Audiogram 101: Your Essential Guide to Understanding Hearing Tests
Updated October 2026
Short Version: An audiogram plots the softest sound you can hear at each pitch. Low pitches sit on the left, high pitches on the right, and loudness grows as you move down the chart. Marks that sit low mean hearing loss. Check where your marks fall against the speech zone, and you will know which sounds you are missing.
Most people leave a hearing test holding a chart they were never taught to read. An audiogram looks like a graph from a math class, with circles, Xs and a curve that seems to slide downhill. Once you know what each axis measures, the chart tells a plain story about which sounds reach you and which ones fade. Learn to read it line by line, and you walk into your next appointment with sharper questions.
If you have not had a test yet, our diagnostic hearing evaluations are where an audiogram starts.
How to Read an Audiogram, Axis by Axis
Read the chart as a map of pitch across the top and loudness down the side. Every mark answers one question: how loud did this pitch have to be before you heard it? ASHA’s explanation of the hearing test chart describes the same layout, with the lowest pitches on the left and soft sounds at the top.
The horizontal axis runs in Hertz. A deep voice or a truck engine sits toward the left. Birdsong, a microwave beep and the hiss of an “s” sit toward the right. The vertical axis runs in decibels. Whisper-quiet sounds sit near the top line. Each step down the chart means the tone had to get louder before you caught it.
Use this quick key while you hold your own chart:
| Part of the chart | What it measures | What to look for |
|---|---|---|
| Horizontal axis | Pitch, in Hertz, low on the left and high on the right | Where your marks start to drop |
| Vertical axis | Loudness, in decibels, soft at the top and loud at the bottom | How far down your marks sit |
| Each mark | Your threshold, the softest tone you heard at that pitch | Whether the two ears match |
| The connecting line | Your hearing across the pitch range | Its overall shape, flat or sloping |
So the higher your marks sit on the page, the better you hear that pitch.
What the Symbols on Your Audiogram Mean
The circles and Xs tell you which ear your provider tested and how the sound reached it. Clinics follow a shared convention, so a chart from one practice reads the same way as a chart from another. Small differences in symbol style do happen, which is why most charts print a legend in the corner.
These are the marks you will see most often:
- Red O: your right ear, tested through headphones or earphones
- Blue X: your left ear, tested the same way
- < and >: bone conduction for the right and left ear, which skips the outer and middle ear
- Brackets, triangles or squares: masked results, where a soft noise kept the other ear busy so it could not answer for this one
The color coding exists so your provider can compare the two ears at a glance. Bring your reading glasses if you use them. The symbols print small, and nobody squints well at a chart about their own ears.
How the Test Finds Each Point on the Chart
Each mark comes from a search for the softest tone you can still detect. Your provider plays a tone, then makes it softer each time you respond. Once you stop hearing it, the tone climbs again until you catch it. That back-and-forth narrows in on your threshold. Your provider marks the chart at that level.
The test runs twice, by two routes. Headphones send sound down the ear canal, through the eardrum and the tiny middle-ear bones, and into the inner ear. A small vibrating band behind the ear sends sound through the skull instead. As the UCSF guide to reading an audiogram puts it, bone conduction bypasses the outer and middle ear and goes straight to the inner ear.
Comparing the two routes is what tells your provider where the trouble sits. When the headphone results are worse than the bone results, something in the outer or middle ear is blocking sound. Wax, fluid or an eardrum problem can do that. When both routes come out low together, the inner ear or the hearing nerve is the source. That pattern is common in adults over fifty.
The two results usually line up one of three ways:
- Gap between the routes: a conductive loss, often medical and sometimes treatable at the source
- Both routes low, no gap: a sensorineural loss, the kind hearing aids help most
- Low on both, with a gap on top: a mixed loss, with a conductive part and an inner-ear part
For more on what sits behind each pattern, see our guide to the types and causes of hearing loss.
Where Speech Sits on the Chart
Everyday conversation lands in a curved zone across the middle of the chart. Hearing care providers call it the speech banana because of its shape. The UCSF guide describes it as the region where the sounds of normal conversation fall. Lay your own marks against it, and you can see which speech sounds reach you.
Vowels carry most of the volume in speech and sit at lower pitches. Consonants like s, f, th and k are softer and higher. Clarity lives in those consonants. A loss that drops off on the right side of the chart lets the vowels through and strips the consonants out. That explains the complaint we hear most: “I can hear people talking. I just cannot understand them.”
