 189,452,459 185,616,438
Common stock, outstanding (in shares) 189,452,459 185,616,438
v3.25.3
Condensed Consolidated Statements of Operations - USD ($)
shares in Thousands, $ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Income Statement [Abstract]        
Net loss $ (19,594) $ (38,236) $ (121,994) $ (164,272)
Net loss before tax (17,757) (37,428) (118,805) (160,195)
Loss from operations (25,545) (39,403) (123,703) (172,352)
Operating Expenses, Total 609,474 533,988 1,770,632 1,605,108
Research and development 117,290 101,487 331,501 333,501
Sales and marketing 250,228 220,264 761,656 649,596
General and administrative 241,413 193,539 670,681 590,715
Impairment of long-lived and indefinite-lived assets 543 18,698 6,794 31,296
Gross Profit, Total 583,929 491,485 1,646,929 1,426,124
Revenue 850,739 708,655 2,368,609 2,045,443
Cost of sales 266,810 217,170 721,680 619,319
Other operating income 0 3,100 0 6,632
Total other income 7,788 1,975 4,898 12,157
Investment income, net 17,577 11,582 34,500 29,596
Interest expense, net (9,789) (9,607) (29,602) (17,439)
Income tax expense $ (1,837) $ (808) $ (3,189) $ (4,077)
Increase (decrease) in net loss per share (in usd per share) $ (0.10) $ (0.21) $ (0.65) $ (0.89)
Net loss per share—basic (in usd per share) $ (0.10) $ (0.21) $ (0.65) $ (0.89)
Weighted average common shares outstanding—diluted (in shares) 189,262 184,795 188,335 183,823
Weighted average common shares outstanding—basic (in shares) 189,262 184,795 188,335 183,823
v3.25.3
Condensed Consolidated Statements of Comprehensive Loss - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Statement of Comprehensive Income [Abstract]        
Comprehensive income (loss) $ (19,437) $ (32,663) $ (117,807) $ (161,070)
Other Comprehensive Income (Loss), Foreign Currency Transaction and Translation Gain (Loss) Arising During Period, Net of Tax 12 1,873 4,201 427
OCI, Debt Securities, Available-for-Sale, Gain (Loss), before Adjustment, after Tax 145 3,700 (14) 2,775
Net loss $ (19,594) $ (38,236) $ (121,994) $ (164,272)
v3.25.3
Condensed Consolidated Statements of Stockholders' Equity - USD ($)
$ in Thousands
Total
Common Stock
Additional Paid-In Capital
Accumulated Other Comprehensive Income (Loss)
Accumulated Deficit​
Common Stock Including Additional Paid in Capital
Beginning balance (in shares) at Dec. 31, 2023   181,364,180        
Beginning balance at Dec. 31, 2023 $ 3,145,305 $ 1,815 $ 6,611,237 $ 1,428 $ (3,469,175)  
Increase (Decrease) in Stockholders' Equity            
Exercise of common stock options (in shares)   71,537        
Stock Issued During Period, Value, Stock Options Exercised   $ 1 (1,409)     $ (1,408)
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures   1,792,087        
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures (44) $ 17 (61)      
Issuance of common stock to fund the Company's 401(k) match (in shares)   617,384        
Issuance of common stock to fund the Company's 401(k) match 40,550 $ 6 40,544      
Employee Benefits and Share-Based Compensation 60,370   60,370      
Net loss (110,228)       (110,228)  
Other comprehensive income (loss) (1,927)     (1,927)    
Ending balance (in shares) at Mar. 31, 2024   183,845,188        
Ending balance at Mar. 31, 2024 3,132,618 $ 1,839 6,710,681 (499) (3,579,403)  
Beginning balance (in shares) at Dec. 31, 2023   181,364,180        
Beginning balance at Dec. 31, 2023 3,145,305 $ 1,815 6,611,237 1,428 (3,469,175)  
Increase (Decrease) in Stockholders' Equity            
Issuance of common stock to fund the Company's 401(k) match 40,550          
Net loss (164,272)          
Ending balance (in shares) at Sep. 30, 2024   185,054,760        
Ending balance at Sep. 30, 2024 3,210,511 $ 1,852 6,837,476 4,630 (3,633,447)  
Beginning balance (in shares) at Mar. 31, 2024   183,845,188        
Beginning balance at Mar. 31, 2024 3,132,618 $ 1,839 6,710,681 (499) (3,579,403)  
Increase (Decrease) in Stockholders' Equity            
Exercise of common stock options (in shares)   8,184        
Stock Issued During Period, Value, Stock Options Exercised   $ 1 42     43
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures   210,590        
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures (4) $ 2 (6)      
Employee Benefits and Share-Based Compensation 56,555   56,555      
Stock Issued During Period, Shares, Employee Stock Purchase Plans   604,226        
Stock Issued During Period, Value, Employee Stock Purchase Plan 19,402 $ 6 19,396      
Net loss (15,808)       (15,808)  
Other comprehensive income (loss) (444)     (444)    
Ending balance (in shares) at Jun. 30, 2024   184,668,188        
Ending balance at Jun. 30, 2024 3,192,362 $ 1,848 6,786,668 (943) (3,595,211)  
Increase (Decrease) in Stockholders' Equity            
Exercise of common stock options (in shares)   79,871        
Stock Issued During Period, Value, Stock Options Exercised   $ 1 2,131     2,132
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures   306,701        
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures (77) $ 3 (80)      
Employee Benefits and Share-Based Compensation 48,757   48,757      
Net loss (38,236)       (38,236)  
Other comprehensive income (loss) 5,573     5,573    
Ending balance (in shares) at Sep. 30, 2024   185,054,760        
Ending balance at Sep. 30, 2024 $ 3,210,511 $ 1,852 6,837,476 4,630 (3,633,447)  
Beginning balance (in shares) at Dec. 31, 2024 185,616,438 185,616,438        
Beginning balance at Dec. 31, 2024 $ 2,402,249 $ 1,857 6,899,368 (944) (4,498,032)  
Increase (Decrease) in Stockholders' Equity            
Exercise of common stock options (in shares)   35,349        
Stock Issued During Period, Value, Stock Options Exercised   $ 0 (422)     (422)
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures   2,149,825        
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures (4,223) $ 22 (4,245)      
Issuance of common stock to fund the Company's 401(k) match (in shares)   793,057        
Issuance of common stock to fund the Company's 401(k) match 43,943 $ 8 43,935      
Employee Benefits and Share-Based Compensation 54,618   54,618      
Net loss (101,215)       (101,215)  
Other comprehensive income (loss) 1,957     1,957    
Ending balance (in shares) at Mar. 31, 2025   188,594,669        
Ending balance at Mar. 31, 2025 $ 2,396,907 $ 1,887 6,993,254 1,013 (4,599,247)  
Beginning balance (in shares) at Dec. 31, 2024 185,616,438 185,616,438        
Beginning balance at Dec. 31, 2024 $ 2,402,249 $ 1,857 6,899,368 (944) (4,498,032)  
Increase (Decrease) in Stockholders' Equity            
Issuance of common stock to fund the Company's 401(k) match 43,943          
Net loss $ (121,994)          
Ending balance (in shares) at Sep. 30, 2025 189,452,459 189,452,459        
Ending balance at Sep. 30, 2025 $ 2,501,419 $ 1,896 7,116,306 3,243 (4,620,026)  
Beginning balance (in shares) at Mar. 31, 2025   188,594,669        
Beginning balance at Mar. 31, 2025 2,396,907 $ 1,887 6,993,254 1,013 (4,599,247)  
Increase (Decrease) in Stockholders' Equity            
Exercise of common stock options (in shares)   8,223        
Stock Issued During Period, Value, Stock Options Exercised   $ 0 293     293
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures   198,615        
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures (490) $ 2 (492)      
Employee Benefits and Share-Based Compensation 55,783   55,783      
Stock Issued During Period, Shares, Employee Stock Purchase Plans   419,070        
Stock Issued During Period, Value, Employee Stock Purchase Plan 16,033 $ 4 16,029      
Net loss (1,185)       (1,185)  
Other comprehensive income (loss) 2,073     2,073    
Ending balance (in shares) at Jun. 30, 2025   189,220,577        
Ending balance at Jun. 30, 2025 2,469,414 $ 1,893 7,064,867 3,086 (4,600,432)  
Increase (Decrease) in Stockholders' Equity            
Exercise of common stock options (in shares)   7,425        
Stock Issued During Period, Value, Stock Options Exercised   $ 1 208     $ 209
Stock Issued During Period, Shares, Restricted Stock Award, Net of Forfeitures   224,457        
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures (390) $ 2 (392)      
Employee Benefits and Share-Based Compensation 51,623   51,623      
Net loss (19,594)       (19,594)  
Other comprehensive income (loss) $ 157     157    
Ending balance (in shares) at Sep. 30, 2025 189,452,459 189,452,459        
Ending balance at Sep. 30, 2025 $ 2,501,419 $ 1,896 $ 7,116,306 $ 3,243 $ (4,620,026)  
v3.25.3
Condensed Consolidated Statements of Stockholders' Equity (Parenthetical) - $ / shares
Sep. 30, 2025
Dec. 31, 2024
Sep. 30, 2024
Statement of Financial Position [Abstract]      
Common stock, par value (in dollars per share) $ 0.01 $ 0.01 $ 0.01
v3.25.3
Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Cash flows from operating activities:    
Net loss $ (121,994) $ (164,272)
Adjustments, Noncash Items, to Reconcile Net Income (Loss) to Cash Provided by (Used in) Operating Activities [Abstract]    
Depreciation 92,765 90,655
Equity Securities, FV-NI, Gain (Loss) 6,817 (1,772)
Deferred tax expense (benefit) (512) 1,827
Stock-based compensation 162,024 165,682
Gain on Settlement of Convertible Notes 0 10,254
Amortization of acquired intangible assets 72,461 71,057
Impairment of long-lived and indefinite-lived assets 6,794 31,296
Gain (Loss) On Contingent Consideration From Disposition Of Asset 0 (6,632)
Remeasurement of contingent consideration liabilities 21,901 (2,326)
Non-cash lease expense 20,248 20,645
Other Noncash Income (Expense) 8,867 (1,437)
Changes in assets and liabilities:    
Accounts receivable, net (56,233) (61,410)
Inventory, net (2,356) (9,516)
Increase (Decrease) in Operating Lease Liability (21,117) (19,345)
Accounts payable and accrued liabilities 165,183 38,258
Other assets (12,194) (6,358)
Other liabilities (13,659) 11,115
Net cash provided by operating activities 339,749 163,473
Cash flows from investing activities:    
Purchases of marketable securities (140,269) (405,385)
Maturities and sales of marketable securities 370,482 150,916
Purchases of property, plant and equipment (103,413) (99,673)
Payments to Acquire Intangible Assets 0 (45,000)
Payments to Acquire Other Investments (51,064) (916)
Proceeds From Contingent Consideration Receivable 27,971 0
Other investing activities 297 (225)
Net cash provided by (used in) investing activities 104,004 (400,283)
Cash flows from financing activities:    
Repayments of Convertible Debt (249,172) 0
Payment, Tax Withholding, Share-Based Payment Arrangement 80 767
Proceeds from Stock Plans 16,033 19,402
Repayments of Accounts Receivable Securitization 0 (50,000)
Proceeds from Convertible Debt 0 266,750
Payment for Contingent Consideration Liability, Financing Activities 19,000 0
Other financing activities (10,158) (15,544)
Net cash provided by (used in) financing activities (262,217) 221,375
Reconciliation of cash, cash equivalents and restricted cash:    
Cash and cash equivalents 789,037 588,830
Restricted cash — included in other long-term assets, net 0 5,837
Total cash, cash equivalents and restricted cash 789,037 594,667
Supplemental disclosure of cash flow information:    
Interest paid 24,281 21,109
Supplemental disclosure of non-cash investing and financing activities    
Issuance of common stock to fund the Company's 401(k) match 43,943 40,550
Property, plant and equipment acquired but not paid 10,773 11,904
Cash, cash equivalents and restricted cash, end of period 789,037 594,667
Cash, cash equivalents and restricted cash, beginning of period 606,636 609,675
Net increase (decrease) in cash, cash equivalents and restricted cash 182,401 (15,008)
Effects of exchange rate changes on cash and cash equivalents $ 865 $ 427
v3.25.3
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
 9 Months Ended
Sep. 30, 2025
Accounting Policies [Abstract]  
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Business
Exact Sciences Corporation (together with its subsidiaries, “Exact,” or the “Company”) was incorporated in February 1995. A leading provider of cancer screening and diagnostic tests, Exact Sciences gives patients and health care professionals the clarity needed to take life-changing action earlier. Building on the success of Cologuard® and Oncotype DX® tests, Exact Sciences is investing in its pipeline to develop innovative solutions for use before, during, and after a cancer diagnosis.
Basis of Presentation and Principles of Consolidation
The accompanying condensed consolidated financial statements, which include the accounts of the Company and those of its wholly owned subsidiaries and variable interest entities, are unaudited and have been prepared on a basis substantially consistent with the Company’s audited financial statements and notes as of and for the year ended December 31, 2024 included in the Company’s Annual Report on Form 10-K (the “2024 Form 10-K”). All intercompany transactions and balances have been eliminated upon consolidation. These condensed consolidated financial statements are prepared in conformity with accounting principles generally accepted (“GAAP”) in the United States of America (“U.S.”) and follow the requirements of the Securities and Exchange Commission (“SEC”) for interim reporting. In the opinion of management, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting only of adjustments of a normal and recurring nature) considered necessary for a fair statement of its financial position, operating results and cash flows for the periods presented. The condensed consolidated balance sheet at December 31, 2024 has been derived from audited financial statements, but does not contain all of the footnote disclosures from the 2024 Form 10-K. The results of the Company’s operations for any interim period are not necessarily indicative of the results of the Company’s operations for any other interim period or for a full fiscal year. The statements should be read in conjunction with the audited financial statements and related notes included in the 2024 Form 10-K.
Use of Estimates
The preparation of the condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Critical accounting policies are those that affect the Company’s financial statements materially and involve difficult, subjective or complex judgments by management, and actual results could differ from those estimates. These estimates include revenue recognition, valuation of intangible assets and goodwill, contingent consideration, and accounting for income taxes. The Company’s critical accounting policies and estimates are explained further in the notes to the condensed consolidated financial statements in this Quarterly Report on Form 10-Q and the 2024 Form 10-K.
Significant Accounting Policies
During the nine months ended September 30, 2025, there were no changes to the Company’s significant accounting policies as described in the Company’s 2024 Form 10-K, except as described in the Recently Adopted Accounting Pronouncements sections below.
Reclassifications
Certain prior year amounts have been reclassified to conform to the current year presentation in the condensed consolidated financial statements and accompanying notes to the condensed consolidated financial statements.
Amortization of acquired intangible assets, which was previously presented as a separate line item on the Company’s condensed consolidated statements of operations, is now presented within the line item each intangible asset relates to within cost of sales, research and development, sales and marketing, and general and administrative expenses. The following amounts of amortization of acquired intangible assets for the three and nine months ended September 30, 2024 have been reclassified to conform to current year presentation: $21.1 million and $63.3 million in cost of sales, respectively, $1.4 million and $1.9 million in research and development, respectively, $1.9 million and $5.8 million in sales and marketing, respectively, and an insignificant amount in general and administrative expenses. Due to the reclassification related to cost of sales, the Company is now presenting gross profit on the Company's condensed consolidated statements of operations.
Certain general and administrative expenses totaling $23.7 million and $71.5 million for the three and nine months ended September 30, 2024, respectively, have been reclassified to sales and marketing expenses to conform to current year presentation. The amounts reclassified are related to customer care and customer experience.
Recent Accounting Pronouncements
Recently Adopted Accounting Pronouncements
The Company did not adopt any accounting standards updates (“ASU”) released by the Financial Accounting Standards Board (“FASB”) in the third quarter of 2025.
Recently Issued Accounting Pronouncements Not Yet Adopted
In October 2023, the FASB issued ASU No. 2023-06, Disclosure Improvements: Codification Amendments in Response to the SEC’s Disclosure Update and Simplification Initiative. This update modifies the disclosure or presentation requirements of a variety of topics in the Accounting Standards Codification to conform with certain SEC amendments in Release No. 33-10532, Disclosure Update and Simplification. The amendments in this update should be applied prospectively, and the effective date for each amendment will be the date on which the SEC’s removal of that related disclosure from Regulation S-X or S-K becomes effective. However, if the SEC has not removed the related disclosure from its regulations by June 30, 2027, the amendments will be removed from the Codification and not become effective. Early adoption is prohibited. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This update improves income tax disclosure requirements, primarily through enhanced transparency and decision usefulness of disclosures. The amendments in this update should be applied prospectively with the option to apply retrospectively and are effective for fiscal years beginning after December 15, 2024. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements and expects to adopt this guidance in the 2025 Annual Report on Form 10-K.
In November 2024, the FASB issued ASU No. 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses. This update enhances financial statement disclosures by requiring public business entities to disclose specified information about certain costs and expenses including the amounts of (a) purchases of inventory, (b) employee compensation, (c) depreciation, and (d) intangible asset amortization included in each relevant expense caption. The update also requires disclosure of certain amounts that are already required to be disclosed under current GAAP, disclosure of a qualitative description of the amounts remaining in relevant expense captions that are not separately disaggregated quantitatively, and disclosure of the total amount of selling expenses and, in annual reporting periods, an entity’s definition of selling expenses. The amendments in this update may be applied either prospectively or retrospectively and are effective for annual reporting periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In May 2025, the FASB issued ASU No. 2025-03, Business Combinations (Topic 805) and Consolidation (Topic 810): Determining the Accounting Acquirer in the Acquisition of a Variable Interest Entity. This guidance clarifies the framework for identifying the accounting acquirer in transactions involving variable interest entities that meet the definition of a business. The amendments should be applied prospectively and are effective for fiscal years beginning after December 15, 2026, including interim periods within those fiscal years. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In July 2025, the FASB issued ASU No. 2025-05, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses for Account Receivable and Contract Assets. This update introduces a practical expedient for all entities when estimating expected credit losses on current accounts receivable and current contract assets arising from revenue transactions accounted for under Topic 606. The expedient allows entities to assume current conditions as of the balance sheet date remain unchanged over the remaining life of the asset. The amendments are required to be applied prospectively and are effective for annual and interim periods beginning after December 15, 2025. Early adoption is permitted. The Company is currently evaluating adoption of the practical expedient.
In September 2025, the FASB issued ASU No. 2025-06, Intangibles—Goodwill and Other— Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software. This update provides amendments to clarify and modernize the accounting for costs incurred to develop or acquire internal-use software. The amendments address the capitalization of implementation costs by utilizing a principles-based approach and consolidates website development guidance under Subtopic 350-40. The amendments can be applied prospectively, modified prospectively, or retrospectively and are effective for annual and interim periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance and the timing of adoption.
In September 2025, the FASB issued ASU No. 2025-07, Derivatives and Hedging (Topic 815) and Revenue from Contracts with Customers (Topic 606): Derivatives Scope Refinements and Scope Clarification for Share-Based Noncash Consideration from a Customer in a Revenue Contract. This update introduces a scope exception to derivative accounting for certain contracts with underlyings tied to operations or activities specific to one of the parties. Additionally, the update clarifies that share-based noncash consideration received from a customer should be accounted for under Topic 606 until the right to receive or retain the consideration becomes unconditional. The amendments can be applied prospectively or modified retrospectively and are effective for annual and interim periods beginning after December 15, 2026. The Company expects to early adopt the provisions related to Topic 815 on a prospective basis and does not expect a significant impact to the Company’s consolidated financial statements. The provisions related to Topic 606 are not applicable.
Net Loss Per Share
Basic net loss per common share was determined by dividing net loss applicable to common stockholders by the weighted average common shares outstanding during the period. Basic and diluted net loss per share is the same because all outstanding common stock equivalents have been excluded, as they are anti-dilutive as a result of the Company’s losses.
The following potentially issuable common shares were not included in the computation of diluted net loss per share because they would have an anti-dilutive effect due to net losses for each period:
September 30,
(In thousands)20252024
Shares issuable upon conversion of convertible notes23,223 26,526 
Shares issuable upon the release of restricted stock awards7,655 7,487 
Shares issuable upon the release of performance share units2,578 2,037 
Shares issuable upon exercise of stock options848 1,028 
34,304 37,078 
Significant Accounting Policies
Significant Accounting Policies
During the nine months ended September 30, 2025, there were no changes to the Company’s significant accounting policies as described in the Company’s 2024 Form 10-K, except as described in the Recently Adopted Accounting Pronouncements sections below.
v3.25.3
REVENUE
 9 Months Ended
Sep. 30, 2025
Revenue from Contract with Customer [Abstract]  
REVENUE REVENUE
The Company’s revenue is primarily generated by its laboratory testing services utilizing its Cologuard and Oncotype® tests. The services are considered completed upon release of a patient’s test result to the ordering healthcare provider.
The following table presents the Company’s revenues disaggregated by revenue source:
Three Months Ended September 30,Nine Months Ended September 30,
(In thousands)2025202420252024
Screening
Medicare Parts B & C$247,353 $201,423 $675,923 $570,550 
Commercial354,867 289,637 978,565 827,509 
Other64,020 53,841 180,240 153,246 
Total Screening666,240 544,901 1,834,728 1,551,305 
Precision Oncology
Medicare Parts B & C$50,924 $47,080 $144,732 $142,597 
Commercial50,376 47,685 146,679 143,572 
International58,784 49,433 165,628 140,688 
Other24,415 19,556 76,842 67,281 
Total Precision Oncology184,499 163,754 533,881 494,138 
Total$850,739 $708,655 $2,368,609 $2,045,443 
Screening revenue primarily includes laboratory service revenue from Cologuard and PreventionGenetics, LLC tests while Precision Oncology revenue primarily includes laboratory service revenue from global Oncotype DX and therapy selection tests.
