Property and Equipment (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 651,949	$ 608,823
Accumulated depreciation	(236,222)	(210,139)
Net property and equipment	415,727	398,684	[1]
Machinery and Equipment, Gross	211,648	220,999
Furniture and Fixtures, Gross	8,285	7,361
Construction in Progress, Gross	83,788	57,144
Land, Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	208,182	206,846
Molds [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	56,187	56,253
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	44,821	44,408
Instruments Placed with Customers [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 39,038	$ 15,812

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