Property and Equipment (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 787,585	$ 776,240
Accumulated depreciation	(331,961)	(320,155)
Net property and equipment	455,624	456,085	[1]
Machinery and Equipment, Gross	241,059	219,057
Furniture and Fixtures, Gross	7,416	7,498
Construction in Progress, Gross	77,483	101,425
Land, Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	233,548	230,454
Molds [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	60,312	60,155
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	93,475	83,217
Instruments Placed with Customers [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 74,292	$ 74,434

[1] December 31, 2019 balances were derived from audited consolidated financial statements.