At each reporting period end, the Company conducts an analysis of the estimates used to calculate the transaction price to determine whether any new information available impacts those estimates made in prior reporting periods. Adjustments to revenue recognized during the period relating to prior period estimates were less than 1% of revenue recorded in the Company’s condensed consolidated statement of operations for the three and nine months ended September 30, 2025 and 2024.
The Company’s deferred revenue, which is reported in other current liabilities in the Company’s condensed consolidated balance sheets, was not significant as of September 30, 2025 and December 31, 2024.
Revenue recognized for the three and nine months ended September 30, 2025 and 2024 that was included in the deferred revenue balance at the beginning of the period was not significant.
v3.25.3
MARKETABLE SECURITIES
 9 Months Ended
Sep. 30, 2025
Cash and Cash Equivalents [Abstract]  
MARKETABLE SECURITIES MARKETABLE SECURITIES
The following table sets forth the Company’s cash, cash equivalents, and marketable securities at September 30, 2025 and December 31, 2024:
(In thousands)September 30, 2025December 31, 2024
Cash and cash equivalents
Cash and money market$781,729 $595,548 
Cash equivalents7,308 5,341 
Total cash and cash equivalents789,037 600,889 
Marketable securities
Available-for-sale debt securities$202,706 $431,165 
Equity securities11,352 5,972 
Total marketable securities214,058 437,137 
Total cash, cash equivalents and marketable securities$1,003,095 $1,038,026 
Available-for-sale debt securities, including the classification within the condensed consolidated balance sheet at September 30, 2025, consisted of the following:
(In thousands)Amortized Cost
Gains in Accumulated Other Comprehensive Income (Loss) (1)
Losses in Accumulated Other Comprehensive Income (Loss) (1)
Estimated Fair Value
Cash equivalents
U.S. government agency securities$7,308 $— $— $7,308 
Total cash equivalents7,308 — — 7,308 
Marketable securities
Corporate bonds$103,623 $652 $(20)$104,255 
U.S. government agency securities68,829 257 (1)69,085 
Asset backed securities29,292 78 (4)29,366 
Total marketable securities201,744 987 (25)202,706 
Total available-for-sale debt securities
$209,052 $987 $(25)$210,014 
______________
(1)There was no tax impact from the gains and losses in accumulated other comprehensive income (loss) (“AOCI”).
Available-for-sale debt securities, including the classification within the condensed consolidated balance sheet at December 31, 2024, consisted of the following:
(In thousands)Amortized Cost
Gains in Accumulated Other Comprehensive Income (Loss) (1)
Losses in Accumulated Other Comprehensive Income (Loss) (1)
Estimated Fair Value
Cash equivalents
U.S. government agency securities$5,341 $— $— $5,341 
Total cash equivalents5,341 — — 5,341 
Marketable securities
Corporate bonds$206,063 $932 $(121)$206,874 
U.S. government agency securities140,992 160 (200)140,952 
Asset backed securities83,134 256 (51)83,339 
Total marketable securities430,189 1,348 (372)431,165 
Total available-for-sale debt securities
$435,530 $1,348 $(372)$436,506 
______________
(1)There was no tax impact from the gains and losses in AOCI.
The following table summarizes contractual underlying maturities of the Company’s available-for-sale debt securities at September 30, 2025:
Due one year or lessDue after one year through five years
(In thousands)CostFair ValueCostFair Value
Cash equivalents
U.S. government agency securities$7,308 $7,308 $— $— 
Total cash equivalents7,308 7,308 — — 
Marketable securities
Corporate bonds$37,654 $37,822 $65,969 $66,433 
U.S. government agency securities25,777 25,811 43,052 43,274 
Asset backed securities15 16 29,277 29,350 
Total marketable securities63,446 63,649 138,298 139,057 
Total available-for-sale securities$70,754 $70,957 $138,298 $139,057 
The following table summarizes the gross unrealized losses and fair values of available-for-sale debt securities in an unrealized loss position as of September 30, 2025 aggregated by investment category and length of time those individual securities have been in a continuous unrealized loss position:
Less than one yearOne year or greaterTotal
(In thousands)Fair ValueGross Unrealized LossFair ValueGross Unrealized LossFair ValueGross Unrealized Loss
Marketable securities
Corporate bonds$9,575 $(20)$302 $— $9,877 $(20)
U.S. government agency securities8,600 (1)— — 8,600 (1)
Asset backed securities2,326 (4)15 — 2,341 (4)
Total available-for-sale securities$20,501 $(25)$317 $— $20,818 $(25)
The Company evaluates investments that are in an unrealized loss position for impairment as a result of credit loss. It was determined that no credit losses exist as of September 30, 2025 and December 31, 2024 because the change in market value for those securities in an unrealized loss position resulted from fluctuating interest rates rather than a deterioration of the credit worthiness of the issuers.
The gains and losses recorded on available-for-sale debt securities and equity securities are included in investment income, net in the Company’s condensed consolidated statements of operations. The gains and losses recorded were not significant for the three and nine months ended September 30, 2025 and 2024.
v3.25.3
INVENTORY
 9 Months Ended
Sep. 30, 2025
Inventory Disclosure [Abstract]  
INVENTORY INVENTORY
Inventory consisted of the following:
(In thousands)September 30, 2025December 31, 2024
Raw materials$70,645 $69,730 
Semi-finished and finished goods94,139 92,653 
Total inventory$164,784 $162,383 
v3.25.3
PROPERTY, PLANT AND EQUIPMENT
 9 Months Ended
Sep. 30, 2025
Property, Plant and Equipment [Abstract]  
PROPERTY, PLANT AND EQUIPMENT PROPERTY, PLANT AND EQUIPMENT
The carrying value and estimated useful lives of property, plant and equipment are as follows:
(In thousands)Estimated Useful LifeSeptember 30, 2025December 31, 2024
Property, plant and equipment
Landn/a$4,716 $4,716 
Leasehold and building improvements(1)243,879 227,885 
Land improvements15 years6,747 6,747 
Buildings
30 - 40 years
290,777 290,777 
Computer equipment and computer software3 years235,050 206,460 
Machinery and equipment
3 - 10 years
378,706 339,421 
Furniture and fixtures
3 - 10 years
36,381 37,176 
Assets under constructionn/a84,445 89,065 
Property, plant and equipment, at cost1,280,701 1,202,247 
Accumulated depreciation(576,636)(508,574)
Property, plant and equipment, net$704,065 $693,673 
______________
(1)Lesser of remaining lease term, building life, or estimated useful life.
Depreciation expense for the three months ended September 30, 2025 and 2024 was $31.7 million and $30.3 million, respectively. Depreciation expense for the nine months ended September 30, 2025 and 2024 was $92.8 million and $90.7 million, respectively.
At September 30, 2025, the Company had $84.4 million of assets under construction, which consisted of $35.1 million in machinery and equipment, $26.0 million in leasehold and building improvements, and $23.3 million in capitalized costs related to software projects. Depreciation will begin on these assets once they are placed into service upon completion.
v3.25.3
INTANGIBLE ASSETS AND GOODWILL
 9 Months Ended
Sep. 30, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
INTANGIBLE ASSETS AND GOODWILL INTANGIBLE ASSETS AND GOODWILL
Intangible Assets
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of September 30, 2025:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated Amortization
Net Balance at September 30, 2025
Finite-lived intangible assets
Acquired developed technology
5.8$887,498 $(474,965)$412,533 
Trade name10.1104,000 (40,590)63,410 
Patents and licenses8.859,492 (16,568)42,924 
Customer relationships5.34,000 (1,667)2,333 
Total finite-lived intangible assets1,054,990 (533,790)521,200 
In-process research and developmentn/a420,000 — 420,000 
Total intangible assets$1,474,990 $(533,790)$941,200 
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of December 31, 2024:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated Amortization
Net Balance at December 31, 2024
Finite-lived intangible assets
Acquired developed technology
6.4$887,104 $(412,504)$474,600 
Trade name10.8104,000 (35,153)68,847 
Patents and licenses9.556,542 (12,963)43,579 
Customer relationships6.04,000 (1,333)2,667 
Total finite-lived intangible assets1,051,646 (461,953)589,693 
In-process research and developmentn/a420,000 — 420,000 
Total intangible assets$1,471,646 $(461,953)$1,009,693 
Amortization of acquired intangible assets for the three months ended September 30, 2025 and 2024 was $24.2 million and $24.4 million, respectively. Amortization of acquired intangible assets for the nine months ended September 30, 2025 and 2024 was $72.5 million and $71.1 million, respectively.
As of September 30, 2025, the estimated future amortization expense associated with the Company’s finite-lived intangible assets for each of the five succeeding fiscal years is as follows:
(In thousands)
2025 (remaining three months)$24,164 
202695,659 
202795,659 
202895,659 
202989,536 
Thereafter120,523 
$521,200 
The Company’s acquired intangible assets are being amortized on a straight-line basis over their estimated useful lives.
There were no impairment losses recorded on finite-lived intangible assets during the three and nine months ended September 30, 2025 and 2024.
Goodwill
The change in the carrying amount of goodwill for the periods ended September 30, 2025 and December 31, 2024 is as follows:
(In thousands)
Balance, January 1, 2024
$2,367,120 
Resolution Bioscience acquisition adjustments225 
Effects of changes in foreign currency exchange rates
(669)
Balance, December 31, 2024
2,366,676 
Effects of changes in foreign currency exchange rates
1,352 
Balance, September 30, 2025
$2,368,028 
There were no impairment losses for the three and nine months ended September 30, 2025 and 2024.
v3.25.3
FAIR VALUE MEASUREMENTS
 9 Months Ended
Sep. 30, 2025
Fair Value Disclosures [Abstract]  
FAIR VALUE MEASUREMENTS FAIR VALUE MEASUREMENTS
The three levels of the fair value hierarchy established are as follows:
Level 1    Quoted prices (unadjusted) in active markets for identical assets or liabilities that the Company has the ability to access as of the reporting date. Active markets are those in which transactions for the asset or liability occur in sufficient frequency and volume to provide pricing information on an ongoing basis.
Level 2    Pricing inputs other than quoted prices in active markets included in Level 1, which are either directly or indirectly observable as of the reporting date. These include quoted prices for similar assets or liabilities in active markets and quoted prices for identical or similar assets or liabilities in markets that are not active.
Level 3    Unobservable inputs that reflect the Company’s assumptions about the assumptions that market participants would use in pricing the asset or liability. Unobservable inputs shall be used to measure fair value to the extent that observable inputs are not available.
The following table presents the Company’s fair value measurements as of September 30, 2025 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair Value at September 30, 2025Quoted Prices in Active Markets for Identical Assets (Level 1)Significant Other Observable Inputs (Level 2)Significant Unobservable Inputs (Level 3)
Cash, cash equivalents, and restricted cash
Cash and money market$781,729 $781,729 $— $— 
U.S. government agency securities7,308 — 7,308 — 
Marketable securities
Corporate bonds$104,255 $— $104,255 $— 
U.S. government agency securities69,085 — 69,085 — 
Asset backed securities29,366 — 29,366 — 
Equity securities11,352 11,352 — — 
Non-marketable securities
$53,262 $— $— $53,262 
Liabilities
Contingent consideration$(284,113)$— $— $(284,113)
Total$772,244 $793,081 $210,014 $(230,851)
The following table presents the Company’s fair value measurements as of December 31, 2024 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair Value at December 31, 2024Quoted Prices in Active Markets for Identical Assets (Level 1)Significant Other Observable Inputs (Level 2)Significant Unobservable Inputs (Level 3)
Cash, cash equivalents and restricted cash
Cash and money market$595,548 $595,548 $— $— 
Restricted cash (1)
5,747 5,747 — — 
U.S. government agency securities5,341 — 5,341 — 
Marketable securities
Corporate bonds$206,874 $— $206,874 $— 
U.S. government agency securities140,952 — 140,952 — 
Asset backed securities83,339 — 83,339 — 
Equity securities5,972 5,972 — — 
Non-marketable securities
$796 $— $— $796 
Liabilities
Contingent consideration$(282,212)$— $— $(282,212)
Total$762,357 $607,267 $436,506 $(281,416)
_________________________________
(1)Restricted cash primarily represents cash held by a third-party financial institution as part of a cash collateral agreement related to the Company’s credit card program. The restrictions will lapse upon the termination of the agreements or the removal of the cash collateral requirement by the third-parties.
There have been no material changes in valuation techniques or transfers between fair value measurement levels during the three and nine months ended September 30, 2025. The fair value of Level 2 instruments classified as cash equivalents and marketable debt securities are valued using a third-party pricing agency where the valuation is based on observable inputs including pricing for similar assets and other observable market factors.
Non-Marketable Securities
The following table summarizes the Company’s non-marketable investments, which are primarily included in other long-term assets on the condensed consolidated balance sheet as of September 30, 2025 and December 31, 2024:
(In thousands)September 30, 2025December 31, 2024
Investments for which the fair value option has been elected$53,262 $796 
Investments without readily determinable fair values50,941 50,448 
Equity method investments7,383 7,488 
Total$111,586 $58,732 
Fair Value Option Securities
The Company has elected the fair value option to measure certain non-marketable securities at fair value to simplify the accounting. The fair value measurement of non-marketable securities is categorized as Level 3 as the measurement amount is primarily based on significant, unobservable inputs.
In August 2025, the Company executed a note purchase agreement with Freenome Holdings, Inc. (“Freenome”) under which the Company purchased a $50.0 million senior convertible note, which bears interest at a rate of 5.0% per year and matures on August 12, 2030. The convertible note and accrued interest will be paid back in cash upon maturity, if not previously repaid or converted into equity at the applicable conversion price pursuant to optional or automatic mechanisms per the note purchase agreement. The Company utilizes a probability-weighted scenario-based discounted cash flow model under the income approach to measure the fair value of the note. Probabilities are applied to each potential scenario and the resulting values are discounted using a present-value factor. The passage of time, in addition to changes in probabilities and the present-value factor, may result in adjustments to the fair value measurement. Interest income is accrued based on the contractual annual interest rate, which is included in interest expense, net in the condensed consolidated statement of operations. The fair value of the convertible note was $50.4 million as of September 30, 2025.
Gains and losses recorded on non-marketable securities for which the fair value option has been elected are recognized in investment income, net in the condensed consolidated statement of operations. The following table provides a reconciliation of the beginning and ending balances of non-marketable securities valued using the fair value option:
(In thousands)Non-Marketable Securities
Beginning balance, January 1, 2025
$796 
Purchases of non-marketable securities
50,850 
Changes in fair value1,616 
Settlement of non-marketable securities— 
Ending balance, September 30, 2025
$53,262 
Investments Without Readily Determinable Fair Values
Investments without readily determinable fair values had the following cumulative upward and downward adjustments and aggregate carrying amounts:
(In thousands)
September 30, 2025September 30, 2024
Cumulative upward adjustments (1)
$5,595 $5,102 
Cumulative downward adjustments and impairments (2)
(16,850)(15,071)
Aggregate carrying value
50,941 52,227 
_________________________________
(1)    There were no material upward adjustments recorded for the three and nine months ended September 30, 2025 and 2024.
(2)    There were no material downward adjustments or impairments recorded for the three and nine months ended September 30, 2025 and 2024.
There were no material realized gains or losses recorded during the three and nine months ended September 30, 2025 and 2024.
Equity Method Investments
The Company has committed capital to venture capital investment funds of $18.0 million, of which $9.8 million remains callable through 2033 as of September 30, 2025. The aggregate carrying amount of these funds was $7.4 million and $7.5 million as of September 30, 2025 and December 31, 2024, respectively. Gains and losses recorded on these funds were not significant for the three and nine months ended September 30, 2025 and 2024.
Contingent Consideration Liabilities
The fair value of the contingent consideration liabilities was $284.1 million and $282.2 million as of September 30, 2025 and December 31, 2024, respectively. As of September 30, 2025, the contingent consideration liability was included in other long-term liabilities in the condensed consolidated balance sheet. As of December 31, 2024, $19.7 million was included in other current liabilities and $262.5 million was included in other long-term liabilities in the condensed consolidated balance sheet.
The following table provides a reconciliation of the beginning and ending balances of contingent consideration:
Three Months Ended September 30,Nine Months Ended September 30,
(In thousands)2025202420252024
Beginning balance
$275,408 $277,921 $282,212 $288,657 
Changes in fair value (1)8,705 5,310 21,901 (2,326)
Payments (2)— — (20,000)(3,100)
Ending balance
$284,113 $283,231 $284,113 $283,231 
______________
(1)The change in fair value of the contingent consideration liability is included in general and administrative expenses in the condensed consolidated statement of operations for the three and nine months ended September 30, 2025 and 2024.
(2)Payments were made in the nine months ended September 30, 2025 and 2024 to settle the product development milestone contingent consideration liabilities previously recorded related to the Company’s acquisitions of Ashion Analytics, LLC (“Ashion”) and OmicEra Diagnostics GmbH, respectively.
This fair value measurement of contingent consideration is categorized as a Level 3 liability, as the measurement amount is based primarily on significant inputs not observable in the market.
The fair value of the contingent consideration liability recorded from the Company’s acquisition of Thrive Earlier Detection Corporation (“Thrive”) related to regulatory milestones was $284.1 million as of September 30, 2025. The fair value of the contingent consideration liabilities recorded from the Company’s acquisitions of Thrive and Ashion related to regulatory and product development milestones was $282.2 million as of December 31, 2024. The Company estimates the fair value of the contingent consideration liabilities related to the regulatory and product development milestones using the probability-weighted scenario based discounted cash flow model, which is consistent with the initial measurement of the contingent consideration liabilities. Probabilities of success are applied to each potential scenario and the resulting values are discounted using a present-value factor. The passage of time in addition to changes in projected milestone achievement timing, present-value factor, the degree of achievement, if applicable, and probabilities of success may result in adjustments to the fair value measurement. The fair value of the contingent consideration liability recorded related to regulatory and product development milestones was determined using a weighted average probability of success of 90% as of September 30, 2025 and December 31, 2024, and a weighted average present-value factor of 5.6% and 6.2% as of September 30, 2025 and December 31, 2024, respectively. The projected fiscal year of payment range is from 2030 to 2031. Unobservable inputs were weighted by the relative fair value of the contingent consideration liabilities.
The revenue milestone associated with the Ashion acquisition is not expected to be achieved and therefore no liability has been recorded for this milestone.
Derivative Financial Instruments
The Company enters into foreign currency forward contracts on the last day of each month to mitigate the impact of adverse movements in foreign exchange rates related to the remeasurement of monetary assets and liabilities and hedge the Company’s foreign currency exchange rate exposure. As of September 30, 2025 and December 31, 2024 the Company had open foreign currency forward contracts with notional amounts of $56.4 million and $44.2 million, respectively. The Company's foreign exchange derivative instruments are classified as Level 2 within the fair value hierarchy as they are valued using inputs that are observable in the market or can be derived principally from or corroborated by observable market data. The fair value of the open foreign currency forward contracts was zero at September 30, 2025 and December 31, 2024 and there were no gains or losses recorded to adjust the fair value of the open foreign currency contract held as of September 30, 2025. The contracts are closed subsequent to each month-end, and the gains and losses recorded from the contracts were not significant for the three and nine months ended September 30, 2025 and 2024.
v3.25.3
LONG-TERM DEBT
 9 Months Ended
Sep. 30, 2025
Debt Disclosure [Abstract]  
LONG-TERM DEBT LONG-TERM DEBT
Revolving Credit Agreement
On January 13, 2025, the Company entered into a senior secured revolving credit agreement (the “Revolving Credit Agreement”) with a syndicate of lenders. The Revolving Credit Agreement replaced the Company’s previous revolving loan agreement dated as of November 5, 2021.
Borrowings under the Revolving Credit Agreement are permitted up to a maximum amount of $500.0 million on a revolving basis. In addition, the Company may request, in lieu of cash advances, letters of credit with an aggregate stated amount outstanding not to exceed $20.0 million. Up to $50.0 million of borrowings may be made, at the Company’s election, in additional currencies. Borrowings under the Revolving Credit Agreement will be used for working capital and other general corporate purposes. The Revolving Credit Facility matures on the earlier to occur of January 13, 2028 and the date that is 91 days prior to the maturity date of indebtedness of the Company and any restricted subsidiary in the event that the aggregate outstanding principal amount of such maturing indebtedness equals or exceeds $300.0 million. The Revolving Credit Agreement also provides for uncommitted incremental facilities in an amount up to $200.0 million plus an unlimited additional amount so long as the Company is in compliance with certain financial covenants.
Outstanding revolving loans denominated in U.S. dollars under the Revolving Credit Agreement will bear interest at a floating rate of either (A) Term SOFR plus 0.10% (subject to a 0.00% floor) plus the Applicable Rate (as defined below) or (B) a base rate (subject to a 1.00% per annum floor) plus the Applicable Rate, as elected by the Company. Revolving loans denominated in foreign currencies will bear interest at floating reference rates described in the Revolving Credit Agreement plus the Applicable Rate. The Applicable Rate means (A) in the case of U.S. dollar base rate loans, a margin ranging from 1.50% to 2.00% per annum, depending on the Company's consolidated secured gross leverage ratio, and (B) in the case of U.S. dollar Term SOFR loans and all foreign currency loans, a margin ranging from 2.50% to 3.00% per annum, depending on the Company's consolidated secured gross leverage ratio.
