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Side-by-side financial comparison of Inspire Medical Systems, Inc. (INSP) and Palomar Holdings, Inc. (PLMR). Click either name above to swap in a different company.

Inspire Medical Systems, Inc. is the larger business by last-quarter revenue ($269.1M vs $253.4M, roughly 1.1× Palomar Holdings, Inc.). On growth, Palomar Holdings, Inc. posted the faster year-over-year revenue change (62.7% vs 12.2%). Palomar Holdings, Inc. produced more free cash flow last quarter ($409.0M vs $41.8M). Over the past eight quarters, Palomar Holdings, Inc.'s revenue compounded faster (46.2% CAGR vs 28.1%).

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.

Palomar Holdings, Inc. is a specialty insurance holding company that primarily provides property insurance products for catastrophe-exposed residential and commercial assets. It mainly operates across the United States, focusing on core segments including earthquake, flood, and windstorm coverage to meet high-risk property protection demands of customers.

INSP vs PLMR — Head-to-Head

Bigger by revenue
INSP
INSP
1.1× larger
INSP
$269.1M
$253.4M
PLMR
Growing faster (revenue YoY)
PLMR
PLMR
+50.4% gap
PLMR
62.7%
12.2%
INSP
More free cash flow
PLMR
PLMR
$367.2M more FCF
PLMR
$409.0M
$41.8M
INSP
Faster 2-yr revenue CAGR
PLMR
PLMR
Annualised
PLMR
46.2%
28.1%
INSP

Income Statement — Q4 FY2025 vs Q4 FY2025

Metric
INSP
INSP
PLMR
PLMR
Revenue
$269.1M
$253.4M
Net Profit
$136.1M
Gross Margin
86.6%
Operating Margin
17.1%
28.7%
Net Margin
50.6%
Revenue YoY
12.2%
62.7%
Net Profit YoY
286.4%
EPS (diluted)
$4.57
$2.05

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
INSP
INSP
PLMR
PLMR
Q4 25
$269.1M
$253.4M
Q3 25
$224.5M
$244.7M
Q2 25
$217.1M
$203.3M
Q1 25
$201.3M
$174.6M
Q4 24
$239.7M
$155.8M
Q3 24
$203.2M
$148.5M
Q2 24
$195.9M
$131.1M
Q1 24
$164.0M
$118.5M
Net Profit
INSP
INSP
PLMR
PLMR
Q4 25
$136.1M
Q3 25
$9.9M
$51.5M
Q2 25
$-3.6M
$46.5M
Q1 25
$3.0M
$42.9M
Q4 24
$35.2M
Q3 24
$18.5M
$30.5M
Q2 24
$9.8M
$25.7M
Q1 24
$-10.0M
$26.4M
Gross Margin
INSP
INSP
PLMR
PLMR
Q4 25
86.6%
Q3 25
85.8%
Q2 25
84.0%
Q1 25
84.7%
Q4 24
85.0%
Q3 24
84.1%
Q2 24
84.8%
Q1 24
84.9%
Operating Margin
INSP
INSP
PLMR
PLMR
Q4 25
17.1%
28.7%
Q3 25
4.3%
27.4%
Q2 25
-1.5%
29.5%
Q1 25
-0.7%
30.8%
Q4 24
13.3%
28.9%
Q3 24
7.0%
25.9%
Q2 24
2.6%
25.5%
Q1 24
-9.3%
29.0%
Net Margin
INSP
INSP
PLMR
PLMR
Q4 25
50.6%
Q3 25
4.4%
21.0%
Q2 25
-1.7%
22.9%
Q1 25
1.5%
24.6%
Q4 24
14.7%
Q3 24
9.1%
20.5%
Q2 24
5.0%
19.6%
Q1 24
-6.1%
22.3%
EPS (diluted)
INSP
INSP
PLMR
PLMR
Q4 25
$4.57
$2.05
Q3 25
$0.34
$1.87
Q2 25
$-0.12
$1.68
Q1 25
$0.10
$1.57
Q4 24
$1.17
$1.29
Q3 24
$0.60
$1.15
Q2 24
$0.32
$1.00
Q1 24
$-0.34
$1.04

Balance Sheet & Financial Strength

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

Metric
INSP
INSP
PLMR
PLMR
Cash + ST InvestmentsLiquidity on hand
$308.3M
$106.9M
Total DebtLower is stronger
Stockholders' EquityBook value
$781.2M
$942.7M
Total Assets
$907.3M
$3.1B
Debt / EquityLower = less leverage

8-quarter trend — quarters aligned by calendar period.

