Revenue Recognition - Disaggregation (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Disaggregation of Revenue [Line Items]
Total revenues	$ 592,183	$ 439,758	$ 1,640,615	$ 1,220,850
United States
Disaggregation of Revenue [Line Items]
Total revenues	582,371	426,274	1,612,479	1,190,559
Americas, excluding U.S.
Disaggregation of Revenue [Line Items]
Total revenues	1,523	2,002	4,786	5,084
Europe, Middle East, India, Africa
Disaggregation of Revenue [Line Items]
Total revenues	6,006	7,722	17,463	18,339
Asia Pacific and Other
Disaggregation of Revenue [Line Items]
Total revenues	2,283	3,760	5,887	6,868
Insurance carriers
Disaggregation of Revenue [Line Items]
Total revenues	559,505	405,208	1,549,140	1,130,364
Laboratory and other partners
Disaggregation of Revenue [Line Items]
Total revenues	25,098	27,622	68,099	70,152
Patients
Disaggregation of Revenue [Line Items]
Total revenues	$ 7,580	$ 6,928	$ 23,376	$ 20,334