The Company is required to pay customary fees for a credit facility of this size and type, including a commitment fee on the unused portion of the Revolving Credit Facility.
Certain of the Company's present and future subsidiaries (the “Subsidiary Guarantors”) guarantee the obligations under the Revolving Credit Agreement. The obligations under the Revolving Credit Agreement are secured by a first priority security interest in substantially all of the Company's and the Subsidiary Guarantors’ assets, subject to certain exceptions and exclusions. The Revolving Credit Agreement contains customary representations and warranties, affirmative covenants and negative covenants for credit facilities of this nature, including financial covenants. The Company must maintain a consolidated secured gross leverage ratio not to exceed 2.50 to 1.00 (subject to certain exceptions) and a consolidated interest charge coverage ratio not less than 3.00 to 1.00, in each case, of as of the last day of each fiscal quarter.
The Company has agreed to various financial covenants under the Revolving Credit Agreement, and as of September 30, 2025, the Company was in compliance with all covenants.
As of September 30, 2025, the Company had $6.0 million of issued and outstanding letters of credit under the Revolving Credit Agreement, which reduced the amount available for cash advances under the facility to $494.0 million. As of September 30, 2025, the Company has not drawn funds from, nor are any amounts outstanding under, the Revolving Credit Agreement.
v3.25.3
CONVERTIBLE NOTES
 9 Months Ended
Sep. 30, 2025
CONVERTIBLE NOTES [Abstract]  
CONVERTIBLE NOTES CONVERTIBLE NOTES
Convertible note obligations included in the condensed consolidated balance sheet consisted of the following as of September 30, 2025:
Fair Value (1)
(In thousands)Principal AmountUnamortized Debt Discount and Issuance CostsNet Carrying AmountAmountLeveling
2031 Convertible Notes - 1.750%
$620,709 $(11,905)$608,804 $576,552 2
2030 Convertible Notes - 2.000%
572,993 (3,115)569,878 589,386 2
2028 Convertible Notes - 0.375%
589,380 (3,783)585,597 545,530 2
2027 Convertible Notes - 0.375%
563,822 (2,464)561,358 541,201 2
Convertible note obligations included in the condensed consolidated balance sheet consisted of the following as of December 31, 2024:
Fair Value (1)
(In thousands)Principal AmountUnamortized Debt Discount and Issuance CostsNet Carrying AmountAmountLeveling
2031 Convertible Notes - 1.750%
$620,709 $(13,511)$607,198 $581,648 2
2030 Convertible Notes - 2.000%
572,993 (3,642)569,351 592,756 2
2028 Convertible Notes - 0.375%
589,380 (4,952)584,428 512,761 2
2027 Convertible Notes - 0.375%
563,822 (3,732)560,090 523,932 2
2025 Convertible Notes - 1.000% (2)
249,172 (19)249,153 246,705 2
______________
(1)The fair values are based on observable market prices for this debt, which is traded in less active markets and therefore is classified as a Level 2 fair value measurement.
(2)The Company’s convertible notes due in 2025 (the “2025 Notes”) matured on January 15, 2025 and were included in convertible notes, net, current portion on the condensed consolidated balance sheet as of December 31, 2024. As discussed in further detail below, the 2025 Notes were settled in cash upon maturity in January 2025.
Issuances and Settlements
Upon maturity of the 2025 Notes on January 15, 2025, the Company made a cash payment of $250.4 million in settlement of the total principal of the 2025 Notes and accrued interest that was previously outstanding as of December 31, 2024.
In April 2024, the Company entered into a privately negotiated exchange and purchase agreement with certain holders of the Company’s convertible notes due in 2028 (“2028 Notes”). The Company issued $620.7 million aggregate principal amount of 1.75% convertible notes due in 2031 (the “2031 Notes” and, collectively with the 2025 Notes, 2027 Notes, 2028 Notes, and 2030 Notes, the “Notes”) in exchange for $359.7 million of aggregate principal of 2028 Notes, and $266.8 million of cash after deducting underwriting discounts. The extinguishment resulted in a gain on settlement of convertible notes of $10.3 million, which was recorded in interest expense, net in the condensed consolidated statement of operations for the nine months ended September 30, 2024. The gain represents the difference between (i) the fair value of the consideration transferred and (ii) the carrying value of the debt at the time of exchange.
The net proceeds from the issuance of the 2031 Notes were approximately $259.8 million, after deducting commissions and offering expenses payable by the Company.
The 2031 Notes will mature on April 15, 2031 and bear interest at a rate of 1.75% per year, payable semi-annually in arrears on October 15 and April 15 of each year, beginning on October 15, 2024. The Company has the ability to repurchase the 2031 Notes after April 17, 2029 upon the occurrence of certain events and during certain periods, as set forth in the Indenture filed at the time of the offering.
Summary of Conversion Features
Until the six-months immediately preceding the maturity date of the applicable series of the Company’s convertible notes, each series of Notes is convertible only upon the occurrence of certain events and during certain periods, as set forth in the Indentures filed at the time of the original offerings. On or after the date that is six-months immediately preceding the maturity date of the applicable series of Notes until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may elect to convert such Notes at any time, and if elected, the conversion would occur on the maturity date. The Notes will be convertible into cash, shares of the Company’s common stock (plus, if applicable, cash in lieu of any fractional share), or a combination of cash and shares of the Company’s common stock, at the Company’s election. If the Notes are not converted prior to the maturity date, the principal amount will be settled in cash upon maturity.
It is the Company’s intent to settle all conversions through combination settlement. The initial conversion rate is 8.96, 8.21, 12.37, and 10.06 shares of common stock per $1,000 principal amount for the 2027 Notes, 2028 Notes, 2030 Notes, and 2031 Notes, respectively, which is equivalent to an initial conversion price of approximately $111.66, $121.84, $80.83, and $99.36 per share of the Company’s common stock for the 2027 Notes, 2028 Notes, 2030 Notes, and 2031 Notes, respectively. The 2027 Notes, 2028 Notes, 2030 Notes, and 2031 Notes are potentially convertible into up to 5.0 million, 4.8 million, 7.1 million, and 6.2 million shares, respectively. The conversion rate is subject to adjustment upon the occurrence of certain specified events as set forth in the Indentures filed at the time of the original offerings but will not be adjusted for accrued and unpaid interest. In addition, holders of the Notes who convert their Notes in connection with a “make-whole fundamental change” (as defined in the Indentures), will, under certain circumstances, be entitled to an increase in the conversion rate.
If the Company undergoes a “fundamental change” (as defined in the Indentures), holders of the Notes may require the Company to repurchase for cash all or part of their Notes at a repurchase price equal to 100% of the principal amount of the Notes to be repurchased, plus accrued and unpaid interest.
Based on the closing price of the Company’s common stock of $54.71 on September 30, 2025, the if-converted values on the Notes do not exceed the principal amount.
The Notes do not contain any financial or operating covenants or any restrictions on the payment of dividends, the issuance of other indebtedness, or the issuance or repurchase of securities by the Company.
Ranking of Convertible Notes
The Notes are the Company’s senior unsecured obligations and (i) rank senior in right of payment to all of its future indebtedness that is expressly subordinated in right of payment to the Notes; (ii) rank equal in right of payment to each outstanding series thereof and to all of the Company’s future liabilities that are not so subordinated, unsecured indebtedness; (iii) are effectively junior to all of the Company’s existing and future secured indebtedness and other secured obligations, to the extent of the value of the assets securing that indebtedness and other secured obligations; and (iv) are structurally subordinated to all indebtedness and other liabilities of the Company’s subsidiaries.
Issuance Costs
Issuance costs are amortized to interest expense, net over the term of the Notes. The following table summarizes the original issuance costs at the time of issuance for each set of Notes:
(In thousands)
2031 Convertible Notes
$6,780 
2030 Convertible Notes4,938 
2028 Convertible Notes24,453 
2027 Convertible Notes14,285 
2025 Convertible Notes17,646 
Interest Expense
Interest expense on the Notes includes the following:
Three Months Ended September 30,Nine Months Ended September 30,
(In thousands)2025202420252024
Debt issuance costs amortization$1,154 $1,334 $3,455 $3,965 
Debt discount amortization386 322 1,134 611 
Gain on settlement of convertible notes
— — — (10,254)
Coupon interest expense6,662 7,285 20,075 19,054 
Total interest expense on convertible notes
$8,202 $8,941 $24,664 $13,376 
The following table summarizes the effective interest rates of the Notes:
Three Months Ended September 30,Nine Months Ended September 30,
2025202420252024
2031 Convertible Notes
2.10 %2.10 %2.10 %2.06 %
2030 Convertible Notes2.12 %2.12 %2.12 %2.09 %
2028 Convertible Notes0.64 %0.64 %0.64 %0.63 %
2027 Convertible Notes0.68 %0.68 %0.67 %0.67 %
2025 Convertible Notesn/a1.18 %1.05 %1.17 %
The remaining period over which the unamortized debt discount will be recognized as non-cash interest expense is 1.46, 2.42, 4.42, and 5.54 years for the 2027 Notes, 2028 Notes, 2030 Notes, and 2031 Notes, respectively.
v3.25.3
LICENSE AND COLLABORATION AGREEMENTS
 9 Months Ended
Sep. 30, 2025
LICENSE AGREEMENTS [Abstract]  
LICENSE AND COLLABORATION AGREEMENTS LICENSE AND COLLABORATION AGREEMENTS
The Company licenses certain technologies that are, or may be, incorporated into its technology under several license agreements, as well as the rights to commercialize certain diagnostic tests through collaboration agreements. Generally, the license agreements require the Company to pay single-digit royalties based on net revenues received using the technologies and may require minimum royalty amounts, milestone payments, or maintenance fees.
Mayo Foundation for Medical Education and Research
In June 2009, the Company entered into an exclusive, worldwide license agreement with the Mayo Foundation for Medical Education and Research (“Mayo”), under which Mayo granted the Company an exclusive, worldwide license to certain Mayo patents and patent applications, as well as a non-exclusive, worldwide license with regard to certain Mayo know-how. The scope of the license covers any screening, surveillance or diagnostic test or tool for use in connection with any type of cancer, pre-cancer, disease or condition. The Company’s license agreement with Mayo was most recently amended and restated in September 2020.
The licensed Mayo patents and patent applications contain both method and composition claims that relate to sample processing, analytical testing and data analysis associated with nucleic acid screening for cancers and other diseases. The jurisdictions covered by these patents and patent applications include the U.S., Australia, Canada, the European Union, China, Japan and Korea. Under the license agreement, the Company assumed the obligation and expense of prosecuting and maintaining the licensed Mayo patents and is obligated to make commercially reasonable efforts to bring to market products using the licensed Mayo intellectual property.
Pursuant to the Company’s agreement with Mayo, the Company is required to pay Mayo a low-single-digit royalty on the Company’s net sales of current and future products using the licensed Mayo intellectual property each year during the term of the Mayo agreement.
The Company is also required to pay Mayo up to $3.0 million in sales-based milestone payments upon cumulative net sales of each product using the licensed Mayo intellectual property reaching specified levels.
The license agreement will remain in effect, unless earlier terminated by the parties in accordance with the agreement, until the last of the licensed patents expires in 2039 (or later, if certain licensed patent applications are issued). However, if the Company is still using the licensed Mayo know-how or certain Mayo-provided biological specimens or their derivatives on such expiration date, the term shall continue until the earlier of the date the Company stops using such know-how and materials and the date that is five years after the last licensed patent expires. The license agreement contains customary termination provisions and permits Mayo to terminate the license agreement if the Company sues Mayo or its affiliates, other than any such suit claiming an uncured material breach by Mayo of the license agreement.
In addition to granting the Company a license to the covered Mayo intellectual property, Mayo provides the Company with product development and research and development assistance pursuant to the license agreement and other collaborative arrangements. In connection with this collaboration, the Company has incurred insignificant charges for the three months ended September 30, 2025 and 2024, respectively. The charges incurred in connection with this collaboration are recorded in research and development expenses in the Company’s condensed consolidated statements of operations.
Johns Hopkins University
Through the acquisition of Thrive, the Company acquired a worldwide exclusive license agreement with Johns Hopkins University (“JHU”) for use of several JHU patents and licensed know-how. The license is designed to enable the Company to leverage JHU intellectual property in the development and commercialization of certain of its products. The agreement terms would require the Company to pay single-digit sales-based royalties and up to a total of $45.0 million in sales-based milestone payments on JHU licensed products that reach specified net sales levels. The Company will record the sales-based royalties once sales of licensed products have occurred and sales-based milestones once achievement is deemed probable. The Company recorded insignificant charges related to sales-based royalties during the three months ended September 30, 2025, and the Company has not incurred charges related to the achievement of any sales-based milestones as of September 30, 2025.
Targeted Digital Sequencing (“TARDIS”) License Agreement
In January 2021, the Company entered into an exclusive, worldwide license to the proprietary TARDIS technology from The Translational Genomics Research Institute (“TGen”). Under the agreement, the Company acquired a royalty-free, worldwide exclusive license to proprietary TARDIS patents and know-how. Under the agreement, the Company was obligated to make milestone payments to TGen of up to $45.0 million in sales-based milestone payments upon cumulative net sales related to molecular residual disease (“MRD”) detection and/or treatment reaching specified levels. These payments were contingent upon achievement of these cumulative revenues on or before December 31, 2030, which was not achieved prior to the termination.
Effective May 1, 2024, the Company entered into termination agreements (the “Termination Agreements”) with TGen for the purpose of terminating the license and sponsored research agreement relating to the TARDIS technology and an additional sponsored research agreement with a broader scope (collectively, the “Original Agreements”). As part of the Termination Agreements, the Company will pay TGen $27.6 million in compensation for the termination of the Original Agreements, which will be allocated into three annual installments of $9.2 million per year beginning in the second quarter of 2024. The fair value of the termination payments as of the date of the Termination Agreements was $25.8 million, which was recorded as research and development expense in the condensed consolidated statement of operations in the second quarter of 2024. The remaining $1.8 million in expense is being recognized ratably through the date of the final payment in the second quarter of 2026. The Company has recorded a liability of $8.8 million representing the fair value of the remaining payments, which is included in accrued liabilities on the condensed consolidated balance sheet as of September 30, 2025. The termination payments eliminate the Company’s obligation to pay TGen any further payments, equities, fees, costs, or other amounts that would have been due under the Original Agreements, including the milestone payments. The Company’s ongoing development efforts for its pipeline tests are not impacted by the Termination Agreements.
Broad Institute, Inc.
In June 2023, the Company entered into an exclusive license agreement with Broad Institute, Inc. (“Broad Institute”) to utilize the Minor Allele Enriched Sequencing Through Recognition Oligonucleotides (“MAESTRO”) technology in the Company’s MRD testing. Under the license agreement, the Company is obligated to make development milestone payments to Broad Institute of up to $6.5 million upon achievement of certain development milestones related to prospective MRD tests that use the MAESTRO technology. In addition, the Company is obligated to make sales-based milestone payments to Broad Institute that equate up to a mid-single-digit royalty upon the achievement of certain cumulative net sales targets of licensed products using the MAESTRO technology beginning at $500.0 million. The Company will record the development milestones once achieved and the sales milestones once achievement is deemed probable. The Company has not incurred charges related to the achievement of development milestones or sales milestones as of September 30, 2025.
Watchmaker Genomics, Inc.
In July 2023, the Company entered into a co-exclusive development and license agreement with Watchmaker Genomics, Inc. (“Watchmaker”) under which the Company granted Watchmaker a co-exclusive license to the non-bisulfite technology for the detection of methylated DNA and other epigenetic modifications (“TAPS”). TAPS is based on patents obtained by the Company through an exclusive license agreement with the Ludwig Institute for Cancer Research. Under the agreement, both parties have the right to use and develop TAPS for commercial purposes. The Company has the potential to receive up to $82.0 million in sales-based milestone payments and mid-single-digit royalties based on future Watchmaker net sales of licensed products including TAPS. Additionally, Watchmaker has the right to sublicense TAPS, and the Company has the potential to receive royalties based on future Watchmaker sublicense receipts. The Company has not received any sales-based milestone payments or royalties on Watchmaker net sales of licensed products, or royalties on Watchmaker sublicense receipts as of September 30, 2025.
TwinStrand Biosciences, Inc.
In July 2024, the Company entered into an agreement with TwinStrand Biosciences, Inc. (“TwinStrand”), under which TwinStrand licensed to the Company intellectual property related to the error correction technology in next-generation sequencing. The Company’s rights are broadly exclusive with respect to cell-free nucleic acid sequencing, subject to certain non-exclusive relationships in the field. The Company also holds exclusive rights to sublicense the licensed intellectual property. Under the license agreement, the Company made upfront payments to TwinStrand totaling $45.0 million in July 2024. The upfront payments were capitalized as a patent and license intangible asset in the condensed consolidated balance sheet, which is amortized over its estimated useful life of 10 years. In addition, the Company agreed to pay TwinStrand a low-single-digit royalty on the Company’s and any sublicensee’s net sales of certain licensed products and services. The Company will record the sales-based royalties once sales using relevant licensed products and services have occurred. The Company has not incurred charges related to the sales-based royalties as of September 30, 2025. Sublicense revenue was not significant for the three and nine months ended September 30, 2025.
Freenome Holdings, Inc.
In August 2025, the Company entered into a Collaboration and License Agreement (the “Agreement”) with Freenome Holdings, Inc., under which the Company and Freenome will collaborate to develop and commercialize certain blood-based screening and diagnostic products (“Collaboration Products”) for colorectal cancer (“CRC”). Upon execution of the Agreement, the Company has co-exclusive rights to commercialize Freenome’s existing CRC screening test as a laboratory developed test in the United States. Upon the later of (1) certain requirements related to antitrust clearance being satisfied (the “Antitrust Clearance Date”) and (2) receipt of first-line U.S. Food and Drug Administration (“FDA”) approval for a Collaboration Product, the Company will obtain exclusive rights to commercialize such Collaboration Products in the United States.
Under the terms of the Agreement, the Company made a payment to Freenome of $75.0 million in cash in November 2025. Following the completion of the antitrust clearance process, the upfront payment will represent a right to either the exclusive license or Freenome securities, and therefore the Company will recognize the upfront consideration within prepaid expenses and other current assets on the condensed consolidated balance sheet upon payment in November 2025. Upon receipt of antitrust clearance, the current asset is expected to be derecognized and expensed as a research and development expense, unless FDA approval is obtained prior to such clearance.
Up to an additional $700.0 million would be payable based upon the achievement of certain development and regulatory milestones, which include a $100.0 million payment upon first-line FDA approval of a Collaboration Product, $100.0 million upon first-line FDA approval for the next-generation test contingent on meeting pre-defined performance benchmarks, and $500.0 million upon a Collaboration Product being rated as a first-line A or B test in the United States Preventive Services Taskforce (“USPSTF”) guidelines or meeting certain payer contracted coverage requirements. If the pre-defined performance benchmarks are not achieved, or if the Collaboration Product is rated as a second-line A or B test in the USPSTF guidelines, then each respective milestone payment may be reduced as provided in the Agreement. The Company will record the development milestones once achieved.
The Company will pay Freenome a laboratory service fee for each CRC blood test processed by Freenome on behalf of the Company prior to laboratory testing being transferred to the Company’s facilities, which will be recognized as cost of sales as incurred. In addition, the Company will pay sales royalties on all net sales of Collaboration Products ranging from 0% to 10% depending on the test’s profitability and subject to customary royalty stacking provisions.
The Company also committed to $20.0 million in joint development costs annually over three years, beginning on the Antitrust Clearance Date, which will be recognized as research and development expenses as incurred.
Additionally, the Company purchased a $50.0 million senior convertible note as discussed in further detail in Note 7.
v3.25.3
STOCKHOLDERS' EQUITY
 9 Months Ended
Sep. 30, 2025
Equity [Abstract]  
STOCKHOLDERS' EQUITY STOCKHOLDERS’ EQUITY
Changes in Accumulated Other Comprehensive Income (Loss)
The amounts recognized in AOCI for the nine months ended September 30, 2025 were as follows:
(In thousands)Cumulative Translation Adjustment
Unrealized Gain (Loss) on Securities (1)
AOCI
Balance at December 31, 2024$(1,920)$976 $(944)
Other comprehensive income before reclassifications
4,201 309 4,510 
Amounts reclassified from accumulated other comprehensive income (loss)
— (323)(323)
Net current period change in accumulated other comprehensive income (loss)
4,201 (14)4,187 
Balance at September 30, 2025$2,281 $962 $3,243 
The amounts recognized in AOCI for the nine months ended September 30, 2024 were as follows:
(In thousands)Cumulative Translation AdjustmentUnrealized Gain (Loss) on Securities (1)
AOCI
Balance at December 31, 2023$1,374 $54 $1,428 
Other comprehensive income before reclassifications
427 2,723 3,150 
Amounts reclassified from accumulated other comprehensive income (loss)
— 52 52 
Net current period change in accumulated other comprehensive income (loss)
427 2,775 3,202 
Balance at September 30, 2024$1,801 $2,829 $4,630 
______________
(1)There was no tax impact from the amounts recognized in AOCI for the nine months ended September 30, 2025 and 2024. The unrealized gain (loss) recorded on available-for-sale securities is a non-cash investing activity.
