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Acquisitions Business Combinations (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Sep. 01, 2017
Business Acquisition [Line Items]        
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High $ 65,000      
Business Combination, Contingent Consideration, Liability 30,900     $ 30,700
Goodwill, Acquired During Period 52,229 $ 41,308    
Amortization of Intangible Assets 11,500 8,300 $ 6,300  
BIOTIX [Member]        
Business Acquisition [Line Items]        
Business Combination, Consideration Transferred 105,000      
Goodwill, Acquired During Period 51,700      
Amortization of Intangible Assets 3,700      
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Net $ 18,800      
Minimum Weighted Average Useful Lives 5 years      
Maximum Weighted Average Useful Lives 18 years      
Other Acquisitions [Member]        
Business Acquisition [Line Items]        
Business Combination, Consideration Transferred $ 3,800 15,600    
Goodwill, Acquired During Period 300 7,500    
Finite-lived Intangible Assets Acquired $ 3,100 $ 9,400    
Minimum Weighted Average Useful Lives   10 years    
Maximum Weighted Average Useful Lives 12 years 15 years    
Henry Troemner, LLC [Member]        
Business Acquisition [Line Items]        
Business Combination, Consideration Transferred   $ 95,800    
Goodwill, Acquired During Period   33,800    
Amortization of Intangible Assets   2,700    
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Net   $ 11,300    
Minimum Weighted Average Useful Lives   3 years    
Maximum Weighted Average Useful Lives   25 years    
Customer Relationships [Member] | BIOTIX [Member]        
Business Acquisition [Line Items]        
Finite-lived Intangible Assets Acquired $ 49,500      
Customer Relationships [Member] | Henry Troemner, LLC [Member]        
Business Acquisition [Line Items]        
Finite-lived Intangible Assets Acquired   $ 43,900    
Technology-Based Intangible Assets [Member] | BIOTIX [Member]        
Business Acquisition [Line Items]        
Finite-lived Intangible Assets Acquired 8,000      
Technology-Based Intangible Assets [Member] | Henry Troemner, LLC [Member]        
Business Acquisition [Line Items]        
Finite-lived Intangible Assets Acquired   2,900    
Other Intangible Assets [Member] | BIOTIX [Member]        
Business Acquisition [Line Items]        
Finite-lived Intangible Assets Acquired 600      
Other Intangible Assets [Member] | Henry Troemner, LLC [Member]        
Business Acquisition [Line Items]        
Finite-lived Intangible Assets Acquired   500    
Trade Names [Member] | BIOTIX [Member]        
Business Acquisition [Line Items]        
Finite-lived Intangible Assets Acquired $ 7,100      
Trade Names [Member] | Henry Troemner, LLC [Member]        
Business Acquisition [Line Items]        
Finite-lived Intangible Assets Acquired   $ 3,400