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Side-by-side financial comparison of AMERICAN SHARED HOSPITAL SERVICES (AMS) and CASTLE BIOSCIENCES INC (CSTL). Click either name above to swap in a different company.

CASTLE BIOSCIENCES INC is the larger business by last-quarter revenue ($87.0M vs $7.7M, roughly 11.3× AMERICAN SHARED HOSPITAL SERVICES). On growth, CASTLE BIOSCIENCES INC posted the faster year-over-year revenue change (0.8% vs -14.8%). CASTLE BIOSCIENCES INC produced more free cash flow last quarter ($19.7M vs $-2.7M). Over the past eight quarters, AMERICAN SHARED HOSPITAL SERVICES's revenue compounded faster (21.7% CAGR vs 9.2%).

American Shared Hospital Services offers turnkey outsourced solutions for advanced radiotherapy, stereotactic radiosurgery and diagnostic imaging equipment to healthcare facilities. It eliminates high upfront capital costs for hospitals, operates primarily across North America, and also serves Latin America and select Asia-Pacific markets, catering to both public and private hospital segments.

Castle Biosciences Inc. is a commercial-stage diagnostic firm that develops and markets proprietary, clinically actionable tests for dermatological conditions such as melanoma and other skin cancers, plus rare diseases. It operates mainly in the U.S. healthcare market, focusing on segments with high unmet need for more accurate diagnostics to guide treatment choices.

AMS vs CSTL — Head-to-Head

Bigger by revenue
CSTL
CSTL
11.3× larger
CSTL
$87.0M
$7.7M
AMS
Growing faster (revenue YoY)
CSTL
CSTL
+15.6% gap
CSTL
0.8%
-14.8%
AMS
More free cash flow
CSTL
CSTL
$22.4M more FCF
CSTL
$19.7M
$-2.7M
AMS
Faster 2-yr revenue CAGR
AMS
AMS
Annualised
AMS
21.7%
9.2%
CSTL

Income Statement — Q4 2025 vs Q4 2025

Metric
AMS
AMS
CSTL
CSTL
Revenue
$7.7M
$87.0M
Net Profit
$-631.0K
Gross Margin
11.7%
79.0%
Operating Margin
-18.1%
-4.4%
Net Margin
-8.2%
Revenue YoY
-14.8%
0.8%
Net Profit YoY
52.5%
EPS (diluted)
$-0.09
$-0.06

Green = leading value per metric. Periods may differ when fiscal calendars don't align.

8-Quarter Revenue & Profit Trend

Side-by-side quarterly history. Quarters aligned by calendar period so offset fiscal years line up.

Revenue
AMS
AMS
CSTL
CSTL
Q4 25
$7.7M
$87.0M
Q3 25
$7.2M
$83.0M
Q2 25
$7.1M
$86.2M
Q1 25
$6.1M
$88.0M
Q4 24
$9.1M
$86.3M
Q3 24
$7.0M
$85.8M
Q2 24
$7.1M
$87.0M
Q1 24
$5.2M
$73.0M
Net Profit
AMS
AMS
CSTL
CSTL
Q4 25
$-631.0K
Q3 25
$-17.0K
$-501.0K
Q2 25
$-280.0K
$4.5M
Q1 25
$-625.0K
$-25.8M
Q4 24
$-1.3M
Q3 24
$-207.0K
$2.3M
Q2 24
$3.6M
$8.9M
Q1 24
$119.0K
$-2.5M
Gross Margin
AMS
AMS
CSTL
CSTL
Q4 25
11.7%
79.0%
Q3 25
22.1%
77.5%
Q2 25
23.1%
79.5%
Q1 25
15.4%
81.4%
Q4 24
35.3%
81.3%
Q3 24
19.6%
81.8%
Q2 24
35.0%
83.3%
Q1 24
41.1%
81.0%
Operating Margin
AMS
AMS
CSTL
CSTL
Q4 25
-18.1%
-4.4%
Q3 25
-4.8%
-8.2%
Q2 25
-7.7%
-4.9%
Q1 25
-21.3%
-31.7%
Q4 24
-20.2%
4.7%
Q3 24
-12.7%
5.9%
Q2 24
-0.0%
5.8%
Q1 24
-1.6%
-7.5%
Net Margin
AMS
AMS
CSTL
CSTL
Q4 25
-8.2%
Q3 25
-0.2%
-0.6%
Q2 25
-4.0%
5.2%
Q1 25
-10.2%
-29.4%
Q4 24
-14.6%
Q3 24
-3.0%
2.6%
Q2 24
51.0%
10.3%
Q1 24
2.3%
-3.5%
EPS (diluted)
AMS
AMS
CSTL
CSTL
Q4 25
$-0.09
$-0.06
Q3 25
$0.00
$-0.02
Q2 25
$-0.04
$0.15
Q1 25
$-0.10
$-0.90
Q4 24
$-0.21
$0.32
Q3 24
$-0.03
$0.08
Q2 24
$0.55
$0.31
Q1 24
$0.02
$-0.09

Balance Sheet & Financial Strength

Snapshot of each company's liquidity, leverage and book value from the latest quarter.

