Revenue Recognition - Disaggregation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Disaggregation of Revenue [Line Items]
Total revenues	$ 1,082,571	$ 820,222	$ 625,486
United States
Disaggregation of Revenue [Line Items]
Total revenues	1,047,636	785,849	590,872
Americas, excluding U.S.
Disaggregation of Revenue [Line Items]
Total revenues	4,908	3,705	4,047
Europe, Middle East, India, and Africa
Disaggregation of Revenue [Line Items]
Total revenues	22,811	16,640	20,429
Asia Pacific and Other
Disaggregation of Revenue [Line Items]
Total revenues	7,216	14,028	10,138
Insurance carriers
Disaggregation of Revenue [Line Items]
Total revenues	954,155	690,754	492,563
Laboratory partners
Disaggregation of Revenue [Line Items]
Total revenues	98,891	94,910	100,019
Patients
Disaggregation of Revenue [Line Items]
Total revenues	29,525	34,558	32,904
Licensing and other
Disaggregation of Revenue [Line Items]
Total revenues	$ 14,049	$ 22,915	$ 45,406