Amounts reclassified from AOCI for the nine months ended September 30, 2025 and 2024 were as follows:
Affected Line Item in the
Statements of Operations		Nine Months Ended September 30,
Details about AOCI Components (In thousands)20252024
Change in value of available-for-sale investments
Sales and maturities of available-for-sale investments
Investment income, net
$(323)$52 
Total reclassifications$(323)$52 
v3.25.3
STOCK-BASED COMPENSATION
 9 Months Ended
Sep. 30, 2025
Share-Based Payment Arrangement [Abstract]  
STOCK-BASED COMPENSATION STOCK-BASED COMPENSATION
Stock-Based Compensation Plans
The Company maintains the following plans for which awards were granted from or had awards outstanding in 2025: the 2010 Omnibus Long-Term Incentive Plan (As Amended and Restated Effective July 27, 2017), the 2019 Omnibus Long-Term Incentive Plan, the 2025 Omnibus Long-Term Incentive Plan, and the 2010 Employee Stock Purchase Plan. These plans are collectively referred to as the “Stock Plans.”
Stock-Based Compensation Expense
The Company records stock-based compensation expense in connection with the amortization of restricted stock and restricted stock unit awards (“RSUs”), performance share units (“PSUs”), stock purchase rights granted under the Company’s employee stock purchase plan (“ESPP”) and stock options granted to employees, non-employee consultants and non-employee directors. The Company recorded $51.6 million and $48.8 million in stock-based compensation expense during the three months ended September 30, 2025 and 2024, respectively. The Company recorded $162.0 million and $165.7 million in stock-based compensation expense during the nine months ended September 30, 2025 and 2024, respectively.
As of September 30, 2025, there was approximately $348.8 million of expected total unrecognized compensation cost related to non-vested stock-based compensation arrangements granted under all equity compensation plans. The Company expects to recognize that cost over a weighted average period of 2.51 years.
Stock Options
A summary of stock option activity under the Stock Plans is as follows:
Option SharesWeighted Average Exercise PriceWeighted Average Remaining Contractual Term (Years)Aggregate Intrinsic Value (1)
(Aggregate intrinsic value in thousands)
Outstanding, January 1, 2025982,742 $53.60 3.1
Exercised(99,926)23.83 
Forfeited(34,528)84.02 
Outstanding, September 30, 2025848,288 $55.86 2.7$13,570 
Vested and expected to vest, September 30, 2025
848,288 $55.86 2.7$13,570 
Exercisable, September 30, 2025848,288 $55.86 2.7$13,570 
______________
(1)The total intrinsic value of options exercised, net of shares withheld for taxes, during the nine months ended September 30, 2025 and 2024 was $2.5 million and $6.2 million, respectively, determined as of the date of exercise.
Restricted Stock and Restricted Stock Units
The fair value of restricted stock and RSUs is determined on the date of grant using the closing stock price on that day.
A summary of restricted stock and RSU activity is as follows:
Restricted SharesWeighted Average Grant Date Fair Value (1)
Outstanding, January 1, 20257,244,796 $63.18 
Granted3,655,785 51.34 
Released (2)(2,505,103)68.30 
Forfeited(740,378)55.97 
Outstanding, September 30, 20257,655,100 $55.96 
______________
(1)The weighted average grant date fair value of the RSUs granted during the nine months ended September 30, 2024 was $56.67.
(2)The fair value of RSUs vested and converted to shares of the Company’s common stock was $171.1 million and $173.3 million during the nine months ended September 30, 2025 and 2024, respectively.
Performance Share Units
The Company has issued performance-based equity awards to certain employees which vest upon the achievement of certain performance goals, including financial performance targets and operational milestones.
A summary of PSU activity is as follows:
Performance Share Units (1)Weighted Average Grant Date Fair Value (2)
Outstanding, January 1, 20252,021,208 $75.86 
Granted1,283,717 59.49 
Released (3)(152,565)88.24 
Forfeited(573,904)81.85 
Outstanding, September 30, 20252,578,456 $65.15 
______________
(1)The PSUs listed above assumes attainment of maximum payout rates as set forth in the performance criteria. Applying actual or expected payout rates, the number of outstanding PSUs as of September 30, 2025 was 1,109,465.
(2)The weighted average grant date fair value of the PSUs granted during the nine months ended September 30, 2024 was $63.68.
(3)The fair value of PSUs vested and converted to shares of the Company’s common stock was $13.5 million and $9.9 million for the nine months ended September 30, 2025 and 2024, respectively.
Employee Stock Purchase Plan
The fair value of shares purchased during the three and nine months ended September 30, 2025 and 2024 under the ESPP is based on the assumptions in the following table:
Three Months Ended September 30,Nine Months Ended September 30,
(In thousands)2025202420252024
Risk-free interest rates
(1)
(1)
4.42% - 5.15%
4.71% - 5.30%
Expected term (in years)(1)(1)
0.5 - 1.25
1.17
Expected volatility(1)(1)
44.40% - 57.15%
55.67% - 63.13%
Dividend yield(1)(1)—%—%
______________
(1)The Company did not issue stock purchase rights under its 2010 Employee Stock Purchase Plan during the period indicated.
v3.25.3
COMMITMENTS AND CONTINGENCIES
 9 Months Ended
Sep. 30, 2025
Commitments and Contingencies Disclosure [Abstract]  
COMMITMENTS AND CONTINGENCIES COMMITMENTS AND CONTINGENCIES
Leases
Supplemental disclosure of cash flow information related to the Company’s cash and non-cash activities with its leases are as follows:
Nine Months Ended September 30,
(In thousands)20252024
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases$30,668$28,658
Operating cash flows from finance leases864991
Finance cash flows from finance leases4,9634,890
Non-cash investing and financing activities:
Right-of-use assets obtained in exchange for new operating lease liabilities
21,64617,860
Right-of-use assets obtained in exchange for new finance lease liabilities—15,995
Weighted-average remaining lease term - operating leases (in years)7.117.58
Weighted-average remaining lease term - finance leases (in years)2.433.08
Weighted-average discount rate - operating leases6.53 %6.55 %
Weighted-average discount rate - finance leases6.68 %6.71 %
As of September 30, 2025 and December 31, 2024, the Company’s right-of-use assets from operating leases are $121.1 million and $117.0 million, respectively, which are reported in operating lease right-of-use assets in the Company’s condensed consolidated balance sheets. As of September 30, 2025, the Company has outstanding operating lease obligations of $195.7 million, of which $31.9 million is reported in operating lease liabilities, current portion and $163.9 million is reported in operating lease liabilities, less current portion in the Company’s condensed consolidated balance sheets. As of December 31, 2024, the Company had outstanding operating lease obligations of $184.5 million, of which $27.4 million is reported in operating lease liabilities, current portion and $157.1 million is reported in operating lease liabilities, less current portion in the Company’s condensed consolidated balance sheets.
As of September 30, 2025 and December 31, 2024, the Company’s right-of-use assets from finance leases are $12.8 million and $19.8 million, respectively, which are reported in other long-term assets, net in the Company’s condensed consolidated balance sheets. As of September 30, 2025, the Company has outstanding finance lease obligations of $13.8 million, of which $5.9 million is reported in other current liabilities and $7.8 million is reported in other long-term liabilities in the Company’s condensed consolidated balance sheets. As of December 31, 2024, the Company had outstanding finance lease obligations of $21.0 million, of which $7.8 million is reported in other current liabilities and $13.2 million is reported in other long-term liabilities in the Company’s condensed consolidated balance sheets.
Legal Matters
In addition to commitments and obligations incurred in the ordinary course of business, from time to time the Company may be subject to a variety of claims and legal proceedings, including legal actions for damages, governmental investigations and other matters. The Company has also instituted, and may in the future institute, additional legal proceedings to enforce its rights and seek remedies, such as monetary damages, injunctive relief and declaratory relief.
The Company accrues costs for certain legal proceedings and regulatory matters to the extent that it determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. While such accrued costs reflect the Company’s best estimate of the probable loss for such matters, the recorded amounts may differ materially from the actual amount of any such losses. In some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal and regulatory proceedings, which may be exacerbated by various factors, including but not limited to, that they may involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; involve a large number of parties, claimants or regulatory bodies; are in the early stages of the proceedings; involve a number of separate proceedings and/or a wide range of potential outcomes; or result in a change of business practices.
As of the date of this Quarterly Report on Form 10-Q, amounts accrued for legal proceedings and regulatory matters were not significant. However, it is possible that in a particular quarter or annual period the Company’s financial condition, results of operations, cash flow and/or liquidity could be materially adversely affected by an ultimate unfavorable resolution of, or development in, legal and/or regulatory proceedings, including as described below. Except for the proceedings discussed below, the Company believes that the ultimate outcome of any of the regulatory and legal proceedings that are currently pending against it should not have a material adverse effect on financial condition, results of operations, cash flow, or liquidity.
Intellectual Property Litigation Matters
In November 2023, the Company filed suit against Geneoscopy, Inc. (“Geneoscopy”) in the United States District Court for the District of Delaware, alleging that certain of Geneoscopy’s products infringe the ‘781 Patent and seeking unspecified monetary damages and injunctive relief (the “’781 Action”) and in January 2024, the Company amended the complaint, alleging that Geneoscopy has made false and misleading statements in the marketing and promotion of its product, in violation of the Lanham Act. In May 2024, the Company filed a second complaint against Geneoscopy alleging infringement of the Company’s U.S. Patent No. 11,970,746 (the “’746 Patent”), which has been consolidated with the ’781 Action. Geneoscopy filed counterclaims against the Company challenging the validity of the patents at issue and alleging breach of contract, misappropriation of trade secrets, unfair competition, and other violations of state and federal law seeking unspecified monetary damages and injunctive relief. On July 16, 2024, the Company filed a motion for preliminary injunction seeking an order prohibiting Geneoscopy from selling its infringing Colosense test in the United States. On May 27, 2025, Geneoscopy filed amended counterclaims against the Company, alleging false advertising under the Lanham Act, as well as other related violations under state law. On August 21, 2025, the Company voluntarily withdrew its motion for preliminary injunction, without prejudice, to preserve the ability to refile after the U.S. Patent and Trademark Office concludes its review of additional asserted patents.
Geneoscopy petitioned the United States Patent and Trademark Office to institute an inter partes review (“IPR”) challenging the validity of the ‘781 Patent and the ‘746 Patent before the Patent Trial and Appeals Board (“PTAB”) and the PTAB instituted review for both patents. On July 9, 2025, the PTAB issued its decision finding all claims of the ‘781 Patent unpatentable. The Company filed a notice of appeal with the United States Court of Appeals for the Federal Circuit on September 10, 2025. A final decision of the review of the ‘746 Patent will be made on or before February 14, 2026. On February 20, 2025, Geneoscopy filed a motion to stay the district court litigation pending IPR of the ‘781 and ‘746 Patents, which the Court denied on August 21, 2025.
v3.25.3
Restructuring and Related Activities
 9 Months Ended
Sep. 30, 2025
Restructuring and Related Activities [Abstract]  
Restructuring and Related Activities Disclosure RESTRUCTURING AND BUSINESS TRANSFORMATION
In August 2025, the Company announced a multi-year productivity plan (the “Plan”). The Plan includes several initiatives that are intended to drive sustainable growth, improve operating leverage, and amplify the Company’s ability to invest in innovation and serve more patients. These savings are expected to primarily come from general and administrative efficiencies, that in addition to restructuring certain support functions globally, include external spend optimization, and building more automation in core operations. The Company began incurring insignificant charges related to the business transformation efforts in 2024, primarily related to consulting services. The Company currently expects to incur additional business transformation costs of approximately $20 million through the completion of certain initiatives already underway, which are expected to be completed by the fourth quarter of 2026. The Company continues to pursue cost savings initiatives, and to the extent further cost saving initiatives are identified, the Company could incur additional charges to implement those business transformation initiatives in future periods.
The Company recorded the following charges related to the Plan for the three and nine months ended September 30, 2025.
(In thousands)
Three Months Ended
Nine Months Ended
Restructuring charges
$15,289 $26,388 
Business transformation costs (1)
17,291 46,220 
Total restructuring and business transformation
$32,580 $72,608 
______________
(1)Business transformation costs represent non-recurring expenses for strategic projects with anticipated long-term benefits to the Company focused on cost reduction and productivity improvement that do not meet the definition of restructuring charges. For the three and nine months ended September 30, 2025, these costs primarily include consulting services, and employee termination benefits.
The restructuring charges were recorded as follows within the condensed consolidated statement of operations:
Three Months Ended September 30, 2025
Cost of salesResearch and developmentSales and marketingGeneral and administrativeTotal
Employee termination costs
$— $74 $483 $13,139 $13,696 
Other costs
— — — 1,593 1,593 
Total restructuring charges$— $74 $483 $14,732 $15,289 
Nine Months Ended September 30, 2025
Cost of salesResearch and developmentSales and marketingGeneral and administrativeTotal
Employee termination costs
$85 $554 $3,154 $15,139 $18,932 
Other costs
— — — 7,456 7,456 
Total restructuring charges$85 $554 $3,154 $22,595 $26,388 
The following table summarizes activity in the liability related to the Company’s restructuring initiatives:
(In thousands)Employee Termination Costs
Other Costs
Total
Balance, December 31, 2024
$— $— $— 
Charges18,932 7,456 26,388 
Payments(3,176)(6,590)(9,766)
Adjustments (1)
533 — 533 
Balance, September 30, 2025
$16,289 $866 $17,155 
______________
(1)Adjustments relate to the effects of foreign currency exchange rates.
The Company does not expect to incur additional significant costs related to this restructuring. Substantially all of the cash payments for the liability are expected to be disbursed by mid 2026.
v3.25.3
ACQUISITIONS AND DIVESTITURES
 9 Months Ended
Sep. 30, 2025
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]  
ACQUISITIONS AND DIVESTITURES ACQUISITIONS AND DIVESTITURES
Divestitures
Oncotype DX Genomic Prostate Score Test
On August 2, 2022, pursuant to an asset purchase agreement (the “Asset Purchase Agreement”) with MDxHealth SA (“MDxHealth”), the Company completed the sale of the intellectual property and know-how related to the Company’s Oncotype DX Genomic Prostate Score test (“GPS test”). On August 23, 2023, the Company and MDxHealth executed the Second Amendment to the Asset Purchase Agreement (the “Second Amendment”). Under the Second Amendment, the Company agreed to allow MDxHealth to defer the 2023 contingent consideration payment by three years in exchange for additional consideration and more favorable contingent consideration terms, including elimination of the minimum revenue thresholds previously required to be met under the Asset Purchase Agreement. Refer to the Company’s 2024 Form 10-K for additional details on the agreements.
As of September 30, 2025 and December 31, 2024, a portion of the contingent consideration is classified as a contract asset. As of September 30, 2025, the contract asset was $31.8 million, which is included in prepaid expenses and other current assets on the condensed consolidated balance sheet. As of December 31, 2024, the contract asset was $25.9 million, which is included in other long-term assets, net on the condensed consolidated balance sheet. The contract asset was estimated using historical GPS test revenues by MDxHealth under the most likely amount method. As of September 30, 2025, the remaining consideration balance of $22.7 million, which includes the amount earned during the 2023 earnout year classified as a receivable, is included in other long-term assets, net on the condensed consolidated balance sheet. As of December 31, 2024, the remaining consideration balance classified as a receivable was $56.6 million, of which $27.9 million is included in prepaid expenses and other current assets and $28.7 million is included in other long-term assets, net on the condensed consolidated balance sheet. As of December 31, 2024, the maximum contingent consideration of $82.5 million under the Second Amendment had been recognized, including an insignificant contingent consideration gain for the three and nine months ended September 30, 2024, which is included in other operating income in the condensed consolidated statement of operations. In April 2025, the Company received the cash payment of $28.0 million related to the 2024 earnout year, which was included in prepaid expenses and other current assets on the condensed consolidated balance sheet as of December 31, 2024. This cash receipt is presented as a cash inflow from investing activities for the nine months ended September 30, 2025 on the condensed consolidated statement of cash flows.
v3.25.3
SEGMENT INFORMATION
 9 Months Ended
Sep. 30, 2025
Segment Reporting [Abstract]  
SEGMENT INFORMATION SEGMENT INFORMATION
The Company is managed as one operating segment, and thus reports as a single reportable segment. This operating segment is focused on the development and global commercialization of clinical laboratory services allowing healthcare providers and patients to make individualized treatment decisions. The accounting policies of the segment are the same as those described in Note 1 - Summary of Significant Accounting Policies. The Company's Chief Operating Decision Maker (“CODM”), its President and Chief Executive Officer, monitors the Company's operating performance and makes decisions regarding allocation of resources to its operations at the consolidated level. The measure of segment profit or loss used by the CODM in assessing performance and deciding how to allocate resources is based on net loss. The CODM is regularly provided consolidated net loss to monitor budget versus actual results on a monthly basis to timely identify deviations from expected results, which is used in assessing performance and deciding where to reinvest profits and allocate resources predominantly in the annual budget and forecasting process. Significant segment expenses regularly provided to the CODM are those presented on the condensed consolidated statement of operations. These significant segment expenses include cost of sales, research and development, sales and marketing, and general and administrative. Additional significant segment expenses that are not separately presented in the condensed consolidated statement of operations include stock-based compensation, depreciation expense, and amortization of acquired intangible assets, which are presented in the condensed consolidated statement of cash flows, and restructuring and business transformation costs, which are presented in Note 14. Other segment items that are presented on the condensed consolidated statements of operations include investment income, net, interest expense, net, income tax expense, and non-recurring items such as impairment of long-lived and indefinite-lived assets, and other operating income.
The measure of segment assets provided to and reviewed by the CODM is reported on the consolidated balance sheet as total assets. Long-lived assets located in countries outside the U.S. are not significant.
The following table summarizes total revenue from customers by geographic region. Product revenues are attributed to countries based on ship-to location.
Three Months Ended September 30,Nine Months Ended September 30,
(In thousands)2025202420252024
United States$791,955 $659,222 $2,202,981 $1,904,755 
Outside of United States58,784 49,433 165,628 140,688 
Total revenues$850,739 $708,655 $2,368,609 $2,045,443 
v3.25.3
INCOME TAXES
 9 Months Ended
Sep. 30, 2025
Income Tax Disclosure [Abstract]  
INCOME TAXES INCOME TAXES
The Company recorded income tax expense of $1.8 million and $0.8 million for the three months ended September 30, 2025 and 2024, respectively. The Company recorded income tax expense of $3.2 million and $4.1 million for the nine months ended September 30, 2025 and 2024, respectively. The Company’s income tax expense recorded during the three and nine months ended September 30, 2025 is primarily related to current foreign and state tax expense. A deferred tax liability of $6.8 million and $7.2 million was recorded as of September 30, 2025 and December 31, 2024, respectively, which is included in other long-term liabilities on the Company’s condensed consolidated balance sheet. The Company continues to maintain a full valuation allowance against its deferred tax assets based on management’s determination that it is more likely than not the benefit will not be realized.
The Company had $46.5 million and $43.3 million of unrecognized tax benefits at September 30, 2025 and December 31, 2024, respectively. These amounts have been recorded as a reduction to the Company’s deferred tax asset, if recognized they would not have an impact on the effective tax rate due to the existing valuation allowance. Certain of the Company's unrecognized tax benefits could change due to activities of various tax authorities, including possible settlement of audits, or through normal expiration of various statutes of limitations. The Company does not expect a material change in unrecognized tax benefits in the next twelve months.
As of September 30, 2025, due to the carryforward of unutilized net operating losses and research and development credits, the Company is subject to U.S. federal income tax examinations for the tax years 2005 through 2025, and to state income tax examinations for the tax years 2005 through 2025. No interest or penalties related to income taxes have been accrued or recognized as of September 30, 2025.
The Organization for Economic Co-operation and Development has endorsed a framework (“Pillar Two”) with model rules introducing a global minimum corporate tax rate via a system where multinational groups with consolidated revenue over €750.0 million are subject to a minimum effective tax rate of 15% on income arising in low-tax jurisdictions on a country-by-country basis. Many countries have implemented laws based on these model rules, with effective dates beginning January 1, 2024. These rules do not have a material impact on the Company for the current period and, as currently designed, are not expected to materially increase the Company’s global tax costs. The Company will continue to monitor U.S. and global legislative action related to Pillar Two for potential impacts.
On July 4, 2025, the One Big Beautiful Bill Act (“OBBBA”) was enacted in the United States. The OBBBA makes permanent several provisions of the Tax Cuts and Jobs Act, including 100% bonus depreciation, immediate expensing of domestic research and development costs, and the limitation on business interest expense. The legislation also introduces modifications to the international tax framework. The provisions of the OBBBA have varying effective dates, with certain provisions effective beginning in 2025 and others phased in through 2027. The Company has evaluated the impact of OBBBA on its consolidated financials statements, including its deferred tax assets and liabilities and overall effective tax rate and has concluded the impact is immaterial due to the Company's existing valuation allowance recorded against its deferred tax assets.
v3.25.3
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)
 9 Months Ended
Sep. 30, 2025
Accounting Policies [Abstract]  
Basis of Presentation and Principles of Consolidation
Basis of Presentation and Principles of Consolidation
The accompanying condensed consolidated financial statements, which include the accounts of the Company and those of its wholly owned subsidiaries and variable interest entities, are unaudited and have been prepared on a basis substantially consistent with the Company’s audited financial statements and notes as of and for the year ended December 31, 2024 included in the Company’s Annual Report on Form 10-K (the “2024 Form 10-K”). All intercompany transactions and balances have been eliminated upon consolidation. These condensed consolidated financial statements are prepared in conformity with accounting principles generally accepted (“GAAP”) in the United States of America (“U.S.”) and follow the requirements of the Securities and Exchange Commission (“SEC”) for interim reporting. In the opinion of management, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting only of adjustments of a normal and recurring nature) considered necessary for a fair statement of its financial position, operating results and cash flows for the periods presented. The condensed consolidated balance sheet at December 31, 2024 has been derived from audited financial statements, but does not contain all of the footnote disclosures from the 2024 Form 10-K. The results of the Company’s operations for any interim period are not necessarily indicative of the results of the Company’s operations for any other interim period or for a full fiscal year. The statements should be read in conjunction with the audited financial statements and related notes included in the 2024 Form 10-K.
