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Q3 2026 Business Update November 4, 2026
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This presentation contains certain “forward-looking statementsˮ within the meaning of applicable securities laws. These statements relate to future events and results of BillionToOne, Inc. (the “Company,ˮ “we,ˮ “us,ˮ or “ourˮ) and involve known and unknown risks, uncertainties and other factors that may cause the actual results, levels of activity, performance or achievements of the Company or its industry to be materially different from those expressed or implied by any forward-looking statements. In some cases, forward-looking statements can be identified by terminology such as “may,ˮ “will,ˮ “could,ˮ “would,ˮ “should,ˮ “to,ˮ “target,ˮ “expect,ˮ “plan,ˮ “anticipate,ˮ “intend,ˮ “believe,ˮ “estimate,ˮ “predict,ˮ “potentialˮ or other comparable terminology. All statements other than statements of historical fact could be deemed forward-looking, including, but not limited to: our 2026 financial guidance, any projections of market opportunities; any statements regarding expectations for future reimbursement opportunities and product performance; any statements regarding the Companyʼs long-term expectations; and the Companyʼs goals and general business and market conditions. The forward-looking statements are based on our beliefs, assumptions and expectations of future performance, taking into account the information currently available to us. These statements are only predictions based upon our current expectations about future events. Forward-looking statements are subject to known and unknown risks, uncertainties and other factors that may cause our actual results, performance or achievements to be materially different from those expressed or implied by such forward-looking statements including but not limited to: our limited operating history and rapid growth; our dependence on sales of our molecular diagnostic tests for our revenue and success; risks relating to the government and other third-party payors failing to provide coverage and adequate payment for our existing and future tests; risks related to our ability to successfully obtain reimbursement from the Medicare program and state Medicaid programs; risks related to our billing and claim processing; risks related to the inherent variability of the insurance coverage and reimbursement landscape; the loss of key members of our senior management team or our inability to attract and retain highly skilled scientists, technicians, clinicians, and sales representatives; risks of damage to or interoperability of our existing laboratory facilities; risks related to our tests in development, including clinical effectiveness or commercial market acceptance; the commercial success of our recently launched tests; risks related to our products meeting the expectations of patients and customers; risks related to international trade policies, including tariffs, sanctions and trade barriers; risks related to legal proceedings, regulatory investigations and inquiries and other legal matters; and risks related to effectively protecting our proprietary technologies. We discuss these and other risks and uncertainties in greater detail under the captions “Risk Factorsˮ and “Managementʼs Discussion and Analysis of Financial Condition and Results of Operationsˮ in filings we make with the Securities and Exchange Commission from time to time. Though we have attempted to identify important factors that could cause actual results to differ materially from those contained in forward-looking statements, there may be other factors that cause results not to be as anticipated, estimated or intended. The assumptions used in the preparation of this presentation, although considered reasonable by us at the time of preparation, may prove to be incorrect. You are cautioned that the information is based on assumptions as to many factors and that actual results may vary from the results projected and such variations may be material. Accordingly, you should not place undue reliance on any forward-looking statements contained herein. We do not undertake to update any forward-looking statements, except in accordance with applicable securities laws. Certain information contained in this presentation relate to or are based on studies, publications, surveys and other data obtained from third-party sources and our own internal estimates and research. While we believe these third-party studies, publications, surveys and other data to be reliable as of the date of this presentation, we have not independently verified, and makes no representations as to the adequacy, fairness, accuracy or completeness of, any information obtained from third-party sources. In addition, no independent source has evaluated the reasonableness or accuracy of our internal estimates or research and no reliance should be made on any information or statements made in this presentation relating to or based on such internal estimates and research. This presentation includes certain non-GAAP financial measures as defined by the SEC rules. These non-GAAP financial measures are in addition to, and not as a substitute for or superior to measures of financial performance prepared in accordance with U.S. GAAP. There are a number of limitations related to the use of these non-GAAP financial measures versus their nearest GAAP equivalents. For example, other companies may calculate non-GAAP financial measures differently or may use other measures to evaluate their performance, all of which could reduce the usefulness of our non-GAAP financial measures as tools for comparison. As required by Regulation G, we have provided a reconciliation of those measures to the most directly comparable GAAP measures, which is available in the appendix. Disclaimer & Forward Looking Statement
