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Goodwill and Intangible Assets (Tables)
 12 Months Ended
Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]  
Summary of Intangible Assets, Net
Intangible assets, net, consist of the following (in thousands):
 
December 31, 2019
 
  
Gross
Carrying
Value
 
  
Accumulated
Amortization
 
  
Net
Carrying
Value
 
Physician and hospital agreements
  $
384,059
    $
(269,889
 )   $
114,170
 
Customer relationships
   
156,530
     
(29,595
 )    
126,935
 
Trade names
   
19,990
     
(2,326
 )    
17,664
 
Patented and other technology
   
34,528
     
(18,890
 )    
15,638
 
                         
   $
595,107
    $
(320,700
 )   $
274,407
 
                         
 
  
December 31, 2018
 
  
Gross
Carrying
Value
 
  
Accumulated
Amortization
 
  
Net
Carrying
Value
 
Physician and hospital agreements
  $
375,344
    $
(222,818
 )   $
152,526
 
Customer relationships
   
156,530
     
(29,595
 )    
126,935
 
Trade names
   
19,990
     
(2,326
 )    
17,664
 
Patented and other technology
   
33,129
     
(17,089
 )    
16,040
 
                         
   $
584,993
    $
(271,828
 )   $
 313,165
 
                         
Amortization Expenses for Existing Intangible Assets for the Next Five Years
Amortization expense for existing intangible assets for the next five years is expected to be as follows (in thousands):
2020
  $
42,502
 
2021
   
36,502
 
2022
   
29,482
 
2023
   
24,482
 
2024
   
10,590