Commitments and Contingencies Contingent Consideration (Acquisitions) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition, Contingent Consideration [Line Items]
Current portion of contingent consideration	$ 3,983	$ 6,293
Contingent consideration non-current portion	15,129	18,008
Bio Helix
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration—BNP Business		4,600
Fair Value, Inputs, Level 3 [Member]
Business Acquisition, Contingent Consideration [Line Items]
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Gain (Loss) Included in Earnings	$ 1,114	$ 100	$ 500