Metric
AMS
AMS
CSTL
CSTL
Cash + ST InvestmentsLiquidity on hand
$3.5M
$299.5M
Total DebtLower is stronger
$17.4M
$10.1M
Stockholders' EquityBook value
$24.0M
$470.9M
Total Assets
$55.5M
$578.6M
Debt / EquityLower = less leverage
0.72×
0.02×

8-quarter trend — quarters aligned by calendar period.

Cash + ST Investments
AMS
AMS
CSTL
CSTL
Q4 25
$3.5M
$299.5M
Q3 25
$5.1M
$287.5M
Q2 25
$11.1M
$275.9M
Q1 25
$11.2M
$275.2M
Q4 24
$11.0M
$293.1M
Q3 24
$13.8M
$95.0M
Q2 24
$14.2M
$85.6M
Q1 24
$12.8M
$82.9M
Total Debt
AMS
AMS
CSTL
CSTL
Q4 25
$17.4M
$10.1M
Q3 25
$18.2M
$10.0M
Q2 25
$19.1M
$10.0M
Q1 25
$19.9M
$10.0M
Q4 24
$20.4M
$10.0M
Q3 24
$14.4M
$10.0M
Q2 24
$15.1M
$10.0M
Q1 24
$15.6M
$10.0M
Stockholders' Equity
AMS
AMS
CSTL
CSTL
Q4 25
$24.0M
$470.9M
Q3 25
$24.6M
$467.0M
Q2 25
$24.5M
$455.4M
Q1 25
$24.6M
$440.3M
Q4 24
$25.2M
$455.8M
Q3 24
$26.4M
$441.1M
Q2 24
$26.5M
$423.9M
Q1 24
$22.8M
$402.5M
Total Assets
AMS
AMS
CSTL
CSTL
Q4 25
$55.5M
$578.6M
Q3 25
$59.6M
$562.8M
Q2 25
$63.5M
$544.7M
Q1 25
$63.3M
$501.7M
Q4 24
$60.2M
$531.2M
Q3 24
$63.3M
$514.6M
Q2 24
$60.8M
$487.3M
Q1 24
$50.1M
$458.5M
Debt / Equity
AMS
AMS
CSTL
CSTL
Q4 25
0.72×
0.02×
Q3 25
0.74×
0.02×
Q2 25
0.78×
0.02×
Q1 25
0.81×
0.02×
Q4 24
0.81×
0.02×
Q3 24
0.54×
0.02×
Q2 24
0.57×
0.02×
Q1 24
0.68×
0.02×

Cash Flow & Capital Efficiency

How much cash each business actually produces after reinvestment. Cash flow is harder to manipulate than net income.

Metric
AMS
AMS
CSTL
CSTL
Operating Cash FlowLast quarter
$-704.0K
$26.9M
Free Cash FlowOCF − Capex
$-2.7M
$19.7M
FCF MarginFCF / Revenue
-34.8%
22.7%
Capex IntensityCapex / Revenue
25.7%
8.3%
Cash ConversionOCF / Net Profit
TTM Free Cash FlowTrailing 4 quarters
$-8.5M
$28.3M

8-quarter trend — quarters aligned by calendar period.

Operating Cash Flow
AMS
AMS
CSTL
CSTL
Q4 25
$-704.0K
$26.9M
Q3 25
$1.7M
$22.6M
Q2 25
$-372.0K
$20.8M
Q1 25
$2.5M
$-6.0M
Q4 24
$274.0K
$24.4M
Q3 24
$472.0K
$23.3M
Q2 24
$1.3M
$24.0M
Q1 24
$-1.9M
$-6.8M
Free Cash Flow
AMS
AMS
CSTL
CSTL
Q4 25
$-2.7M
$19.7M
Q3 25
$-2.0M
$7.8M
Q2 25
$-2.3M
$11.6M
Q1 25
$-1.5M
$-10.8M
Q4 24
$-4.4M
$16.8M
Q3 24
$-407.0K
$17.0M
Q2 24
$70.0K
$18.8M
Q1 24
$-3.0M
$-16.0M
FCF Margin
AMS
AMS
CSTL
CSTL
Q4 25
-34.8%
22.7%
Q3 25
-28.3%
9.4%
Q2 25
-32.1%
13.4%
Q1 25
-24.7%
-12.2%
Q4 24
-48.4%
19.5%
Q3 24
-5.8%
19.8%
Q2 24
1.0%
21.6%
Q1 24
-58.4%
-21.9%
Capex Intensity
AMS
AMS
CSTL
CSTL
Q4 25
25.7%
8.3%
Q3 25
51.6%
17.9%
Q2 25
26.9%
10.7%
Q1 25
65.7%
5.4%
Q4 24
51.4%
8.8%
Q3 24
12.6%
7.4%
Q2 24
17.2%
6.0%
Q1 24
22.7%
12.5%
Cash Conversion
AMS
AMS
CSTL
CSTL
Q4 25
Q3 25
Q2 25
4.60×
Q1 25
Q4 24
Q3 24
10.29×
Q2 24
0.36×
2.69×
Q1 24
-15.67×

Financial Flow Comparison

Revenue → gross profit → operating profit → net profit for each company.

Revenue Breakdown by Segment

AMS
AMS

Direct Patient Services$4.0M51%
Rental Income From Medical Services$2.7M35%
Pbrt Services$1.2M15%

CSTL
CSTL

Dermatologic$48.6M56%
Non Dermatologic$38.4M44%

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