Use of Estimates
Use of Estimates
The preparation of the condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Critical accounting policies are those that affect the Company’s financial statements materially and involve difficult, subjective or complex judgments by management, and actual results could differ from those estimates. These estimates include revenue recognition, valuation of intangible assets and goodwill, contingent consideration, and accounting for income taxes. The Company’s critical accounting policies and estimates are explained further in the notes to the condensed consolidated financial statements in this Quarterly Report on Form 10-Q and the 2024 Form 10-K.
Recent Accounting Pronouncements
Recent Accounting Pronouncements
Recently Adopted Accounting Pronouncements
The Company did not adopt any accounting standards updates (“ASU”) released by the Financial Accounting Standards Board (“FASB”) in the third quarter of 2025.
Recently Issued Accounting Pronouncements Not Yet Adopted
In October 2023, the FASB issued ASU No. 2023-06, Disclosure Improvements: Codification Amendments in Response to the SEC’s Disclosure Update and Simplification Initiative. This update modifies the disclosure or presentation requirements of a variety of topics in the Accounting Standards Codification to conform with certain SEC amendments in Release No. 33-10532, Disclosure Update and Simplification. The amendments in this update should be applied prospectively, and the effective date for each amendment will be the date on which the SEC’s removal of that related disclosure from Regulation S-X or S-K becomes effective. However, if the SEC has not removed the related disclosure from its regulations by June 30, 2027, the amendments will be removed from the Codification and not become effective. Early adoption is prohibited. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This update improves income tax disclosure requirements, primarily through enhanced transparency and decision usefulness of disclosures. The amendments in this update should be applied prospectively with the option to apply retrospectively and are effective for fiscal years beginning after December 15, 2024. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements and expects to adopt this guidance in the 2025 Annual Report on Form 10-K.
In November 2024, the FASB issued ASU No. 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses. This update enhances financial statement disclosures by requiring public business entities to disclose specified information about certain costs and expenses including the amounts of (a) purchases of inventory, (b) employee compensation, (c) depreciation, and (d) intangible asset amortization included in each relevant expense caption. The update also requires disclosure of certain amounts that are already required to be disclosed under current GAAP, disclosure of a qualitative description of the amounts remaining in relevant expense captions that are not separately disaggregated quantitatively, and disclosure of the total amount of selling expenses and, in annual reporting periods, an entity’s definition of selling expenses. The amendments in this update may be applied either prospectively or retrospectively and are effective for annual reporting periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In May 2025, the FASB issued ASU No. 2025-03, Business Combinations (Topic 805) and Consolidation (Topic 810): Determining the Accounting Acquirer in the Acquisition of a Variable Interest Entity. This guidance clarifies the framework for identifying the accounting acquirer in transactions involving variable interest entities that meet the definition of a business. The amendments should be applied prospectively and are effective for fiscal years beginning after December 15, 2026, including interim periods within those fiscal years. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance on its consolidated financial statements.
In July 2025, the FASB issued ASU No. 2025-05, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses for Account Receivable and Contract Assets. This update introduces a practical expedient for all entities when estimating expected credit losses on current accounts receivable and current contract assets arising from revenue transactions accounted for under Topic 606. The expedient allows entities to assume current conditions as of the balance sheet date remain unchanged over the remaining life of the asset. The amendments are required to be applied prospectively and are effective for annual and interim periods beginning after December 15, 2025. Early adoption is permitted. The Company is currently evaluating adoption of the practical expedient.
In September 2025, the FASB issued ASU No. 2025-06, Intangibles—Goodwill and Other— Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software. This update provides amendments to clarify and modernize the accounting for costs incurred to develop or acquire internal-use software. The amendments address the capitalization of implementation costs by utilizing a principles-based approach and consolidates website development guidance under Subtopic 350-40. The amendments can be applied prospectively, modified prospectively, or retrospectively and are effective for annual and interim periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the potential impact of this guidance and the timing of adoption.
In September 2025, the FASB issued ASU No. 2025-07, Derivatives and Hedging (Topic 815) and Revenue from Contracts with Customers (Topic 606): Derivatives Scope Refinements and Scope Clarification for Share-Based Noncash Consideration from a Customer in a Revenue Contract. This update introduces a scope exception to derivative accounting for certain contracts with underlyings tied to operations or activities specific to one of the parties. Additionally, the update clarifies that share-based noncash consideration received from a customer should be accounted for under Topic 606 until the right to receive or retain the consideration becomes unconditional. The amendments can be applied prospectively or modified retrospectively and are effective for annual and interim periods beginning after December 15, 2026. The Company expects to early adopt the provisions related to Topic 815 on a prospective basis and does not expect a significant impact to the Company’s consolidated financial statements. The provisions related to Topic 606 are not applicable.
Net Loss Per Share
Net Loss Per Share
Basic net loss per common share was determined by dividing net loss applicable to common stockholders by the weighted average common shares outstanding during the period. Basic and diluted net loss per share is the same because all outstanding common stock equivalents have been excluded, as they are anti-dilutive as a result of the Company’s losses.
Basis of Accounting, Policy
Business
Exact Sciences Corporation (together with its subsidiaries, “Exact,” or the “Company”) was incorporated in February 1995. A leading provider of cancer screening and diagnostic tests, Exact Sciences gives patients and health care professionals the clarity needed to take life-changing action earlier. Building on the success of Cologuard® and Oncotype DX® tests, Exact Sciences is investing in its pipeline to develop innovative solutions for use before, during, and after a cancer diagnosis
v3.25.3
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)
 9 Months Ended
Sep. 30, 2025
Accounting Policies [Abstract]  
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share
The following potentially issuable common shares were not included in the computation of diluted net loss per share because they would have an anti-dilutive effect due to net losses for each period:
September 30,
(In thousands)20252024
Shares issuable upon conversion of convertible notes23,223 26,526 
Shares issuable upon the release of restricted stock awards7,655 7,487 
Shares issuable upon the release of performance share units2,578 2,037 
Shares issuable upon exercise of stock options848 1,028 
34,304 37,078 
v3.25.3
REVENUE (Tables)
 9 Months Ended
Sep. 30, 2025
Revenue from Contract with Customer [Abstract]  
Schedule of disaggregation of revenue
The following table presents the Company’s revenues disaggregated by revenue source:
Three Months Ended September 30,Nine Months Ended September 30,
(In thousands)2025202420252024
Screening
Medicare Parts B & C$247,353 $201,423 $675,923 $570,550 
Commercial354,867 289,637 978,565 827,509 
Other64,020 53,841 180,240 153,246 
Total Screening666,240 544,901 1,834,728 1,551,305 
Precision Oncology
Medicare Parts B & C$50,924 $47,080 $144,732 $142,597 
Commercial50,376 47,685 146,679 143,572 
International58,784 49,433 165,628 140,688 
Other24,415 19,556 76,842 67,281 
Total Precision Oncology184,499 163,754 533,881 494,138 
Total$850,739 $708,655 $2,368,609 $2,045,443 
v3.25.3
MARKETABLE SECURITIES (Tables)
 9 Months Ended
Sep. 30, 2025
Cash and Cash Equivalents [Abstract]  
Cash, Cash Equivalents and Investments
The following table sets forth the Company’s cash, cash equivalents, and marketable securities at September 30, 2025 and December 31, 2024:
(In thousands)September 30, 2025December 31, 2024
Cash and cash equivalents
Cash and money market$781,729 $595,548 
Cash equivalents7,308 5,341 
Total cash and cash equivalents789,037 600,889 
Marketable securities
Available-for-sale debt securities$202,706 $431,165 
Equity securities11,352 5,972 
Total marketable securities214,058 437,137 
Total cash, cash equivalents and marketable securities$1,003,095 $1,038,026 
Schedule of available-for-sale securities
Available-for-sale debt securities, including the classification within the condensed consolidated balance sheet at September 30, 2025, consisted of the following:
(In thousands)Amortized Cost
Gains in Accumulated Other Comprehensive Income (Loss) (1)
Losses in Accumulated Other Comprehensive Income (Loss) (1)
Estimated Fair Value
Cash equivalents
U.S. government agency securities$7,308 $— $— $7,308 
Total cash equivalents7,308 — — 7,308 
Marketable securities
Corporate bonds$103,623 $652 $(20)$104,255 
U.S. government agency securities68,829 257 (1)69,085 
Asset backed securities29,292 78 (4)29,366 
Total marketable securities201,744 987 (25)202,706 
Total available-for-sale debt securities
$209,052 $987 $(25)$210,014 
______________
(1)There was no tax impact from the gains and losses in accumulated other comprehensive income (loss) (“AOCI”).
Available-for-sale debt securities, including the classification within the condensed consolidated balance sheet at December 31, 2024, consisted of the following:
(In thousands)Amortized Cost
Gains in Accumulated Other Comprehensive Income (Loss) (1)
Losses in Accumulated Other Comprehensive Income (Loss) (1)
Estimated Fair Value
Cash equivalents
U.S. government agency securities$5,341 $— $— $5,341 
Total cash equivalents5,341 — — 5,341 
Marketable securities
Corporate bonds$206,063 $932 $(121)$206,874 
U.S. government agency securities140,992 160 (200)140,952 
Asset backed securities83,134 256 (51)83,339 
Total marketable securities430,189 1,348 (372)431,165 
Total available-for-sale debt securities
$435,530 $1,348 $(372)$436,506 
______________
(1)There was no tax impact from the gains and losses in AOCI.
Schedule of contractual maturities of available-for-sale investments
The following table summarizes contractual underlying maturities of the Company’s available-for-sale debt securities at September 30, 2025:
Due one year or lessDue after one year through five years
(In thousands)CostFair ValueCostFair Value
Cash equivalents
U.S. government agency securities$7,308 $7,308 $— $— 
Total cash equivalents7,308 7,308 — — 
Marketable securities
Corporate bonds$37,654 $37,822 $65,969 $66,433 
U.S. government agency securities25,777 25,811 43,052 43,274 
Asset backed securities15 16 29,277 29,350 
Total marketable securities63,446 63,649 138,298 139,057 
Total available-for-sale securities$70,754 $70,957 $138,298 $139,057 
Schedule of gross unrealized losses and fair values of investments in an unrealized loss position
The following table summarizes the gross unrealized losses and fair values of available-for-sale debt securities in an unrealized loss position as of September 30, 2025 aggregated by investment category and length of time those individual securities have been in a continuous unrealized loss position:
Less than one yearOne year or greaterTotal
(In thousands)Fair ValueGross Unrealized LossFair ValueGross Unrealized LossFair ValueGross Unrealized Loss
Marketable securities
Corporate bonds$9,575 $(20)$302 $— $9,877 $(20)
U.S. government agency securities8,600 (1)— — 8,600 (1)
Asset backed securities2,326 (4)15 — 2,341 (4)
Total available-for-sale securities$20,501 $(25)$317 $— $20,818 $(25)
v3.25.3
INVENTORY (Tables)
 9 Months Ended
Sep. 30, 2025
Inventory Disclosure [Abstract]  
Schedule of inventory
Inventory consisted of the following:
(In thousands)September 30, 2025December 31, 2024
Raw materials$70,645 $69,730 
Semi-finished and finished goods94,139 92,653 
Total inventory$164,784 $162,383 
v3.25.3
PROPERTY, PLANT AND EQUIPMENT (Tables)
 9 Months Ended
Sep. 30, 2025
Property, Plant and Equipment [Abstract]  
Schedule of property, plant and equipment, net
The carrying value and estimated useful lives of property, plant and equipment are as follows:
(In thousands)Estimated Useful LifeSeptember 30, 2025December 31, 2024
Property, plant and equipment
Landn/a$4,716 $4,716 
Leasehold and building improvements(1)243,879 227,885 
Land improvements15 years6,747 6,747 
Buildings
30 - 40 years
290,777 290,777 
Computer equipment and computer software3 years235,050 206,460 
Machinery and equipment
3 - 10 years
378,706 339,421 
Furniture and fixtures
3 - 10 years
36,381 37,176 
Assets under constructionn/a84,445 89,065 
Property, plant and equipment, at cost1,280,701 1,202,247 
Accumulated depreciation(576,636)(508,574)
Property, plant and equipment, net$704,065 $693,673 
______________
(1)Lesser of remaining lease term, building life, or estimated useful life.
v3.25.3
INTANGIBLE ASSETS AND GOODWILL (Tables)
 9 Months Ended
Sep. 30, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of net-book value and estimated remaining life and finite lived intangible assets
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of September 30, 2025:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated Amortization
Net Balance at September 30, 2025
Finite-lived intangible assets
Acquired developed technology
5.8$887,498 $(474,965)$412,533 
Trade name10.1104,000 (40,590)63,410 
Patents and licenses8.859,492 (16,568)42,924 
Customer relationships5.34,000 (1,667)2,333 
Total finite-lived intangible assets1,054,990 (533,790)521,200 
In-process research and developmentn/a420,000 — 420,000 
Total intangible assets$1,474,990 $(533,790)$941,200 
The following table summarizes the net-book-value and estimated remaining life of the Company’s intangible assets as of December 31, 2024:
(In thousands)Weighted Average Remaining Life (Years)CostAccumulated Amortization
Net Balance at December 31, 2024
Finite-lived intangible assets
Acquired developed technology
6.4$887,104 $(412,504)$474,600 
Trade name10.8104,000 (35,153)68,847 
Patents and licenses9.556,542 (12,963)43,579 
Customer relationships6.04,000 (1,333)2,667 
Total finite-lived intangible assets1,051,646 (461,953)589,693 
In-process research and developmentn/a420,000 — 420,000 
Total intangible assets$1,471,646 $(461,953)$1,009,693 
Schedule of estimated future amortization expense, intangible assets
As of September 30, 2025, the estimated future amortization expense associated with the Company’s finite-lived intangible assets for each of the five succeeding fiscal years is as follows:
(In thousands)
2025 (remaining three months)$24,164 
202695,659 
202795,659 
202895,659 
202989,536 
Thereafter120,523 
$521,200 
Schedule of carrying amount of goodwill
The change in the carrying amount of goodwill for the periods ended September 30, 2025 and December 31, 2024 is as follows:
(In thousands)
Balance, January 1, 2024
$2,367,120 
Resolution Bioscience acquisition adjustments225 
Effects of changes in foreign currency exchange rates
(669)
Balance, December 31, 2024
2,366,676 
Effects of changes in foreign currency exchange rates
1,352 
Balance, September 30, 2025
$2,368,028 
v3.25.3
FAIR VALUE MEASUREMENTS (Tables)
 9 Months Ended
Sep. 30, 2025
Fair Value Disclosures [Abstract]  
Schedule of fair value measurements along with the level within the fair value hierarchy in which the fair value measurements fall
The following table presents the Company’s fair value measurements as of September 30, 2025 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair Value at September 30, 2025Quoted Prices in Active Markets for Identical Assets (Level 1)Significant Other Observable Inputs (Level 2)Significant Unobservable Inputs (Level 3)
Cash, cash equivalents, and restricted cash
Cash and money market$781,729 $781,729 $— $— 
U.S. government agency securities7,308 — 7,308 — 
Marketable securities
Corporate bonds$104,255 $— $104,255 $— 
U.S. government agency securities69,085 — 69,085 — 
Asset backed securities29,366 — 29,366 — 
Equity securities11,352 11,352 — — 
Non-marketable securities
$53,262 $— $— $53,262 
Liabilities
Contingent consideration$(284,113)$— $— $(284,113)
Total$772,244 $793,081 $210,014 $(230,851)
The following table presents the Company’s fair value measurements as of December 31, 2024 along with the level within the fair value hierarchy in which the fair value measurements, in their entirety, fall.
(In thousands)Fair Value at December 31, 2024Quoted Prices in Active Markets for Identical Assets (Level 1)Significant Other Observable Inputs (Level 2)Significant Unobservable Inputs (Level 3)
Cash, cash equivalents and restricted cash
Cash and money market$595,548 $595,548 $— $— 
Restricted cash (1)
5,747 5,747 — — 
U.S. government agency securities5,341 — 5,341 — 
Marketable securities
Corporate bonds$206,874 $— $206,874 $— 
U.S. government agency securities140,952 — 140,952 — 
Asset backed securities83,339 — 83,339 — 
Equity securities5,972 5,972 — — 
Non-marketable securities
$796 $— $— $796 
Liabilities
Contingent consideration$(282,212)$— $— $(282,212)
Total$762,357 $607,267 $436,506 $(281,416)
_________________________________
(1)Restricted cash primarily represents cash held by a third-party financial institution as part of a cash collateral agreement related to the Company’s credit card program. The restrictions will lapse upon the termination of the agreements or the removal of the cash collateral requirement by the third-parties.
Fair Value, by Balance Sheet Grouping [Table Text Block]
The following table summarizes the Company’s non-marketable investments, which are primarily included in other long-term assets on the condensed consolidated balance sheet as of September 30, 2025 and December 31, 2024:
(In thousands)September 30, 2025December 31, 2024
Investments for which the fair value option has been elected$53,262 $796 
Investments without readily determinable fair values50,941 50,448 
Equity method investments7,383 7,488 
Total$111,586 $58,732 
Securities Owned Not Readily Marketable [Table Text Block]
Gains and losses recorded on non-marketable securities for which the fair value option has been elected are recognized in investment income, net in the condensed consolidated statement of operations. The following table provides a reconciliation of the beginning and ending balances of non-marketable securities valued using the fair value option:
(In thousands)Non-Marketable Securities
Beginning balance, January 1, 2025
$796 
Purchases of non-marketable securities
50,850 
Changes in fair value1,616 
Settlement of non-marketable securities— 
Ending balance, September 30, 2025
$53,262 
Other Investments Not Readily Marketable
Investments without readily determinable fair values had the following cumulative upward and downward adjustments and aggregate carrying amounts:
(In thousands)
September 30, 2025September 30, 2024
Cumulative upward adjustments (1)
$5,595 $5,102 
Cumulative downward adjustments and impairments (2)
(16,850)(15,071)
Aggregate carrying value
50,941 52,227 
_________________________________
(1)    There were no material upward adjustments recorded for the three and nine months ended September 30, 2025 and 2024.
(2)    There were no material downward adjustments or impairments recorded for the three and nine months ended September 30, 2025 and 2024.
Schedule of fair value of contingent consideration
The following table provides a reconciliation of the beginning and ending balances of contingent consideration:
Three Months Ended September 30,Nine Months Ended September 30,
(In thousands)2025202420252024
Beginning balance
$275,408 $277,921 $282,212 $288,657 
Changes in fair value (1)8,705 5,310 21,901 (2,326)
Payments (2)— — (20,000)(3,100)
Ending balance
$284,113 $283,231 $284,113 $283,231 
______________
(1)The change in fair value of the contingent consideration liability is included in general and administrative expenses in the condensed consolidated statement of operations for the three and nine months ended September 30, 2025 and 2024.
(2)Payments were made in the nine months ended September 30, 2025 and 2024 to settle the product development milestone contingent consideration liabilities previously recorded related to the Company’s acquisitions of Ashion Analytics, LLC (“Ashion”) and OmicEra Diagnostics GmbH, respectively.
v3.25.3
CONVERTIBLE NOTES (Tables)
 9 Months Ended
Sep. 30, 2025
CONVERTIBLE NOTES [Abstract]  
Schedule of convertible note obligations included in the condensed consolidated balance sheets
Convertible note obligations included in the condensed consolidated balance sheet consisted of the following as of September 30, 2025:
Fair Value (1)
(In thousands)Principal AmountUnamortized Debt Discount and Issuance CostsNet Carrying AmountAmountLeveling
2031 Convertible Notes - 1.750%
$620,709 $(11,905)$608,804 $576,552 2
2030 Convertible Notes - 2.000%
572,993 (3,115)569,878 589,386 2
2028 Convertible Notes - 0.375%
589,380 (3,783)585,597 545,530 2
2027 Convertible Notes - 0.375%
563,822 (2,464)561,358 541,201 2
Convertible note obligations included in the condensed consolidated balance sheet consisted of the following as of December 31, 2024:
Fair Value (1)
(In thousands)Principal AmountUnamortized Debt Discount and Issuance CostsNet Carrying AmountAmountLeveling
2031 Convertible Notes - 1.750%
$620,709 $(13,511)$607,198 $581,648 2
2030 Convertible Notes - 2.000%
572,993 (3,642)569,351 592,756 2
2028 Convertible Notes - 0.375%
589,380 (4,952)584,428 512,761 2
2027 Convertible Notes - 0.375%
563,822 (3,732)560,090 523,932 2
2025 Convertible Notes - 1.000% (2)
249,172 (19)249,153 246,705 2
______________
(1)The fair values are based on observable market prices for this debt, which is traded in less active markets and therefore is classified as a Level 2 fair value measurement.
(2)The Company’s convertible notes due in 2025 (the “2025 Notes”) matured on January 15, 2025 and were included in convertible notes, net, current portion on the condensed consolidated balance sheet as of December 31, 2024. As discussed in further detail below, the 2025 Notes were settled in cash upon maturity in January 2025.