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Zero to $492M ARR* in ~6 years $100B TAM (US)** Patented QCT™ technology enabling single-molecule sensitivity Category-defining products in prenatal and oncology Culture of fiscal discipline & efficient operations incorporating AI GAAP profitability & positive cash flows with accumulated deficit ~10% that of public competitors 70%+ gross margin Significant opportunity for further ASP growth and COGS-per-test reductions smNGS single-molecule next-generation sequencing; QCT™: Quantitative Counting Templates™; ARR annualized revenue run-rate; TAM total addressable market; ASP average sales price * Q3 2026 revenue of $123.0M annualized. Calculated as Q3 multiplied by 4. ** Our estimated US annual market opportunity includes important assumptions, including the number of eligible patients, frequency of testing and ASPs. See our public filings with the SEC for more information regarding our total addressable market calculations and assumptions. Revolutionary smNGS Platform & Products Superior Gross Margin Profile GAAP Profitability Our 4 Pillars of Differentiation 3 Scalable Rapid Growth
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Scalable Rapid Growth Revolutionary smNGS Platform & Products Superior Gross Margin Profile GAAP Profitability Summary of Q3 Achievements4 Unity Fetal Risk Screen validated as a first-line screen in The Green Journal (Obstetrics & Gynecology) Head-to-Head results of Northstar Response versus tumor-informed test published in The Journal of Liquid Biopsy Launching Northstar Clear: tissue- free MRD test on December 15 Prenatal revenue up 42% YoY Oncology revenue up 96% YoY Q3 revenue of $123.0M, up 47% YoY ASP growth to $589 per test, 18% YoY increase COGS per test of $169 (+10% YoY) reflecting faster oncology growth Gross margin of 71% Achieved $11.0M in GAAP operating income, reflecting a 9% GAAP operating margin and a 18% adjusted EBITDA margin Cash-flow positive with a strong balance sheet of $562M cash
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Revolutionary smNGS Platform & Products
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CONFIDENTIAL & PROPRIETARYCONFIDENTIAL & PROPRIETARY First and largest prospective study in intended-use population: Unity Fetal Risk Screen validated as a first-line prenatal screen Peer-reviewed in The Green Journal (Obstetrics & Gynecology). In collaboration with 9 US institutions. Consistent performance across a racially and ethnically diverse population. Pillar 1 — Platform & Product Prenatal6 PUBLISHED Aug 18, 2026 >98% of outcomes obtained for 2212 pregnancies Outcome Ascertainment 94.4% Sensitivity Specificity 99.5% 9-in-10 vs. 1-in-4 max with traditional screening Personalized Fetal Risk As high as 1-in-10,000 As low as
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CONFIDENTIAL & PROPRIETARYCONFIDENTIAL & PROPRIETARY Head-to-head study: Northstar Response demonstrates on-par to superior results vs. a tumor-informed assay Peer-reviewed in The Journal of Liquid Biopsy. First head-to-head comparison with the most widely used tumor-informed assay in patients on active treatment for advanced cancer Pillar 1 — Platform & Product Oncology7 PUBLISHED Oct 7, 2026 94% 67/71 sequential pairs Overall Concordance 100% in all divergent cases Clinical Alignment Agreement on the direction of ctDNA change between Northstar Response and a tumor-informed assay Clinical records supported Northstar Response’s findings in all divergent cases, whereas the tumor-informed assay’s results were either false-positive or false-negative against clinical response or progression
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Head-to-head performance against tumor-informed assay. Initial data in CRC. Further evidence generation in 2027. Northstar Clear™ Commercial launch on December 15 Tissue-free MRD, with tumor-informed performance Platform expansion. T ogether with Select and Response, Northstar will now span across early- and late-stage care. Pan-cancer, blood-only design. Available for all solid tumors from Day 1.
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Scalable Rapid Growth
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Total test volume grew 25% YoY. 10 Test Volume Delivered Quarterly 206K • Total test volume grew 25% YoY and more than 10,000 tests sequentially. • Both prenatal and oncology had strong sequential growth in test volumes during the quarter. • Growth was driven by strong execution, expansion of our field sales force, and continued positive reception to our new product enhancements in both prenatal and oncology. Note: includes delivered and billable tests 25% Pillar 2 — Scalable Rapid Growth Percentage growth rates represent growth from Q3 2025 to Q3 2026
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Oncology GAAP Revenue QuarterlyPrenatal GAAP Revenue Quarterly 11 Percentage growth rates represent growth from Q3 2025 to Q3 2026 $105.9M* $17 .1M * Includes revenue associated with clinical trial services 96% 42% Pillar 2 — Scalable Rapid Growth
