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Property and Equipment (Details) - USD ($)
$ in Thousands
3 Months Ended 6 Months Ended
Jun. 30, 2019
Jun. 30, 2018
Jun. 30, 2019
Jun. 30, 2018
Dec. 31, 2018
Property and equipment          
Total property and equipment $ 33,127   $ 33,127   $ 31,890
Accumulated depreciation (19,478)   (19,478)   (17,451)
Property and equipment, net 13,649   13,649   14,439
Depreciation expense 1,000 $ 1,000 2,100 $ 1,900  
Equipment          
Property and equipment          
Total property and equipment 18,824   $ 18,824   18,602
Equipment | Minimum          
Property and equipment          
Estimated useful life     5 years    
Equipment | Maximum          
Property and equipment          
Estimated useful life     7 years    
Furniture and fixtures          
Property and equipment          
Total property and equipment 954   $ 954   954
Furniture and fixtures | Minimum          
Property and equipment          
Estimated useful life     5 years    
Furniture and fixtures | Maximum          
Property and equipment          
Estimated useful life     7 years    
Computer and software          
Property and equipment          
Total property and equipment 8,919   $ 8,919   8,783
Estimated useful life     3 years    
Leasehold improvements          
Property and equipment          
Total property and equipment 1,977   $ 1,977   1,978
Leasehold improvements | Minimum          
Property and equipment          
Estimated useful life     2 years    
Leasehold improvements | Maximum          
Property and equipment          
Estimated useful life     8 years    
Reusable instruments          
Property and equipment          
Total property and equipment $ 2,453   $ 2,453   $ 1,573
Estimated useful life     5 years