Cash + ST Investments
INSP
INSP
PLMR
PLMR
Q4 25
$308.3M
$106.9M
Q3 25
$322.6M
$111.7M
Q2 25
$300.9M
$81.3M
Q1 25
$369.2M
$119.3M
Q4 24
$445.5M
$80.4M
Q3 24
$411.0M
$86.5M
Q2 24
$439.7M
$47.8M
Q1 24
$441.4M
$61.4M
Stockholders' Equity
INSP
INSP
PLMR
PLMR
Q4 25
$781.2M
$942.7M
Q3 25
$666.5M
$878.1M
Q2 25
$677.8M
$847.2M
Q1 25
$635.7M
$790.4M
Q4 24
$689.7M
$729.0M
Q3 24
$696.6M
$703.3M
Q2 24
$638.1M
$532.6M
Q1 24
$589.0M
$501.7M
Total Assets
INSP
INSP
PLMR
PLMR
Q4 25
$907.3M
$3.1B
Q3 25
$807.7M
$2.9B
Q2 25
$802.2M
$2.8B
Q1 25
$730.8M
$2.4B
Q4 24
$808.4M
$2.3B
Q3 24
$796.2M
$2.3B
Q2 24
$728.4M
$2.0B
Q1 24
$685.8M
$1.9B

Cash Flow & Capital Efficiency

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

Metric
INSP
INSP
PLMR
PLMR
Operating Cash FlowLast quarter
$52.5M
$409.1M
Free Cash FlowOCF − Capex
$41.8M
$409.0M
FCF MarginFCF / Revenue
15.5%
161.4%
Capex IntensityCapex / Revenue
4.0%
0.1%
Cash ConversionOCF / Net Profit
0.39×
TTM Free Cash FlowTrailing 4 quarters
$78.5M
$700.6M

8-quarter trend — quarters aligned by calendar period.

Operating Cash Flow
INSP
INSP
PLMR
PLMR
Q4 25
$52.5M
$409.1M
Q3 25
$68.5M
$83.6M
Q2 25
$2.7M
$120.9M
Q1 25
$-6.7M
$87.2M
Q4 24
$69.2M
$261.2M
Q3 24
$52.3M
$100.3M
Q2 24
$-78.0K
$55.1M
Q1 24
$8.9M
$33.1M
Free Cash Flow
INSP
INSP
PLMR
PLMR
Q4 25
$41.8M
$409.0M
Q3 25
$58.1M
$83.6M
Q2 25
$-6.3M
$120.8M
Q1 25
$-15.1M
$87.1M
Q4 24
$62.2M
$260.9M
Q3 24
$44.3M
$100.1M
Q2 24
$-12.5M
Q1 24
$-2.8M
FCF Margin
INSP
INSP
PLMR
PLMR
Q4 25
15.5%
161.4%
Q3 25
25.9%
34.2%
Q2 25
-2.9%
59.4%
Q1 25
-7.5%
49.9%
Q4 24
25.9%
167.5%
Q3 24
21.8%
67.4%
Q2 24
-6.4%
Q1 24
-1.7%
Capex Intensity
INSP
INSP
PLMR
PLMR
Q4 25
4.0%
0.1%
Q3 25
4.6%
0.0%
Q2 25
4.1%
0.0%
Q1 25
4.2%
0.0%
Q4 24
2.9%
0.2%
Q3 24
3.9%
0.1%
Q2 24
6.3%
0.0%
Q1 24
7.1%
0.0%
Cash Conversion
INSP
INSP
PLMR
PLMR
Q4 25
0.39×
Q3 25
6.90×
1.63×
Q2 25
2.60×
Q1 25
-2.24×
2.03×
Q4 24
1.96×
Q3 24
2.83×
3.29×
Q2 24
-0.01×
2.14×
Q1 24
1.26×

Financial Flow Comparison

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

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