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Side-by-side financial comparison of Custom Truck One Source, Inc. (CTOS) and Inspire Medical Systems, Inc. (INSP). Click either name above to swap in a different company.
Custom Truck One Source, Inc. is the larger business by last-quarter revenue ($422.2M vs $269.1M, roughly 1.6× Inspire Medical Systems, Inc.). Inspire Medical Systems, Inc. runs the higher net margin — 50.6% vs -4.2%, a 54.8% gap on every dollar of revenue. On growth, Inspire Medical Systems, Inc. posted the faster year-over-year revenue change (12.2% vs -8.5%). Over the past eight quarters, Inspire Medical Systems, Inc.'s revenue compounded faster (28.1% CAGR vs 14.8%).
Custom Truck One Source, Inc. is a leading provider of specialized heavy truck and equipment solutions in North America. It offers custom vehicle manufacturing, equipment sales and rentals, aftermarket parts, and maintenance services, serving core infrastructure, utility, construction, and energy industry segments.
Inspire Medical Systems, Inc. is a medical technology firm that develops, manufactures and commercializes implantable neurostimulation solutions for obstructive sleep apnea. Its core product serves patients intolerant to CPAP therapy, with main markets across North America, Europe, and select Asia-Pacific regions, operating in sleep medicine and otolaryngology segments.
CTOS vs INSP — Head-to-Head
Income Statement — Q1 FY2026 vs Q4 FY2025
| Metric | | |
|---|---|---|
| Revenue | $422.2M | $269.1M |
| Net Profit | $-17.8M | $136.1M |
| Gross Margin | 20.3% | 86.6% |
| Operating Margin | 2.9% | 17.1% |
| Net Margin | -4.2% | 50.6% |
| Revenue YoY | -8.5% | 12.2% |
| Net Profit YoY | -333.7% | 286.4% |
| EPS (diluted) | $-0.08 | $4.57 |
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.
| Q1 26 | $422.2M | — | ||
| Q4 25 | $387.3M | $269.1M | ||
| Q3 25 | $359.9M | $224.5M | ||
| Q2 25 | $392.2M | $217.1M | ||
| Q1 25 | $307.1M | $201.3M | ||
| Q4 24 | $398.3M | $239.7M | ||
| Q3 24 | $337.5M | $203.2M | ||
| Q2 24 | $320.6M | $195.9M |
| Q1 26 | $-17.8M | — | ||
| Q4 25 | $20.9M | $136.1M | ||
| Q3 25 | $-5.8M | $9.9M | ||
| Q2 25 | $-28.4M | $-3.6M | ||
| Q1 25 | $-17.8M | $3.0M | ||
| Q4 24 | $27.6M | $35.2M | ||
| Q3 24 | $-17.4M | $18.5M | ||
| Q2 24 | $-24.5M | $9.8M |
| Q1 26 | 20.3% | — | ||
| Q4 25 | 31.8% | 86.6% | ||
| Q3 25 | 28.0% | 85.8% | ||
| Q2 25 | 26.1% | 84.0% | ||
| Q1 25 | 27.9% | 84.7% | ||
| Q4 24 | 29.7% | 85.0% | ||
| Q3 24 | 27.2% | 84.1% | ||
| Q2 24 | 27.8% | 84.8% |
| Q1 26 | 2.9% | — | ||
| Q4 25 | 13.4% | 17.1% | ||
| Q3 25 | 9.1% | 4.3% | ||
| Q2 25 | 7.1% | -1.5% | ||
| Q1 25 | 4.0% | -0.7% | ||
| Q4 24 | 16.9% | 13.3% | ||
| Q3 24 | 6.8% | 7.0% | ||
| Q2 24 | 5.5% | 2.6% |
| Q1 26 | -4.2% | — | ||
| Q4 25 | 5.4% | 50.6% | ||
| Q3 25 | -1.6% | 4.4% | ||
| Q2 25 | -7.2% | -1.7% | ||
| Q1 25 | -5.8% | 1.5% | ||
| Q4 24 | 6.9% | 14.7% | ||
| Q3 24 | -5.2% | 9.1% | ||
| Q2 24 | -7.6% | 5.0% |
| Q1 26 | $-0.08 | — | ||
| Q4 25 | $0.10 | $4.57 | ||
| Q3 25 | $-0.03 | $0.34 | ||
| Q2 25 | $-0.13 | $-0.12 | ||
| Q1 25 | $-0.08 | $0.10 | ||
| Q4 24 | $0.11 | $1.17 | ||
| Q3 24 | $-0.07 | $0.60 | ||
| Q2 24 | $-0.10 | $0.32 |
Balance Sheet & Financial Strength
Snapshot of each company's liquidity, leverage and book value from the latest quarter.
| Metric | | |
|---|---|---|
| Cash + ST InvestmentsLiquidity on hand | $6.3M | $308.3M |
| Total DebtLower is stronger | $25.9M | — |
| Stockholders' EquityBook value | $809.1M | $781.2M |
| Total Assets | $3.4B | $907.3M |
| Debt / EquityLower = less leverage | 0.03× | — |
8-quarter trend — quarters aligned by calendar period.
