Property and Equipment (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 633,479	$ 608,823
Accumulated depreciation	(225,897)	(210,139)
Net property and equipment	407,582	398,684	[1]
Machinery and Equipment, Gross	236,234	220,999
Furniture and Fixtures, Gross	7,651	7,361
Construction in Progress, Gross	64,068	57,144
Land, Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	207,922	206,846
Molds [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	56,431	56,253
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	45,652	44,408
Instruments Placed with Customers [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 15,521	$ 15,812

[1] December 31, 2017 balances were derived from audited consolidated financial statements.