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Acquisitions - Purchase Price Allocation (Details) - USD ($) $ in Thousands | 12 Months Ended |  |
--- | --- | --- | ---
Dec. 31, 2018 | Dec. 31, 2019 | Dec. 31, 2017
Business Acquisition [Line Items] |  |  |
Intangible assets subject to amortization | $ 171,113 |  |
Goodwill | 439,452 | $ 439,095 | $ 454,612
Measurement period adjustments | 5,142 |  |
Paragon Medical |  |  |
Business Acquisition [Line Items] |  |  |
Goodwill | $ 161,800 |  |

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