Schedule of allocation of transaction costs related to convertible debt
Issuance costs are amortized to interest expense, net over the term of the Notes. The following table summarizes the original issuance costs at the time of issuance for each set of Notes:
(In thousands)
2031 Convertible Notes
$6,780 
2030 Convertible Notes4,938 
2028 Convertible Notes24,453 
2027 Convertible Notes14,285 
2025 Convertible Notes17,646 
Schedule of interest expense
Interest expense on the Notes includes the following:
Three Months Ended September 30,Nine Months Ended September 30,
(In thousands)2025202420252024
Debt issuance costs amortization$1,154 $1,334 $3,455 $3,965 
Debt discount amortization386 322 1,134 611 
Gain on settlement of convertible notes
— — — (10,254)
Coupon interest expense6,662 7,285 20,075 19,054 
Total interest expense on convertible notes
$8,202 $8,941 $24,664 $13,376 
Schedule of effective interest rates related to convertible debt
The following table summarizes the effective interest rates of the Notes:
Three Months Ended September 30,Nine Months Ended September 30,
2025202420252024
2031 Convertible Notes
2.10 %2.10 %2.10 %2.06 %
2030 Convertible Notes2.12 %2.12 %2.12 %2.09 %
2028 Convertible Notes0.64 %0.64 %0.64 %0.63 %
2027 Convertible Notes0.68 %0.68 %0.67 %0.67 %
2025 Convertible Notesn/a1.18 %1.05 %1.17 %
v3.25.3
STOCKHOLDERS' EQUITY (Tables)
 9 Months Ended
Sep. 30, 2025
Equity [Abstract]  
Schedule of amounts recognized in accumulated other comprehensive income (loss) (AOCI)
The amounts recognized in AOCI for the nine months ended September 30, 2025 were as follows:
(In thousands)Cumulative Translation Adjustment
Unrealized Gain (Loss) on Securities (1)
AOCI
Balance at December 31, 2024$(1,920)$976 $(944)
Other comprehensive income before reclassifications
4,201 309 4,510 
Amounts reclassified from accumulated other comprehensive income (loss)
— (323)(323)
Net current period change in accumulated other comprehensive income (loss)
4,201 (14)4,187 
Balance at September 30, 2025$2,281 $962 $3,243 
The amounts recognized in AOCI for the nine months ended September 30, 2024 were as follows:
(In thousands)Cumulative Translation AdjustmentUnrealized Gain (Loss) on Securities (1)
AOCI
Balance at December 31, 2023$1,374 $54 $1,428 
Other comprehensive income before reclassifications
427 2,723 3,150 
Amounts reclassified from accumulated other comprehensive income (loss)
— 52 52 
Net current period change in accumulated other comprehensive income (loss)
427 2,775 3,202 
Balance at September 30, 2024$1,801 $2,829 $4,630 
______________
(1)There was no tax impact from the amounts recognized in AOCI for the nine months ended September 30, 2025 and 2024. The unrealized gain (loss) recorded on available-for-sale securities is a non-cash investing activity.
Schedule of amounts reclassified from accumulated other comprehensive income (loss)
Amounts reclassified from AOCI for the nine months ended September 30, 2025 and 2024 were as follows:
Affected Line Item in the
Statements of Operations		Nine Months Ended September 30,
Details about AOCI Components (In thousands)20252024
Change in value of available-for-sale investments
Sales and maturities of available-for-sale investments
Investment income, net
$(323)$52 
Total reclassifications$(323)$52 
v3.25.3
STOCK-BASED COMPENSATION (Tables)
 9 Months Ended
Sep. 30, 2025
Share-Based Payment Arrangement [Abstract]  
Summary of Stock Option Activity Under the Stock Plans
A summary of stock option activity under the Stock Plans is as follows:
Option SharesWeighted Average Exercise PriceWeighted Average Remaining Contractual Term (Years)Aggregate Intrinsic Value (1)
(Aggregate intrinsic value in thousands)
Outstanding, January 1, 2025982,742 $53.60 3.1
Exercised(99,926)23.83 
Forfeited(34,528)84.02 
Outstanding, September 30, 2025848,288 $55.86 2.7$13,570 
Vested and expected to vest, September 30, 2025
848,288 $55.86 2.7$13,570 
Exercisable, September 30, 2025848,288 $55.86 2.7$13,570 
______________
(1)The total intrinsic value of options exercised, net of shares withheld for taxes, during the nine months ended September 30, 2025 and 2024 was $2.5 million and $6.2 million, respectively, determined as of the date of exercise.
Summary of Restricted Stock and Restricted Stock Unit Activity Under the Stock Plans
A summary of restricted stock and RSU activity is as follows:
Restricted SharesWeighted Average Grant Date Fair Value (1)
Outstanding, January 1, 20257,244,796 $63.18 
Granted3,655,785 51.34 
Released (2)(2,505,103)68.30 
Forfeited(740,378)55.97 
Outstanding, September 30, 20257,655,100 $55.96 
______________
(1)The weighted average grant date fair value of the RSUs granted during the nine months ended September 30, 2024 was $56.67.
(2)The fair value of RSUs vested and converted to shares of the Company’s common stock was $171.1 million and $173.3 million during the nine months ended September 30, 2025 and 2024, respectively.
Share-based Payment Arrangement, Performance Shares, Activity
A summary of PSU activity is as follows:
Performance Share Units (1)Weighted Average Grant Date Fair Value (2)
Outstanding, January 1, 20252,021,208 $75.86 
Granted1,283,717 59.49 
Released (3)(152,565)88.24 
Forfeited(573,904)81.85 
Outstanding, September 30, 20252,578,456 $65.15 
______________
(1)The PSUs listed above assumes attainment of maximum payout rates as set forth in the performance criteria. Applying actual or expected payout rates, the number of outstanding PSUs as of September 30, 2025 was 1,109,465.
(2)The weighted average grant date fair value of the PSUs granted during the nine months ended September 30, 2024 was $63.68.
(3)The fair value of PSUs vested and converted to shares of the Company’s common stock was $13.5 million and $9.9 million for the nine months ended September 30, 2025 and 2024, respectively.
Schedule of Share-Based Compensation, Employee Stock Purchase Plan, Activity
The fair value of shares purchased during the three and nine months ended September 30, 2025 and 2024 under the ESPP is based on the assumptions in the following table:
Three Months Ended September 30,Nine Months Ended September 30,
(In thousands)2025202420252024
Risk-free interest rates
(1)
(1)
4.42% - 5.15%
4.71% - 5.30%
Expected term (in years)(1)(1)
0.5 - 1.25
1.17
Expected volatility(1)(1)
44.40% - 57.15%
55.67% - 63.13%
Dividend yield(1)(1)—%—%
______________
(1)The Company did not issue stock purchase rights under its 2010 Employee Stock Purchase Plan during the period indicated.
v3.25.3
COMMITMENTS AND CONTINGENCIES (Tables)
 9 Months Ended
Sep. 30, 2025
Commitments and Contingencies Disclosure [Abstract]  
Supplemental disclosure of cash flow information related to our operating leases
Supplemental disclosure of cash flow information related to the Company’s cash and non-cash activities with its leases are as follows:
Nine Months Ended September 30,
(In thousands)20252024
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases$30,668$28,658
Operating cash flows from finance leases864991
Finance cash flows from finance leases4,9634,890
Non-cash investing and financing activities:
Right-of-use assets obtained in exchange for new operating lease liabilities
21,64617,860
Right-of-use assets obtained in exchange for new finance lease liabilities—15,995
Weighted-average remaining lease term - operating leases (in years)7.117.58
Weighted-average remaining lease term - finance leases (in years)2.433.08
Weighted-average discount rate - operating leases6.53 %6.55 %
Weighted-average discount rate - finance leases6.68 %6.71 %
v3.25.3
Restructuring and Related Activities (Tables)
 9 Months Ended
Sep. 30, 2025
Restructuring and Related Activities [Abstract]  
Restructuring and Related Costs
The Company recorded the following charges related to the Plan for the three and nine months ended September 30, 2025.
(In thousands)
Three Months Ended
Nine Months Ended
Restructuring charges
$15,289 $26,388 
Business transformation costs (1)
17,291 46,220 
Total restructuring and business transformation
$32,580 $72,608 
______________
(1)Business transformation costs represent non-recurring expenses for strategic projects with anticipated long-term benefits to the Company focused on cost reduction and productivity improvement that do not meet the definition of restructuring charges. For the three and nine months ended September 30, 2025, these costs primarily include consulting services, and employee termination benefits.
Schedule of Restructuring Reserve by Type of Cost
The following table summarizes activity in the liability related to the Company’s restructuring initiatives:
(In thousands)Employee Termination Costs
Other Costs
Total
Balance, December 31, 2024
$— $— $— 
Charges18,932 7,456 26,388 
Payments(3,176)(6,590)(9,766)
Adjustments (1)
533 — 533 
Balance, September 30, 2025
$16,289 $866 $17,155 
______________
(1)Adjustments relate to the effects of foreign currency exchange rates.
Restructuring and related costs by expense caption
The restructuring charges were recorded as follows within the condensed consolidated statement of operations:
Three Months Ended September 30, 2025
Cost of salesResearch and developmentSales and marketingGeneral and administrativeTotal
Employee termination costs
$— $74 $483 $13,139 $13,696 
Other costs
— — — 1,593 1,593 
Total restructuring charges$— $74 $483 $14,732 $15,289 
Nine Months Ended September 30, 2025
Cost of salesResearch and developmentSales and marketingGeneral and administrativeTotal
Employee termination costs
$85 $554 $3,154 $15,139 $18,932 
Other costs
— — — 7,456 7,456 
Total restructuring charges$85 $554 $3,154 $22,595 $26,388 
v3.25.3
SEGMENT INFORMATION (Tables)
 9 Months Ended
Sep. 30, 2025
Segment Reporting [Abstract]  
Revenue from external customers by geographic areas
The following table summarizes total revenue from customers by geographic region. Product revenues are attributed to countries based on ship-to location.
Three Months Ended September 30,Nine Months Ended September 30,
(In thousands)2025202420252024
United States$791,955 $659,222 $2,202,981 $1,904,755 
Outside of United States58,784 49,433 165,628 140,688 
Total revenues$850,739 $708,655 $2,368,609 $2,045,443 
v3.25.3
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - RECLASSIFICATIONS (Details) - USD ($)
$ in Millions
 3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Accounting Policies [Abstract]      
Reclassification, Comparability Adjustment  
Reclassifications
Certain prior year amounts have been reclassified to conform to the current year presentation in the condensed consolidated financial statements and accompanying notes to the condensed consolidated financial statements.
Amortization of acquired intangible assets, which was previously presented as a separate line item on the Company’s condensed consolidated statements of operations, is now presented within the line item each intangible asset relates to within cost of sales, research and development, sales and marketing, and general and administrative expenses. The following amounts of amortization of acquired intangible assets for the three and nine months ended September 30, 2024 have been reclassified to conform to current year presentation: $21.1 million and $63.3 million in cost of sales, respectively, $1.4 million and $1.9 million in research and development, respectively, $1.9 million and $5.8 million in sales and marketing, respectively, and an insignificant amount in general and administrative expenses. Due to the reclassification related to cost of sales, the Company is now presenting gross profit on the Company's condensed consolidated statements of operations.
Certain general and administrative expenses totaling $23.7 million and $71.5 million for the three and nine months ended September 30, 2024, respectively, have been reclassified to sales and marketing expenses to conform to current year presentation. The amounts reclassified are related to customer care and customer experience.
  
General and Administrative Expense      
Reclassification [Line Items]      
Prior Period Reclassification Adjustment $ 23.7   $ 71.5
Cost of Sales      
Reclassification [Line Items]      
Prior Period Reclassification Adjustment 21.1   63.3
Research and Development Expense      
Reclassification [Line Items]      
Prior Period Reclassification Adjustment 1.4   1.9
Selling and Marketing Expense      
Reclassification [Line Items]      
Prior Period Reclassification Adjustment $ 1.9   $ 5.8
v3.25.3
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Net Loss Per Share (Details) - shares
shares in Thousands
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Common shares not included in the computation of diluted net loss per share    
Potentially issuable common shares not included in the computation of diluted net loss per share because they would have an anti-dilutive effect 34,304 37,078
Shares issuable upon exercise of stock options    
Common shares not included in the computation of diluted net loss per share    
Potentially issuable common shares not included in the computation of diluted net loss per share because they would have an anti-dilutive effect 848 1,028
Shares issuable upon the release of restricted stock awards    
Common shares not included in the computation of diluted net loss per share    
Potentially issuable common shares not included in the computation of diluted net loss per share because they would have an anti-dilutive effect 7,655 7,487
Shares issuable upon the release of performance share units    
Common shares not included in the computation of diluted net loss per share    
Potentially issuable common shares not included in the computation of diluted net loss per share because they would have an anti-dilutive effect 2,578 2,037
Shares issuable upon conversion of convertible notes    
Common shares not included in the computation of diluted net loss per share    
Potentially issuable common shares not included in the computation of diluted net loss per share because they would have an anti-dilutive effect 23,223 26,526
v3.25.3
REVENUE - Schedule of Disaggregation of Revenue (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Disaggregation of Revenue [Line Items]        
Revenue recognized $ 850,739 $ 708,655 $ 2,368,609 $ 2,045,443
Screening        
Disaggregation of Revenue [Line Items]        
Revenue recognized 666,240 544,901 1,834,728 1,551,305
Screening | Medicare Parts B & C        
Disaggregation of Revenue [Line Items]        
Revenue recognized 247,353 201,423 675,923 570,550
Screening | Commercial        
Disaggregation of Revenue [Line Items]        
Revenue recognized 354,867 289,637 978,565 827,509
Screening | Other        
Disaggregation of Revenue [Line Items]        
Revenue recognized 64,020 53,841 180,240 153,246
Precision Oncology        
Disaggregation of Revenue [Line Items]        
Revenue recognized 184,499 163,754 533,881 494,138
Precision Oncology | Medicare Parts B & C        
Disaggregation of Revenue [Line Items]        
Revenue recognized 50,924 47,080 144,732 142,597
Precision Oncology | Commercial        
Disaggregation of Revenue [Line Items]        
Revenue recognized 50,376 47,685 146,679 143,572
Precision Oncology | International        
Disaggregation of Revenue [Line Items]        
Revenue recognized 58,784 49,433 165,628 140,688
Precision Oncology | Other        
Disaggregation of Revenue [Line Items]        
Revenue recognized $ 24,415 $ 19,556 $ 76,842 $ 67,281
v3.25.3
REVENUE - Narrative (Details)
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Disaggregation of Revenue [Line Items]        
Contract with Customer, Liability, Cumulative Catch-up Adjustment to Revenue, Change in Estimate of Transaction Price as a Percentage of Revenue     (1.00%) (1.00%)
Variable consideration        
Disaggregation of Revenue [Line Items]        
Contract with Customer, Liability, Cumulative Catch-up Adjustment to Revenue, Change in Estimate of Transaction Price as a Percentage of Revenue (1.00%) (1.00%)    
v3.25.3
MARKETABLE SECURITIES - Schedule of Cash and Cash Equivalents (Details) - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Sep. 30, 2024
Marketable securities      
Cash and money market $ 781,729 $ 595,548  
Cash equivalents 7,308 5,341  
Total cash, cash equivalents and restricted cash 789,037 600,889 $ 588,830
Equity securities 11,352 5,972  
Marketable securities 214,058 437,137  
Total cash, cash equivalents and marketable securities 1,003,095 1,038,026  
Marketable securities      
Marketable securities      
Available-for-sale debt securities $ 202,706 $ 431,165  
v3.25.3
MARKETABLE SECURITIES - Schedule of Available For Sale Securities (Details) - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Available-for-sale securities    
Amortized Cost $ 209,052 $ 435,530
Gains in Accumulated Other Comprehensive Income (Loss) 987 1,348
Losses in Accumulated Other Comprehensive Income (Loss) (25) (372)
Estimated Fair Value 210,014 436,506
Cash equivalents    
Available-for-sale securities    
Amortized Cost 7,308 5,341
Gains in Accumulated Other Comprehensive Income (Loss) 0 0
Losses in Accumulated Other Comprehensive Income (Loss) 0 0
Estimated Fair Value 7,308 5,341
Marketable securities    
Available-for-sale securities    
Amortized Cost 201,744 430,189
Gains in Accumulated Other Comprehensive Income (Loss) 987 1,348
Losses in Accumulated Other Comprehensive Income (Loss) (25) (372)
Estimated Fair Value 202,706 431,165
U.S. government agency securities | Cash equivalents    
Available-for-sale securities    
Amortized Cost 7,308 5,341
Gains in Accumulated Other Comprehensive Income (Loss) 0 0
Losses in Accumulated Other Comprehensive Income (Loss) 0 0
Estimated Fair Value 7,308 5,341
U.S. government agency securities | Marketable securities    
Available-for-sale securities    
Amortized Cost 68,829 140,992
Gains in Accumulated Other Comprehensive Income (Loss) 257 160
Losses in Accumulated Other Comprehensive Income (Loss) (1) (200)
Estimated Fair Value 69,085 140,952
Corporate bonds | Marketable securities    
Available-for-sale securities    
Amortized Cost 103,623 206,063
Gains in Accumulated Other Comprehensive Income (Loss) 652 932
Losses in Accumulated Other Comprehensive Income (Loss) (20) (121)
Estimated Fair Value 104,255 206,874
Asset backed securities | Marketable securities    
Available-for-sale securities    
Amortized Cost 29,292 83,134
Gains in Accumulated Other Comprehensive Income (Loss) 78 256
Losses in Accumulated Other Comprehensive Income (Loss) (4) (51)
Estimated Fair Value $ 29,366 $ 83,339
v3.25.3
MARKETABLE SECURITIES - Schedule of Underlying Maturities of AFS Securities (Details) - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Available-for-sale securities    
Due in one year or less, Cost $ 70,754  
Due in one year or less, Fair Value 70,957  
Due after one year through five years, Cost 138,298  
Due after one year through five years, Fair Value 139,057  
Debt Securities, Available-for-Sale, Amortized Cost, Excluding Accrued Interest, before Allowance for Credit Loss 209,052 $ 435,530
Gains in Accumulated Other Comprehensive Income (Loss) 987 1,348
Losses in Accumulated Other Comprehensive Income (Loss) (25) (372)
Estimated Fair Value 210,014 436,506
Cash equivalents    
Available-for-sale securities    
Due in one year or less, Cost 7,308  
Due in one year or less, Fair Value 7,308  
Due after one year through five years, Cost 0  
Due after one year through five years, Fair Value 0  
Debt Securities, Available-for-Sale, Amortized Cost, Excluding Accrued Interest, before Allowance for Credit Loss 7,308 5,341
Gains in Accumulated Other Comprehensive Income (Loss) 0 0
Losses in Accumulated Other Comprehensive Income (Loss) 0 0
Estimated Fair Value 7,308 5,341
Cash equivalents | U.S. government agency securities    
Available-for-sale securities    
Due in one year or less, Cost 7,308  
Due in one year or less, Fair Value 7,308  
Due after one year through five years, Cost 0  
Due after one year through five years, Fair Value 0  
Debt Securities, Available-for-Sale, Amortized Cost, Excluding Accrued Interest, before Allowance for Credit Loss 7,308 5,341
Gains in Accumulated Other Comprehensive Income (Loss) 0 0
Losses in Accumulated Other Comprehensive Income (Loss) 0 0
Estimated Fair Value 7,308 5,341
Marketable securities    
Available-for-sale securities    
Due in one year or less, Cost 63,446  
Due in one year or less, Fair Value 63,649  
Due after one year through five years, Cost 138,298  
Due after one year through five years, Fair Value 139,057  
Debt Securities, Available-for-Sale, Amortized Cost, Excluding Accrued Interest, before Allowance for Credit Loss 201,744 430,189
Gains in Accumulated Other Comprehensive Income (Loss) 987 1,348
Losses in Accumulated Other Comprehensive Income (Loss) (25) (372)
Estimated Fair Value 202,706 431,165
Marketable securities | U.S. government agency securities    
Available-for-sale securities    
Due in one year or less, Cost 25,777  
Due in one year or less, Fair Value 25,811  
Due after one year through five years, Cost 43,052  
Due after one year through five years, Fair Value 43,274  
Debt Securities, Available-for-Sale, Amortized Cost, Excluding Accrued Interest, before Allowance for Credit Loss 68,829 140,992
Gains in Accumulated Other Comprehensive Income (Loss) 257 160
Losses in Accumulated Other Comprehensive Income (Loss) (1) (200)
Estimated Fair Value 69,085 140,952
Marketable securities | Corporate bonds    
Available-for-sale securities    
Due in one year or less, Cost 37,654  
Due in one year or less, Fair Value 37,822  
Due after one year through five years, Cost 65,969  
Due after one year through five years, Fair Value 66,433  
Debt Securities, Available-for-Sale, Amortized Cost, Excluding Accrued Interest, before Allowance for Credit Loss 103,623 206,063
Gains in Accumulated Other Comprehensive Income (Loss) 652 932
Losses in Accumulated Other Comprehensive Income (Loss) (20) (121)
Estimated Fair Value 104,255 206,874
Marketable securities | Asset backed securities    
Available-for-sale securities    
Due in one year or less, Cost 15  
Due in one year or less, Fair Value 16  
Due after one year through five years, Cost 29,277  
Due after one year through five years, Fair Value 29,350  
Debt Securities, Available-for-Sale, Amortized Cost, Excluding Accrued Interest, before Allowance for Credit Loss 29,292 83,134
Gains in Accumulated Other Comprehensive Income (Loss) 78 256
Losses in Accumulated Other Comprehensive Income (Loss) (4) (51)
Estimated Fair Value $ 29,366 $ 83,339
v3.25.3
MARKETABLE SECURITIES - Schedule of Gross Unrealized Losses and Fair Values of Investments in an Unrealized Loss Position (Details)
$ in Thousands
Sep. 30, 2025
USD ($)
Marketable securities  