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Rapid revenue growth: zero to $492M* ARR in ~6 years. Total GAAP Revenue Quarterly *Annualized revenue run-rate: Q3 2026 revenue of $123.0M annualized. Calculated as Q3 2026 revenue multiplied by 4. Percentage growth rates represent growth from Q3 2025 to Q3 2026 47% YoY revenue growth driven by rapid YoY increases both in tests delivered (25%) and ASP (18%). 12 $123.0M 47% Pillar 2 — Scalable Rapid Growth
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Superior Gross Margin Profile
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Overall ASP continued to increase. • Overall ASP increased 7% QoQ and 18% YoY to $589 including true-up. Without true-up, ASP increased 3% QoQ and 15% YoY to $552, as a result of (i) more payor contracts, (ii) increased pricing for RhD NIPT via its PLA code, and (iii) higher proportion of oncology tests. Overall ASP* * Overall ASP is the weighted average ASP across all of our prenatal and oncology products. It is computed by dividing revenue for our prenatal and oncology tests by the number of tests that are delivered and billable. The number of tests that are delivered and billable in a given period represents that number of billable tests for which we deliver a result to the ordering provider in such period. In this chart we show overall ASP both including and excluding true-up revenue. 14 Pillar 3 — Superior Gross Margin Profile $589 +18% Percentage growth rates represent growth from Q3 2025 to Q3 2026
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Overall COGS per test was $169 in Q3. Pillar 3 — Superior Gross Margin Profile Overall COGS Per Test Quarterly ● The overall COGS-per-test increased to $169 in Q3 from $161 in Q2, due to continued shift in the test volume mix towards oncology and transient impact from recent product launches. ● Oncology tests continue to have consistent QoQ decrease in COGS. ● Importantly, Response is already approximately gross-margin breakeven. ● We expect our overall COGS per test to rise slightly over time as the faster growth of oncology continues. $169 15 +10% Percentage growth rates represent growth from Q3 2025 to Q3 2026
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70.9% gross margin: stable despite faster growth of oncology. Pillar 3 — Superior Gross Margin Profile Gross Margin Quarterly 16 • GM was relatively consistent, 70.9%, despite the faster growth of oncology, which has lower margins in its current state. GM is higher by +1 pp YoY due to higher ASPs. • Prenatal gross margin was 75% and oncology gross margin increased to 45% (prior to MolDX coverage of Response). +1% 70.9% Percentage growth rates represent growth from Q3 2025 to Q3 2026
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GAAP Profitability
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CONFIDENTIAL & PROPRIETARY Q3 2026 Financials Financials18 Actual Q3 2025 Actual Q2 2026 Actual Q3 2026 YoY Growth Commentary Total Tests Delivered 165,000 196,000 206,000 25% Overall ASP per test (excluding true-up) $487 $537 $552 14% True-up (per test) $15 $14 $37 Overall ASP Per Test $502 $551 $589 18% Revenue - Total Prenatal $74.8 $95.8 $105.9 42% ● Prenatal total revenues of $105.9M in Q3-26 (~$424M ARR) Revenue - Total Oncology $8.7 $13.7 $17.1 96% ● Oncology revenues achieving $68M ARR and ~ 2x YoY Total Revenue $83.5 $109.4 $123.0 47% ● Total revenues of $123.0M (~$492M ARR) Gross Margin % - Total 69.9% 70.5% 70.9% 1 pp ● Overall GM increased 1pp YoY Operating Profit (Loss) $9.6 $5.5 $11.0 ● 9% positive operating margin. GAAP profitable & cash-flow positive for Q3 Adjusted EBITDA $15.8 $16.1 $22.7 44% ● 18% Adjusted EBITDA margin Ending Cash Balance $195.2 $548.6 $561.5 188%
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CONFIDENTIAL & PROPRIETARY $72M $153M Raising 2026 guidance to $460M-$470M revenue & maintaining GAAP profitability. Guidance19 Projections Actuals $305M Projections vs Actuals Historical Guidance Previous vs Current Jan 2026 Guidance ~86% CAGR Mar 2026 Guidance $430M$445M May 2026 Guidance $450M$465M $460M $470M Nov 2026 Guidance
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Summary To build a category-defining company and enter the S&P 500 LONG-TERM GOAL We are transforming healthcare: one molecule at a time, one patient at a time. 20 Strong gross margin profile with 71% GM Unity validated in prospective study Response shows on-par to superior performance vs. tumor-informed assay Launching MRD Continued profitability achieving 9% GAAP operating margin and 18% adjusted EBITDA margin 47% YoY revenue growth leading to $492M annualized revenue run-rate
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Thank you.
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CONFIDENTIAL & PROPRIETARY22 Appendix EBITDA Reconciliation Q3 2025 Q2 2026 Q3 2026 Net Income Loss $5.7M $8.1M $17.4M Provision for Income Taxes $0.1M $0.5M $0.0M Interest Income $1.5M $4.7M $4.9M Interest Expense $0.0M $0.0M $0.0M Depreciation and Amortization $1.7M $1.8M $2.0M EBITDA $5.8M $4.7M $14.5M Note: Numbers may not add due to rounding
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CONFIDENTIAL & PROPRIETARY23 Appendix Adjusted EBITDA Reconciliation Q3 2025 Q2 2026 Q3 2026 Net Income Loss $5.7M $8.1M $17.4M Provision for Income Taxes $0.1M $0.5M $0.0M Interest Income $1.5M $4.7M $4.9M Interest Expense $0.0M $0.0M $0.0M Depreciation and Amortization $1.7M $1.8M $2.0M Stock-Based Compensation Expense $4.5M $8.2M $9.7M Change in Fair Value of Term Loan $3.9M $3.0M $1.5M Change in Fair Value of Warrant Liabilities $1.6M $0.3M $0.0M Adjusted EBITDA $15.8M $16.1M $22.7M Note: Numbers may not add due to rounding