Property and Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 819,823	$ 776,240
Accumulated depreciation	(363,475)	(320,155)
Net property and equipment	456,348	456,085	[1]
Machinery and Equipment, Gross	258,083	219,057
Furniture and Fixtures, Gross	7,602	7,498
Construction in Progress, Gross	78,557	101,425
Land, Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	234,368	230,454
Molds [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	60,379	60,155
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	96,990	83,217
Instruments Placed with Customers [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 83,844	$ 74,434

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