Total fair value of available-for-sale securities in a continuous unrealized loss position for less than twelve months $ 20,501
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position for less than twelve months (25)
Debt securities, available-for-sale, continuous unrealized loss position, 12 months of longer 317
Debt securities, available-for-sale, continuous unrealized loss position, 12 months of longer, accumulated loss 0
Total fair value of available-for-sale securities in a continuous unrealized loss position 20,818
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position (25)
Corporate bonds | Marketable securities  
Marketable securities  
Total fair value of available-for-sale securities in a continuous unrealized loss position for less than twelve months 9,575
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position for less than twelve months (20)
Debt securities, available-for-sale, continuous unrealized loss position, 12 months of longer 302
Debt securities, available-for-sale, continuous unrealized loss position, 12 months of longer, accumulated loss 0
Total fair value of available-for-sale securities in a continuous unrealized loss position 9,877
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position (20)
Asset backed securities | Marketable securities  
Marketable securities  
Total fair value of available-for-sale securities in a continuous unrealized loss position for less than twelve months 2,326
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position for less than twelve months (4)
Debt securities, available-for-sale, continuous unrealized loss position, 12 months of longer 15
Debt securities, available-for-sale, continuous unrealized loss position, 12 months of longer, accumulated loss 0
Total fair value of available-for-sale securities in a continuous unrealized loss position 2,341
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position (4)
U.S. government agency securities | Marketable securities  
Marketable securities  
Total fair value of available-for-sale securities in a continuous unrealized loss position for less than twelve months 8,600
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position for less than twelve months (1)
Debt securities, available-for-sale, continuous unrealized loss position, 12 months of longer 0
Debt securities, available-for-sale, continuous unrealized loss position, 12 months of longer, accumulated loss 0
Total fair value of available-for-sale securities in a continuous unrealized loss position 8,600
Total gross unrealized losses of available-for-sale securities in a continuous unrealized loss position $ (1)
v3.25.3
INVENTORY (Details) - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Inventory Disclosure [Abstract]    
Raw materials $ 70,645 $ 69,730
Semi-finished and finished goods 94,139 92,653
Total inventory $ 164,784 $ 162,383
v3.25.3
PROPERTY, PLANT AND EQUIPMENT - Schedule of Estimated Useful Lives (Details) - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Property, plant and equipment    
Property, plant and equipment, at cost $ 1,280,701 $ 1,202,247
Accumulated depreciation (576,636) (508,574)
Property, plant and equipment, net 704,065 693,673
Land    
Property, plant and equipment    
Property, plant and equipment, at cost 4,716 4,716
Leasehold and building improvements    
Property, plant and equipment    
Property, plant and equipment, at cost $ 243,879 227,885
Land improvements    
Property, plant and equipment    
Estimated Useful Life 15 years  
Property, plant and equipment, at cost $ 6,747 6,747
Buildings    
Property, plant and equipment    
Property, plant and equipment, at cost $ 290,777 290,777
Computer equipment and computer software    
Property, plant and equipment    
Estimated Useful Life 3 years  
Property, plant and equipment, at cost $ 235,050 206,460
Machinery and equipment    
Property, plant and equipment    
Property, plant and equipment, at cost 378,706 339,421
Furniture and fixtures    
Property, plant and equipment    
Property, plant and equipment, at cost 36,381 37,176
Assets under construction    
Property, plant and equipment    
Property, plant and equipment, at cost $ 84,445 $ 89,065
Minimum | Buildings    
Property, plant and equipment    
Estimated Useful Life 30 years  
Minimum | Machinery and equipment    
Property, plant and equipment    
Estimated Useful Life 3 years  
Minimum | Furniture and fixtures    
Property, plant and equipment    
Estimated Useful Life 3 years  
Maximum | Buildings    
Property, plant and equipment    
Estimated Useful Life 40 years  
Maximum | Machinery and equipment    
Property, plant and equipment    
Estimated Useful Life 10 years  
Maximum | Furniture and fixtures    
Property, plant and equipment    
Estimated Useful Life 10 years  
v3.25.3
PROPERTY, PLANT AND EQUIPMENT - Narrative (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Property, plant and equipment        
Depreciation $ 31,700 $ 30,300 $ 92,765 $ 90,655
Assets under construction 84,400   84,400  
Machinery and equipment        
Property, plant and equipment        
Assets under construction 35,100   35,100  
Leasehold and building improvements        
Property, plant and equipment        
Assets under construction 26,000   26,000  
Computer software        
Property, plant and equipment        
Assets under construction $ 23,300   $ 23,300  
v3.25.3
INTANGIBLE ASSETS AND GOODWILL - Schedule of Finite Lived Intangible Assets Net Balances and Weighted Average Useful Lives (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Finite-Lived Intangible Assets [Line Items]          
Cost $ 1,054,990   $ 1,054,990   $ 1,051,646
Accumulated Amortization (533,790)   (533,790)   (461,953)
Intangibles, net 521,200   521,200   589,693
In-process research and development 420,000   420,000   420,000
Finite-lived and indefinite-lived intangible assets, gross 1,474,990   1,474,990   1,471,646
Finite-lived and indefinite-lived intangible assets, net 941,200   941,200   $ 1,009,693
Impairment of intangible assets, finite-lived 0 $ 0 0 $ 0  
Amortization of acquired intangible assets $ 24,200 $ 24,400 $ 72,461 $ 71,057  
Trade name          
Finite-Lived Intangible Assets [Line Items]          
Weighted-average remaining useful life of finite-lived intangible asset (in years) 10 years 1 month 6 days   10 years 1 month 6 days   10 years 9 months 18 days
Cost $ 104,000   $ 104,000   $ 104,000
Accumulated Amortization (40,590)   (40,590)   (35,153)
Intangibles, net $ 63,410   $ 63,410   $ 68,847
Customer relationships          
Finite-Lived Intangible Assets [Line Items]          
Weighted-average remaining useful life of finite-lived intangible asset (in years) 5 years 3 months 18 days   5 years 3 months 18 days   6 years
Cost $ 4,000   $ 4,000   $ 4,000
Accumulated Amortization (1,667)   (1,667)   (1,333)
Intangibles, net $ 2,333   $ 2,333   $ 2,667
Patents and licenses          
Finite-Lived Intangible Assets [Line Items]          
Weighted-average remaining useful life of finite-lived intangible asset (in years) 8 years 9 months 18 days   8 years 9 months 18 days   9 years 6 months
Cost $ 59,492   $ 59,492   $ 56,542
Accumulated Amortization (16,568)   (16,568)   (12,963)
Intangibles, net $ 42,924   $ 42,924   $ 43,579
Developed Technology Rights          
Finite-Lived Intangible Assets [Line Items]          
Weighted-average remaining useful life of finite-lived intangible asset (in years) 5 years 9 months 18 days   5 years 9 months 18 days   6 years 4 months 24 days
Cost $ 887,498   $ 887,498   $ 887,104
Accumulated Amortization (474,965)   (474,965)   (412,504)
Intangibles, net $ 412,533   $ 412,533   $ 474,600
v3.25.3
INTANGIBLE ASSETS AND GOODWILL - Schedule of Future Amortization Expense (Details) - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]    
2025 $ 24,164  
2026 95,659  
2027 95,659  
2028 95,659  
2029 89,536  
Thereafter 120,523  
Intangibles, net $ 521,200 $ 589,693
v3.25.3
INTANGIBLE ASSETS AND GOODWILL - Schedule of Changes in Goodwill (Details) - USD ($)
$ in Thousands
 9 Months Ended 12 Months Ended
Sep. 30, 2025
Dec. 31, 2024
Recognized Goodwill    
Beginning balance $ 2,366,676 $ 2,367,120
Goodwill, foreign currency translation gain (loss) 1,352 (669)
Ending balance $ 2,368,028 2,366,676
Resolution Bioscience    
Recognized Goodwill    
Resolution Bioscience acquisition adjustments   $ 225
v3.25.3
INTANGIBLE ASSETS AND GOODWILL - Narrative (Details) - USD ($)
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Finite-Lived Intangible Assets [Line Items]          
Gross value of intangible asset $ 1,054,990,000   $ 1,054,990,000   $ 1,051,646,000
Finite-lived intangible assets, accumulated amortization 533,790,000   533,790,000   461,953,000
Intangibles, net 521,200,000   521,200,000   589,693,000
Impairment losses 0 $ 0 0 $ 0  
Developed Technology Rights          
Finite-Lived Intangible Assets [Line Items]          
Gross value of intangible asset 887,498,000   887,498,000   887,104,000
Finite-lived intangible assets, accumulated amortization 474,965,000   474,965,000   412,504,000
Intangibles, net $ 412,533,000   $ 412,533,000   $ 474,600,000
v3.25.3
FAIR VALUE MEASUREMENTS - Schedule of Fair Value (Details) - USD ($)
$ in Thousands
Sep. 30, 2025
Jun. 30, 2025
Dec. 31, 2024
Sep. 30, 2024
Jun. 30, 2024
Dec. 31, 2023
Fair value measurements            
Equity securities $ 11,352   $ 5,972      
Non-marketable securities 53,262   796      
Contingent consideration 284,113 $ 275,408 282,212 $ 283,231 $ 277,921 $ 288,657
Fair Value, Recurring            
Fair value measurements            
Restricted Cash, Fair Value Disclosure     5,747      
Equity securities 11,352   5,972      
Non-marketable securities 53,262   796      
Contingent consideration 284,113   282,212      
Total 772,244   762,357      
Fair Value, Recurring | Corporate bonds            
Fair value measurements            
Estimated Fair Value 104,255   206,874      
Fair Value, Recurring | U.S. government agency securities            
Fair value measurements            
Estimated Fair Value 69,085   140,952      
Fair Value, Recurring | Asset backed securities            
Fair value measurements            
Estimated Fair Value 29,366   83,339      
Fair Value, Recurring | Cash and money market            
Fair value measurements            
Cash and cash equivalents, fair value 781,729   595,548      
Fair Value, Recurring | U.S. government agency securities            
Fair value measurements            
Cash and cash equivalents, fair value 7,308   5,341      
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring            
Fair value measurements            
Restricted Cash, Fair Value Disclosure     5,747      
Equity securities 11,352   5,972      
Non-marketable securities 0   0      
Contingent consideration 0   0      
Total 793,081   607,267      
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring | Corporate bonds            
Fair value measurements            
Estimated Fair Value 0   0      
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring | U.S. government agency securities            
Fair value measurements            
Estimated Fair Value 0   0      
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring | Asset backed securities            
Fair value measurements            
Estimated Fair Value 0   0      
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring | Cash and money market            
Fair value measurements            
Cash and cash equivalents, fair value 781,729   595,548      
Quoted Prices in Active Markets for Identical Assets (Level 1) | Fair Value, Recurring | U.S. government agency securities            
Fair value measurements            
Cash and cash equivalents, fair value 0   0      
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring            
Fair value measurements            
Restricted Cash, Fair Value Disclosure     0      
Equity securities 0   0      
Non-marketable securities 0   0      
Contingent consideration 0   0      
Total 210,014   436,506      
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring | Corporate bonds            
Fair value measurements            
Estimated Fair Value 104,255   206,874      
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring | U.S. government agency securities            
Fair value measurements            
Estimated Fair Value 69,085   140,952      
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring | Asset backed securities            
Fair value measurements            
Estimated Fair Value 29,366   83,339      
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring | Cash and money market            
Fair value measurements            
Cash and cash equivalents, fair value 0   0      
Significant Other Observable Inputs (Level 2) | Fair Value, Recurring | U.S. government agency securities            
Fair value measurements            
Cash and cash equivalents, fair value 7,308   5,341      
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring            
Fair value measurements            
Restricted Cash, Fair Value Disclosure     0      
Equity securities 0   0      
Non-marketable securities 53,262   796      
Contingent consideration 284,113   282,212      
Total (230,851)   (281,416)      
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring | Corporate bonds            
Fair value measurements            
Estimated Fair Value 0   0      
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring | U.S. government agency securities            
Fair value measurements            
Estimated Fair Value 0   0      
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring | Asset backed securities            
Fair value measurements            
Estimated Fair Value 0   0      
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring | Cash and money market            
Fair value measurements            
Cash and cash equivalents, fair value 0   0      
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring | U.S. government agency securities            
Fair value measurements            
Cash and cash equivalents, fair value $ 0   $ 0      
v3.25.3
FAIR VALUE MEASUREMENTS - Schedule of Non-marketable Equity Investments (Details) - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
Dec. 31, 2024
Sep. 30, 2024
Fair Value Disclosures [Abstract]      
Equity Securities without Readily Determinable Fair Value, Upward Price Adjustment, Cumulative Amount $ 5,595   $ 5,102
Equity Securities without Readily Determinable Fair Value, Downward Price Adjustment, Cumulative Amount (16,850)   (15,071)
Other Investment Not Readily Marketable, Fair Value 50,941 $ 50,448 52,227
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]      
Other Assets, Fair Value Disclosure 111,586 58,732  
Non-marketable securities 53,262 796  
Other Investment Not Readily Marketable, Fair Value 50,941 50,448 $ 52,227
Equity Method Investments, Fair Value Disclosure 7,383 7,488  
Security Owned Not Readily Marketable [Line Items]      
Changes in fair value 1,616    
Settlements 0    
Purchases of non-marketable securities 50,850    
Non-marketable securities $ 53,262 $ 796  
Other Investments Not Readily Marketable
Investments without readily determinable fair values had the following cumulative upward and downward adjustments and aggregate carrying amounts:
(In thousands)
September 30, 2025September 30, 2024
Cumulative upward adjustments (1)
$5,595 $5,102 
Cumulative downward adjustments and impairments (2)
(16,850)(15,071)
Aggregate carrying value
50,941 52,227 
_________________________________
(1)    There were no material upward adjustments recorded for the three and nine months ended September 30, 2025 and 2024.
(2)    There were no material downward adjustments or impairments recorded for the three and nine months ended September 30, 2025 and 2024. 		   
v3.25.3
FAIR VALUE MEASUREMENTS - Fair Value of Contingent Consideration (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Fair Value Disclosures [Abstract]        
Beginning balance $ 275,408 $ 277,921 $ 282,212 $ 288,657
Change in amount of contingent consideration liability 8,705 5,310 21,901 (2,326)
Ending balance 284,113 283,231 284,113 283,231
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]        
Contingent consideration 284,113 283,231 284,113 283,231
Change in amount of contingent consideration liability 8,705 5,310 21,901 (2,326)
Payment for Contingent Consideration Liability, Financing Activities     19,000 0
Ashion        
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]        
Payment for Contingent Consideration Liability, Financing Activities $ 0   $ 20,000  
Omicera        
Fair Value Disclosure, Asset and Liability, Not Measured at Fair Value [Line Items]        
Payment for Contingent Consideration Liability, Financing Activities   $ 0   $ 3,100
v3.25.3
FAIR VALUE MEASUREMENTS - Narrative (Details)
 9 Months Ended
Sep. 30, 2025
USD ($)
Sep. 30, 2024
USD ($)
Aug. 04, 2025
USD ($)
Jun. 30, 2025
USD ($)
Dec. 31, 2024
USD ($)
Jun. 30, 2024
USD ($)
Dec. 31, 2023
USD ($)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]              
Contingent consideration $ 284,113,000 $ 283,231,000   $ 275,408,000 $ 282,212,000 $ 277,921,000 $ 288,657,000
Contingent consideration liability, measurement input         0.90    
Business Combination, Contingent Consideration, Liability, Current         $ 19,700,000    
Business Combination, Contingent Consideration, Liability, Noncurrent         262,500,000    
Equity Method Investments, Fair Value Disclosure 7,383,000       7,488,000    
Other Investment Not Readily Marketable, Fair Value 50,941,000 52,227,000     50,448,000    
Venture capital investment fund              
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]              
Committed capital 18,000,000            
Committed capital callable 9,800,000            
Equity Method Investments, Fair Value Disclosure $ 7,400,000       $ 7,500,000    
Freenome Holdings, Inc              
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]              
Investment Owned, Cost     $ 50,000,000.0        
Investment Interest Rate 500.00%            
Investment owned, at fair value $ 50,400,000            
Product development and other milestone-based payments | Weighted average | Measurement Input, Probability of Success              
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]              
Contingent consideration liability, measurement input 0.90            
Product development and other milestone-based payments | Weighted average | Measurement Input, Present-value Factor              
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]              
Contingent consideration liability, measurement input 0.056       0.062    
Foreign exchange forward              
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]              
Derivative, notional amount $ 56,400,000       $ 44,200,000    
Derivative, fair value 0       0    
Gain (Loss) on derivative instruments, net, pretax 0 $ 0          
Fair Value, Recurring              
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]              
Contingent consideration 284,113,000       282,212,000    
Significant Unobservable Inputs (Level 3) | Fair Value, Recurring              
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]              
Contingent consideration 284,113,000       282,212,000    
Thrive, Ashion and OmicEra | Fair value              
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]              
Contingent consideration         $ 282,200,000    
Resolution Bioscience acquisition adjustments | Fair value              
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]              
Contingent consideration $ 284,100,000            
v3.25.3
LONG-TERM DEBT - Narrative (Details) - Revolving loan agreement - USD ($)
 9 Months Ended
Jan. 13, 2025
Sep. 30, 2025
Long-term debt    
Maximum borrowing capacity $ 500,000,000  
Line of Credit Facility, Maximum Amount Outstanding During Period $ 20,000,000  
Line of Credit Facility, Currency 50.0 million  
Line of Credit Facility, Uncommitted Incremental Facilities   $ 200,000,000
Line of Credit Facility, Floating Rate Less SOFR Rate   10.00%
Line of Credit Facility, Floating Rate Floor   0.00%
Line of Credit Facility, Base Rate Floor   100.00%
Letters of Credit Outstanding, Amount   $ 6,000,000
Remaining borrowing capacity   $ 494,000,000
Indebtedness    
Long-term debt    
Line of Credit Facility, Frequency of Payment and Payment Terms   300.0 million
Minimum    
Long-term debt    
Line of Credit Facility, Base Rate Margin   150.00%
Line of Credit Facility, SOFR Base Rate Margin   250.00%
Gross Leverage Ratio Covenant Term   $ 1
Interest Charge Coverage Ratio Covenant Term   $ 3
Maximum    
Long-term debt    
Line of Credit Facility, Base Rate Margin   200.00%
Line of Credit Facility, SOFR Base Rate Margin   300.00%
Gross Leverage Ratio Covenant Term   $ 2.5
Interest Charge Coverage Ratio Covenant Term   $ 1
v3.25.3
CONVERTIBLE NOTES - Schedule of Convertible Notes (Details) - USD ($)
$ in Thousands
Sep. 30, 2025
Dec. 31, 2024
2027 Convertible Notes    
Long-term debt    
Coupon interest rate 0.375% 0.375%
Principal Amount $ 589,380 $ 589,380
Unamortized Debt Discount and Issuance Costs (3,783) (4,952)
Net Carrying Amount 585,597 584,428
2027 Convertible Notes | Significant Other Observable Inputs (Level 2) | Fair value    
Long-term debt    
Amount $ 545,530 $ 512,761
2028 Convertible Notes    
Long-term debt    
Coupon interest rate 0.375% 0.375%
Principal Amount $ 563,822 $ 563,822
Unamortized Debt Discount and Issuance Costs (2,464) (3,732)
Net Carrying Amount 561,358 560,090
2028 Convertible Notes | Significant Other Observable Inputs (Level 2) | Fair value    
Long-term debt    
Amount $ 541,201 $ 523,932
2030 Convertible Notes    
Long-term debt    
Coupon interest rate   1.00%
Principal Amount   $ 249,172
Unamortized Debt Discount and Issuance Costs   (19)
Net Carrying Amount   249,153
2030 Convertible Notes | Significant Other Observable Inputs (Level 2) | Fair value    
Long-term debt    
Amount   $ 246,705
Convertible Notes Payable2030    
Long-term debt    
Coupon interest rate 2.00% 2.00%
Principal Amount $ 572,993 $ 572,993
Unamortized Debt Discount and Issuance Costs (3,115) (3,642)
Net Carrying Amount 569,878 569,351
Convertible Notes Payable2030 | Significant Other Observable Inputs (Level 2) | Fair value    
Long-term debt    
Amount $ 589,386 $ 592,756
Convertible Notes Payable2031    
Long-term debt    
Coupon interest rate 1.75% 1.75%
Principal Amount $ 620,709 $ 620,709
Unamortized Debt Discount and Issuance Costs (11,905) (13,511)
Net Carrying Amount 608,804 607,198
Convertible Notes Payable2031 | Significant Other Observable Inputs (Level 2) | Fair value    
