Property and Equipment - Components of Property and Equipment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 238,775	$ 212,739
Less: Accumulated depreciation	(142,272)	(129,103)
Property and equipment, net	96,503	83,636
Equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	123,139	105,428
Computer Software
Property, Plant and Equipment [Line Items]
Property and equipment, gross	34,469	33,878
Building and Building Improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	38,332	38,095
Leasehold Improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	25,237	19,876
Furniture
Property, Plant and Equipment [Line Items]
Property and equipment, gross	14,902	12,766
Land
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 2,696	$ 2,696
Minimum
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	1 year
Minimum | Equipment
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	1 year
Minimum | Computer Software
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	1 year
Minimum | Building and Building Improvements
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	2 years
Minimum | Leasehold Improvements
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	1 year
Minimum | Furniture
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	1 year
Maximum
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	40 years
Maximum | Equipment
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	15 years
Maximum | Computer Software
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	5 years
Maximum | Building and Building Improvements
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	40 years
Maximum | Leasehold Improvements
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	17 years
Maximum | Furniture
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful lives (years)	13 years