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Property and Equipment (Details) - USD ($) $ in Thousands | Sep. 30, 2019 | Dec. 31, 2018
--- | --- | ---
Property, Plant and Equipment [Line Items] |  |  |
Total property and equipment, cost | $ 749,118 | $ 694,864 |
Accumulated depreciation | (305,031) | (262,223) |
Net property and equipment | 444,087 | 432,641 | [1]
Machinery and Equipment, Gross | 213,957 | 203,431 |
Furniture and Fixtures, Gross | 7,405 | 7,409 |
Construction in Progress, Gross | 85,908 | 70,864 |
Land, Buildings and Improvements [Member] |  |  |
Property, Plant and Equipment [Line Items] |  |  |
Total property and equipment, cost | 228,960 | 212,283 |
Molds [Member] |  |  |
Property, Plant and Equipment [Line Items] |  |  |
Total property and equipment, cost | 59,749 | 59,700 |
Computer Equipment and Software [Member] |  |  |
Property, Plant and Equipment [Line Items] |  |  |
Total property and equipment, cost | 82,993 | 80,420 |
Instruments Placed with Customers [Member] |  |  |
Property, Plant and Equipment [Line Items] |  |  |
Total property and equipment, cost | $ 70,146 | $ 60,757 |
[1] | December 31, 2018 balances were derived from audited consolidated financial statements.

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