Long-term debt    
Amount $ 576,552 $ 581,648
v3.25.3
CONVERTIBLE NOTES - Narrative (Details)
$ / shares in Units, $ in Thousands, shares in Millions
 1 Months Ended 3 Months Ended 9 Months Ended
Apr. 30, 2024
USD ($)
Sep. 30, 2025
USD ($)
$ / shares
Sep. 30, 2024
USD ($)
Sep. 30, 2025
USD ($)
$ / shares
shares
Sep. 30, 2024
USD ($)
Dec. 31, 2024
USD ($)
Apr. 17, 2024
USD ($)
Long-term debt              
Principal amount, convertible note       $ 1      
Repurchase price, as percentage of principal amount, if company undergoes change of control       100      
Market price (in dollars per share) | $ / shares   $ 54.71   $ 54.71      
Proceeds from Convertible Debt       $ 0 $ 266,750    
Gain (Loss) on Extinguishment of Debt $ 10,300            
Other Investment Not Readily Marketable, Fair Value   $ 50,941 $ 52,227 50,941 $ 52,227 $ 50,448  
Repayments of Debt       $ 250,400      
2030 Convertible Notes              
Long-term debt              
Effective interest rate (as a percent)     1.18% 1.05% 1.17%    
2028 Convertible Notes              
Long-term debt              
Conversion rate, number of shares to be issued per $1,000 of principal amount (in shares)       8.96      
Conversion price (in dollars per share) | $ / shares   $ 111.66   $ 111.66      
Potential shares issued from convertible instrument (in shares) | shares       5.0      
Effective interest rate (as a percent)   0.68% 0.68% 0.67% 0.67%    
Interest expense amortization term   1 year 5 months 15 days   1 year 5 months 15 days      
2027 Convertible Notes              
Long-term debt              
Conversion rate, number of shares to be issued per $1,000 of principal amount (in shares)       8.21      
Conversion price (in dollars per share) | $ / shares   $ 121.84   $ 121.84      
Potential shares issued from convertible instrument (in shares) | shares       4.8      
Effective interest rate (as a percent)   0.64% 0.64% 0.64% 0.63%    
Amount of debt extinguished 359,700            
Interest expense amortization term   2 years 5 months 1 day   2 years 5 months 1 day      
Convertible Notes Payable2030              
Long-term debt              
Conversion rate, number of shares to be issued per $1,000 of principal amount (in shares)       12.37      
Conversion price (in dollars per share) | $ / shares   $ 80.83   $ 80.83      
Potential shares issued from convertible instrument (in shares) | shares       7.1      
Effective interest rate (as a percent)   2.12% 2.12% 2.12% 2.09%    
Interest expense amortization term   4 years 5 months 1 day   4 years 5 months 1 day      
Convertible Notes Payable2031              
Long-term debt              
Conversion rate, number of shares to be issued per $1,000 of principal amount (in shares)       10.06      
Conversion price (in dollars per share) | $ / shares   $ 99.36   $ 99.36      
Potential shares issued from convertible instrument (in shares) | shares       6.2      
Effective interest rate (as a percent)   2.10% 2.10% 2.10% 2.06%    
Face amount             $ 620,700
Proceeds from Convertible Debt 266,800            
Proceeds from Debt, Net of Issuance Costs $ 259,800            
Interest expense amortization term   5 years 6 months 14 days   5 years 6 months 14 days      
v3.25.3
CONVERTIBLE NOTES - Schedule of Transaction Costs (Details)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
USD ($)
Convertible Notes Payable2027  
Long-term debt  
Total transaction costs $ 14,285
Convertible Notes Payable2028  
Long-term debt  
Total transaction costs 24,453
Convertible Notes Payable2030  
Long-term debt  
Total transaction costs 4,938
2030 Convertible Notes  
Long-term debt  
Total transaction costs 17,646
Convertible Notes Payable2031  
Long-term debt  
Total transaction costs $ 6,780
v3.25.3
CONVERTIBLE NOTES - Summary of Interest Expense (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Debt Disclosure [Abstract]        
Total interest expense on convertible notes $ 8,202 $ 8,941 $ 24,664 $ 13,376
Debt issuance costs amortization 1,154 1,334 3,455 3,965
Debt discount amortization 386 322 1,134 611
Gain on Settlement of Convertible Notes 0 0 0 (10,254)
Coupon interest expense $ 6,662 $ 7,285 $ 20,075 $ 19,054
v3.25.3
CONVERTIBLE NOTES - Schedule of Effective Interest Rates Related to Convertible Debt (Details)
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
2030 Convertible Notes        
Schedule of Convertible notes [Line Items]        
Effective interest rate (as a percent)   1.18% 1.05% 1.17%
2028 Convertible Notes        
Schedule of Convertible notes [Line Items]        
Effective interest rate (as a percent) 0.68% 0.68% 0.67% 0.67%
2027 Convertible Notes        
Schedule of Convertible notes [Line Items]        
Effective interest rate (as a percent) 0.64% 0.64% 0.64% 0.63%
Convertible Notes Payable2030        
Schedule of Convertible notes [Line Items]        
Effective interest rate (as a percent) 2.12% 2.12% 2.12% 2.09%
Convertible Notes Payable2031        
Schedule of Convertible notes [Line Items]        
Effective interest rate (as a percent) 2.10% 2.10% 2.10% 2.06%
v3.25.3
LICENSE AND COLLABORATION AGREEMENTS - Mayo (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Oct. 31, 2017
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]          
Research and development expense $ 117,290 $ 101,487 $ 331,501 $ 333,501  
Licensing agreements | Mayo          
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]          
Period patent remains in effect     5 years    
Collaborative Arrangements Amount Agreed to Pay upon Achievement of Sale Milestones         $ 3,000
v3.25.3
LICENSE AND COLLABORATION AGREEMENTS - John Hopkins University (Details) - Licensing agreements - USD ($)
$ in Millions
Jun. 30, 2023
Jan. 05, 2021
Resolution Bioscience acquisition adjustments    
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]    
Sales-based Milestone Payments   $ 45.0
Sales milestone range one | The Broad Institute, LLC    
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]    
Collaborative arrangement sales milestone amount $ 500.0  
v3.25.3
LICENSE AND COLLABORATION AGREEMENTS - The Broad Institute (Details)
$ in Thousands
Jun. 30, 2023
USD ($)
Product development and other milestone-based payments | The Broad Institute, LLC | Licensing agreements  
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]  
Collaborative Arrangements Development Milestone Amount $ 6,500
v3.25.3
LICENSE AND COLLABORATION AGREEMENTS - Translational Genomics Research Institute (Details) - TARDIS Technology - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
May 01, 2024
Jan. 11, 2021
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]      
Contract Termination Fee, Unamortized Liability $ 1,800    
Contract Termination Fee, Fair-Value   $ 25,800  
Contract Termination Fee, Liability $ 8,800    
Contract termination fee   27,600  
Contract Termination Fee Annual Installments   $ 9,200  
Payments Contingent on Milestones Payable     $ 45,000
v3.25.3
LICENSE AND COLLABORATION AGREEMENTS - Watchmaker Genomics (Details)
$ in Millions
Jul. 31, 2023
USD ($)
Watchmaker Genomics, Inc | Licensing agreements  
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]  
Collaboration arrangement, milestones to be paid $ 82.0
v3.25.3
LICENSE AND COLLABORATION AGREEMENTS - TwinStrand Biosciences (Details) - TwinStrand Biosciences, Inc - USD ($)
$ in Millions
Jul. 01, 2024
Sep. 30, 2025
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]    
Intangible asset acquired $ 45  
Weighted-average remaining useful life of finite-lived intangible asset (in years)   10 years
v3.25.3
LICENSE AND COLLABORATION AGREEMENTS - Freenome Holdings (Details)
$ in Thousands
Aug. 04, 2025
USD ($)
Maximum  
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]  
Sales Royalties Percentage 10.00%
Freenome Holdings, Inc  
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]  
Payments to Acquire Productive Assets $ 75,000
Research and Development Arrangement, Contract to Perform for Others, Costs Incurred, Gross 20,000
Investment Owned, Cost 50,000
Collaborative Arrangements Development Milestone Amount 700,000
Freenome Holdings, Inc | First Milestone Payment  
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]  
Collaborative Arrangements Development Milestone Amount 100,000
Freenome Holdings, Inc | Second Milestone Payment  
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]  
Collaborative Arrangements Development Milestone Amount 100,000
Freenome Holdings, Inc | Third Milestone Payment  
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]  
Collaborative Arrangements Development Milestone Amount $ 500,000
Freenome Holdings, Inc | Minimum  
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]  
Sales Royalties Percentage 0.00%
v3.25.3
STOCKHOLDERS' EQUITY - Schedule of OCI (Details) - USD ($)
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
AOCI Attributable to Parent, Net of Tax [Roll Forward]    
Beginning balance $ 2,402,249,000 $ 3,145,305,000
Other comprehensive income before reclassifications 4,510,000 3,150,000
Amounts reclassified from accumulated other comprehensive income (loss) (323,000) 52,000
Net current period change in accumulated other comprehensive income (loss) 4,187,000 3,202,000
Ending balance 2,501,419,000 3,210,511,000
AOCI Tax, Attributable to Parent 0 0
Cumulative Translation Adjustment    
AOCI Attributable to Parent, Net of Tax [Roll Forward]    
Beginning balance (1,920,000) 1,374,000
Other comprehensive income before reclassifications 4,201,000 427,000
Amounts reclassified from accumulated other comprehensive income (loss) 0 0
Net current period change in accumulated other comprehensive income (loss) 4,201,000 427,000
Ending balance 2,281,000 1,801,000
Unrealized Gain (Loss) on Marketable Securities    
AOCI Attributable to Parent, Net of Tax [Roll Forward]    
Beginning balance 976,000 54,000
Other comprehensive income before reclassifications 309,000 2,723,000
Amounts reclassified from accumulated other comprehensive income (loss) (323,000) 52,000
Net current period change in accumulated other comprehensive income (loss) (14,000) 2,775,000
Ending balance 962,000 2,829,000
AOCI    
AOCI Attributable to Parent, Net of Tax [Roll Forward]    
Beginning balance (944,000) 1,428,000
Ending balance $ 3,243,000 $ 4,630,000
v3.25.3
STOCKHOLDERS' EQUITY - Schedule of Amounts Reclassified from AOCI (Details) - Reclassification out of accumulated other comprehensive income - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Changes in Accumulated Other Comprehensive Income (Loss)    
Total reclassifications $ (323) $ 52
Unrealized Gain (Loss) on Marketable Securities    
Changes in Accumulated Other Comprehensive Income (Loss)    
Investment income, net $ (323) $ 52
v3.25.3
STOCK-BASED COMPENSATION - Narrative (Details) - USD ($)
$ in Millions
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Stock-based compensation        
Stock-based compensation expense $ 51.6 $ 48.8 $ 162.0 $ 165.7
Stock plans        
Stock-based compensation        
Unrecognized compensation cost $ 348.8   $ 348.8  
Weighted average period for recognition of cost     2 years 6 months 3 days  
v3.25.3
STOCK-BASED COMPENSATION - Fair Value and Activity (Details) - Stock plans - USD ($)
$ / shares in Units, $ in Thousands
 9 Months Ended
Dec. 31, 2024
Sep. 30, 2025
Sep. 30, 2024
Shares      
Outstanding at the beginning of the period (in shares)   982,742  
Exercised (in shares)   (99,926)  
Forfeited (in shares)   (34,528)  
Outstanding at the end of the period (in shares) 982,742 848,288  
Vested and expected to vest at end of period (in shares)   848,288  
Exercisable at the end of the period (in shares)   848,288  
Weighted Average Exercise Price      
Outstanding at the beginning of the period (in dollars per share)   $ 53.60  
Exercised (in dollars per share)   23.83  
Forfeited (in dollars per share)   84.02  
Outstanding at the end of the period (in dollars per share) $ 53.60 55.86  
Vested and expected to vest at end of period (in dollars per share)   55.86  
Exercisable at the end of the period (in dollars per share)   $ 55.86  
Weighted Average Remaining Contractual Term      
Outstanding 3 years 1 month 6 days 2 years 8 months 12 days  
Vested and expected to vest at end of period   2 years 8 months 12 days  
Exercisable at the end of the period   2 years 8 months 12 days  
Aggregate Intrinsic Value      
Outstanding at the end of the period   $ 13,570  
Vested and expected to vest at end of period   13,570  
Exercisable at the end of the period   13,570  
Total intrinsic value of options exercised   $ 2,500 $ 6,200
v3.25.3
STOCK-BASED COMPENSATION - Share-based Payment Arrangement, Restricted Stock and Restricted Stock Unit, Activity (Details) - USD ($)
$ / shares in Units, $ in Millions
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Restricted Shares and RSUs    
Restricted Shares    
Outstanding at the beginning of the period (in shares) 7,244,796  
Granted (in shares) 3,655,785  
Released (in shares) (2,505,103)  
Forfeited (in shares) (740,378)  
Outstanding at the end of the period (in shares) 7,655,100  
Weighted Average Exercise Price    
Outstanding at the beginning of the period (in dollars per share) $ 63.18  
Granted (in dollars per share) 51.34  
Released (in dollars per share) 68.30  
Forfeited (in dollars per share) 55.97  
Outstanding at the end of the period (in dollars per share) $ 55.96  
Fair value of equity instruments other than options vested in period $ 171.1 $ 173.3
Restricted stock units    
Weighted Average Exercise Price    
Granted (in dollars per share)   $ 56.67
v3.25.3
STOCK-BASED COMPENSATION - Share-based Payment Arrangement, Performance Shares, Activity (Details) - Shares issuable upon the release of performance share units - USD ($)
$ / shares in Units, $ in Millions
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Stock-based compensation      
Outstanding (in shares) 2,578,456   2,021,208
Outstanding (in dollars per share) $ 65.15   $ 75.86
Granted (in shares) 1,283,717    
Granted (in dollars per share) $ 59.49 $ 63.68  
Released (in shares) (152,565)    
Released (in dollars per share) $ 88.24    
Forfeited (in shares) (573,904)    
Forfeited (in dollars per share) $ 81.85    
Number of outstanding performance share units (in shares) 1,109,465    
Fair value of equity instruments other than options vested in period $ 13.5 $ 9.9  
v3.25.3
STOCK-BASED COMPENSATION - Schedule of Share-based Payment Award, Employee Stock Purchase Plan, Valuation Assumptions (Details)
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Stock-based compensation    
Risk-free interest rates, minimum (as a percent)   4.71%
Risk-free interest rates, maximum (as a percent)   5.30%
Employee stock    
Stock-based compensation    
Risk-free interest rates, minimum (as a percent) 4.42%  
Risk-free interest rates, maximum (as a percent) 5.15%  
Expected volatility, maximum (as a percent) 57.15% 63.13%
Expected Volatility Rate, Minimum (as a percent) 44.40% 55.67%
Dividend yield (as a percent) 0.00% 0.00%
Employee stock | Minimum    
Stock-based compensation    
Expected term (in years) 6 months 1 year 2 months 1 day
Employee stock | Maximum    
Stock-based compensation    
Expected term (in years) 1 year 3 months  
v3.25.3
COMMITMENTS AND CONTINGENCIES - Supplemental Disclosure of Cash Flow Information (Details) - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Cash paid for amounts included in the measurement of lease liabilities:    
Operating cash flows from operating leases $ 30,668 $ 28,658
Operating cash flows from finance leases 864 991
Finance cash flows from finance leases 4,963 4,890
Non-cash investing and financing activities:    
Right-of-use assets obtained in exchange for new operating lease liabilities 21,646 17,860
Right-of-use assets obtained in exchange for new finance lease liabilities $ 0 $ 15,995
Weighted-average remaining lease term - operating leases (in years) 7 years 1 month 9 days 7 years 6 months 29 days
Weighted-average remaining lease term - finance leases (in years) 2 years 5 months 4 days 3 years 29 days
Weighted-average discount rate - operating leases 6.53% 6.55%
Weighted-average discount rate - finance leases 6.68% 6.71%
v3.25.3
COMMITMENTS AND CONTINGENCIES - Additional Information (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Lessee, Lease, Description [Line Items]          
Operating lease right-of-use assets $ 121,114   $ 121,114   $ 116,952
Additional amount to be recognized at lease commencement for the lease liability 195,700   195,700   184,500
Operating lease liability, current 31,851   31,851   27,405
Operating lease liability, noncurrent 163,886   163,886   157,133
Finance lease, right-of-use asset $ 12,800   $ 12,800   19,800
Finance lease, right-of-use asset, statement of financial position, extensible list Other long-term assets, net   Other long-term assets, net    
Finance lease liability $ 13,800   $ 13,800   21,000
Finance lease liability, current $ 5,900   $ 5,900   $ 7,800
Finance lease, liability, current, statement of financial position, extensible list Other current liabilities   Other current liabilities   Other current liabilities
Finance lease liability, noncurrent $ 7,800   $ 7,800   $ 13,200
Finance lease, liability, noncurrent, statement of financial position, extensible list Other long-term liabilities   Other long-term liabilities   Other long-term liabilities
Impairment of long-lived and indefinite-lived assets $ 543 $ 18,698 $ 6,794 $ 31,296  
v3.25.3
Restructuring and Related Activities (Details)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
USD ($)
Sep. 30, 2025
USD ($)
Restructuring and Related Activities [Abstract]    
Restructuring and Related Cost, Expected Cost Remaining $ 20,000 $ 20,000
Restructuring Costs 15,289 26,388
Business Transformation Costs 17,291 46,220
Restructuring and Related Cost, Incurred Cost 32,580 72,608
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs 15,289 26,388
Payments for Restructuring   (9,766)
Restructuring Reserve, Accrual Adjustment   533
Restructuring Reserve 17,155 17,155
Cost of Sales    
Restructuring and Related Activities [Abstract]    
Restructuring Costs   85
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs   85
Selling and Marketing Expense    
Restructuring and Related Activities [Abstract]    
Restructuring Costs 483 3,154
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs 483 3,154
General and Administrative Expense    
Restructuring and Related Activities [Abstract]    
Restructuring Costs 14,732 22,595
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs 14,732 22,595
Research and Development Expense    
Restructuring and Related Activities [Abstract]    
Restructuring Costs 74 554
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs 74 554
Employee Severance    
Restructuring and Related Activities [Abstract]    
Restructuring Costs 13,696 18,932
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs 13,696 18,932
Payments for Restructuring   (3,176)
Restructuring Reserve, Accrual Adjustment   533
Restructuring Reserve 16,289 16,289
Employee Severance | Cost of Sales    
Restructuring and Related Activities [Abstract]    
Restructuring Costs   85
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs   85
Employee Severance | Selling and Marketing Expense    
Restructuring and Related Activities [Abstract]    
Restructuring Costs 483 3,154
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs 483 3,154
Employee Severance | General and Administrative Expense    
Restructuring and Related Activities [Abstract]    
Restructuring Costs 13,139 15,139
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs 13,139 15,139
Employee Severance | Research and Development Expense    
Restructuring and Related Activities [Abstract]    
Restructuring Costs 74 554
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs 74 554
Other Restructuring    
Restructuring and Related Activities [Abstract]    
Restructuring Costs 1,593 7,456
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs 1,593 7,456
Payments for Restructuring   (6,590)
Restructuring Reserve, Accrual Adjustment   0
Restructuring Reserve 866 866
Other Restructuring | General and Administrative Expense    
Restructuring and Related Activities [Abstract]    
Restructuring Costs 1,593 7,456
Restructuring Cost and Reserve [Line Items]    
Restructuring Costs $ 1,593 $ 7,456
v3.25.3
BUSINESS COMBINATIONS AND ASSET ACQUISITIONS - Schedule of Divestitures (Details) - USD ($)
$ in Millions
Sep. 30, 2025
Apr. 30, 2025
Dec. 31, 2024
Business Acquisition [Line Items]      
Contract asset $ 31.8   $ 25.9
Contract with Customer, Receivable, after Allowance for Credit Loss $ 22.7   56.6
Cash Collected from Disposal Group, Contingent Consideration Arrangements   $ 28.0  
Other long-term assets      
Business Acquisition [Line Items]      
Contract with Customer, Receivable, after Allowance for Credit Loss, Noncurrent     28.7
Other Current Assets [Member]      
Business Acquisition [Line Items]      
Contract with Customer, Receivable, after Allowance for Credit Loss, Current     $ 27.9
v3.25.3
ACQUISITIONS AND DIVESTITURES - Narrative (Details)
$ in Thousands
Dec. 31, 2024
USD ($)
Disposal Group, Disposed of by Sale, Not Discontinued Operations [Member] | Oncotype DX Genomic Prostate Score Test [Member]  
Business Acquisition [Line Items]  
Disposal Group, Contingent Consideration Arrangements, Range Of Outcomes, Value, High $ 82,500
v3.25.3
SEGMENT INFORMATION (Details)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
USD ($)
Sep. 30, 2024
USD ($)
Sep. 30, 2025
USD ($)
reportable_segment
segment
Sep. 30, 2024
USD ($)
Segment Reporting, Revenue Reconciling Item [Line Items]        
Revenue $ 850,739 $ 708,655 $ 2,368,609 $ 2,045,443
Number of Operating Segments | segment     1  
Number of Reportable Segments | reportable_segment     1  
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration]     Chief Executive Officer [Member]  
Segment Reporting, CODM, Profit (Loss) Measure, How Used, Description     monitors the Company's operating performance and makes decisions regarding allocation of resources to its operations at the consolidated level  
United States        
Segment Reporting, Revenue Reconciling Item [Line Items]        
Revenue 791,955 659,222 $ 2,202,981 1,904,755
Outside of United States        
Segment Reporting, Revenue Reconciling Item [Line Items]        
Revenue $ 58,784 $ 49,433 $ 165,628 $ 140,688
v3.25.3
INCOME TAXES (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Income Tax Disclosure [Abstract]          
Tax expense (benefit) $ 1,837 $ 808 $ 3,189 $ 4,077  
Deferred tax liabilities, net 6,800   6,800   $ 7,200
Unrecognized Tax Benefits that Would Impact Effective Tax Rate $ 46,500   $ 46,500   $ 43,300