| Q1 26 | $6.3M | — | ||
| Q4 25 | $6.3M | $308.3M | ||
| Q3 25 | $13.1M | $322.6M | ||
| Q2 25 | $5.3M | $300.9M | ||
| Q1 25 | $5.4M | $369.2M | ||
| Q4 24 | $3.8M | $445.5M | ||
| Q3 24 | $8.4M | $411.0M | ||
| Q2 24 | $8.1M | $439.7M |
| Q1 26 | $25.9M | — | ||
| Q4 25 | $1.6B | — | ||
| Q3 25 | $1.6B | — | ||
| Q2 25 | $1.6B | — | ||
| Q1 25 | $1.6B | — | ||
| Q4 24 | $1.5B | — | ||
| Q3 24 | $1.6B | — | ||
| Q2 24 | $1.5B | — |
| Q1 26 | $809.1M | — | ||
| Q4 25 | $809.1M | $781.2M | ||
| Q3 25 | $784.7M | $666.5M | ||
| Q2 25 | $790.1M | $677.8M | ||
| Q1 25 | $813.4M | $635.7M | ||
| Q4 24 | $861.3M | $689.7M | ||
| Q3 24 | $837.5M | $696.6M | ||
| Q2 24 | $856.7M | $638.1M |
| Q1 26 | $3.4B | — | ||
| Q4 25 | $3.4B | $907.3M | ||
| Q3 25 | $3.5B | $807.7M | ||
| Q2 25 | $3.6B | $802.2M | ||
| Q1 25 | $3.5B | $730.8M | ||
| Q4 24 | $3.5B | $808.4M | ||
| Q3 24 | $3.6B | $796.2M | ||
| Q2 24 | $3.5B | $728.4M |
| Q1 26 | 0.03× | — | ||
| Q4 25 | 2.03× | — | ||
| Q3 25 | 2.10× | — | ||
| Q2 25 | 2.04× | — | ||
| Q1 25 | 1.97× | — | ||
| Q4 24 | 1.77× | — | ||
| Q3 24 | 1.87× | — | ||
| Q2 24 | 1.79× | — |
Cash Flow & Capital Efficiency
How much cash each business actually produces after reinvestment. Cash flow is harder to manipulate than net income.
| Metric | | |
|---|---|---|
| Operating Cash FlowLast quarter | — | $52.5M |
| Free Cash FlowOCF − Capex | — | $41.8M |
| FCF MarginFCF / Revenue | — | 15.5% |
| Capex IntensityCapex / Revenue | — | 4.0% |
| Cash ConversionOCF / Net Profit | — | 0.39× |
| TTM Free Cash FlowTrailing 4 quarters | — | $78.5M |
8-quarter trend — quarters aligned by calendar period.
| Q1 26 | — | — | ||
| Q4 25 | $47.3M | $52.5M | ||
| Q3 25 | $81.5M | $68.5M | ||
| Q2 25 | $125.7M | $2.7M | ||
| Q1 25 | $55.6M | $-6.7M | ||
| Q4 24 | $82.1M | $69.2M | ||
| Q3 24 | $16.5M | $52.3M | ||
| Q2 24 | $37.8M | $-78.0K |
| Q1 26 | — | — | ||
| Q4 25 | — | $41.8M | ||
| Q3 25 | — | $58.1M | ||
| Q2 25 | — | $-6.3M | ||
| Q1 25 | — | $-15.1M | ||
| Q4 24 | — | $62.2M | ||
| Q3 24 | — | $44.3M | ||
| Q2 24 | — | $-12.5M |
| Q1 26 | — | — | ||
| Q4 25 | — | 15.5% | ||
| Q3 25 | — | 25.9% | ||
| Q2 25 | — | -2.9% | ||
| Q1 25 | — | -7.5% | ||
| Q4 24 | — | 25.9% | ||
| Q3 24 | — | 21.8% | ||
| Q2 24 | — | -6.4% |
| Q1 26 | — | — | ||
| Q4 25 | — | 4.0% | ||
| Q3 25 | — | 4.6% | ||
| Q2 25 | — | 4.1% | ||
| Q1 25 | — | 4.2% | ||
| Q4 24 | — | 2.9% | ||
| Q3 24 | — | 3.9% | ||
| Q2 24 | — | 6.3% |
| Q1 26 | — | — | ||
| Q4 25 | 2.27× | 0.39× | ||
| Q3 25 | — | 6.90× | ||
| Q2 25 | — | — | ||
| Q1 25 | — | -2.24× | ||
| Q4 24 | 2.98× | 1.96× | ||
| Q3 24 | — | 2.83× | ||
| Q2 24 | — | -0.01× |
Financial Flow Comparison
Revenue → gross profit → operating profit → net profit for each company.
Revenue Breakdown by Segment
CTOS
| Equipment sales | $273.9M | 65% |
| Rental revenue | $116.3M | 28% |
| Parts sales and services | $32.1M | 8% |
INSP
Segment breakdown not available.