When you read your chart against the speech zone, check three things:
- Marks above the zone: those speech sounds reach you at normal conversation levels
- Inside the zone: some sounds at that pitch reach you, and softer speakers will fade
- Marks below the zone: those sounds are missing unless someone raises their voice
A chart that dips below the zone on the right is a common reason restaurants feel harder than they used to.
What Degree of Hearing Loss Your Results Show
The depth of your marks sets the degree of loss, named in bands from slight to profound. Providers use the same bands everywhere, which keeps the language consistent from one clinic to the next. The ranges below follow ASHA’s degree of hearing loss scale.
| Degree | Range (dB HL) | What it can feel like |
|---|---|---|
| Normal | -10 to 15 | Soft speech comes through without effort |
| Slight | 16 to 25 | Whispers and distant voices start to slip |
| Mild | 26 to 40 | Soft speech and busy rooms take effort |
| Moderate | 41 to 55 | Normal conversation needs close attention |
| Moderately severe | 56 to 70 | Most speech is hard to follow without help |
| Severe | 71 to 90 | Only loud speech gets through |
| Profound | 91 and above | Very loud sound may be felt more than heard |
Few charts sit in a single band. A common chart reads mild on the left and moderate or worse on the right. That sloping shape is typical of age-related loss. Our guide to the degrees of hearing loss goes deeper on each band.
Two shapes deserve a closer look from your provider:
- One ear much worse than the other: an uneven result can point to a cause worth checking medically
- A sudden change from your last test: a quick drop calls for a licensed medical professional promptly
Neither one means something serious is wrong. Both mean the next step is a conversation, not a guess.
What Your Audiogram Means for Treatment
Your audiogram is the prescription, and everything after the test builds on it. A provider programs hearing aids to the exact shape of your chart, pitch by pitch. Two people with the same degree of loss can need very different settings because their curves differ.
Treatment usually tracks the degree:
- Slight to mild: monitoring, communication strategies, or hearing aids if daily life is already harder
- Moderate to moderately severe: hearing aids fit to your curve
- Severe to profound: power devices with custom earmolds, and sometimes a cochlear implant referral
- Conductive gap present: a medical look at the cause first, because a physician can treat some conductive losses directly
The chart alone does not finish the job. Someone still has to confirm that the hearing aids deliver what your results call for inside your ear. We measure that with professional hearing aid fittings that check the output against your targets. A fitting that skips that step is working from a prediction rather than your real ear.
Should You Keep a Copy of Your Audiogram?
Yes. Ask for a copy before you leave any hearing test, and keep it with your health records. Your chart is a baseline. The next test only means something when someone can lay it next to the last one.
A copy earns its keep in a few situations:
- Tracking change: two charts side by side show whether your hearing is stable or shifting
- Seeing a physician: an ear, nose and throat doctor will want the numbers, not a summary
- Getting a second opinion: a printed chart lets another provider start from real data
- Using a hearing benefit: some insurance and benefit programs ask for recent test results
Hold onto it the same way you would keep your eyeglass prescription.
Getting an Audiogram in Sioux Falls or Buffalo
A first visit with us starts with a free consultation that includes a hearing test, so you leave knowing where your hearing stands. There is no pressure to buy and no obligation. Your hearing care provider walks you through the chart in plain language, pointing to the axes and symbols as you go.
Some patients need a deeper look. A diagnostic evaluation is a separate appointment that insurance covers. We bill your insurance for it directly. Coverage varies by plan, so we verify your benefits before your appointment and you know what is covered before you commit. Our hearing aid insurance benefits guide explains how that check works.
| Appointment | Cost to you | Best if you |
|---|---|---|
| Free consultation | No charge | Want to know where your hearing stands and what your options are |
| Diagnostic evaluation | Billed to your insurance, coverage varies by plan | Need in-depth testing, a physician referral, or a full medical record of your hearing |
“Nobody should walk out of a hearing test with just a pass or a fail,” says Dr. Jade Husby, Au.D., owner of Stanford Hearing. “I want you to see the shape of your own chart, because that shape tells us what comes next.”
Before you leave, we book your follow-up so the next step is already on the calendar. Book at our Sioux Falls hearing center or our Buffalo hearing center, whichever sits closer to home.
Why Choose Stanford Hearing
A chart only helps when someone takes the time to explain it. We are locally owned. Our team has cared for patients in Sioux Falls and Buffalo for more than 20 years. Neighbors have also voted us a consistent Sioux Falls Local Best winner. Every patient gets the same footing:
- Free consultations with no pressure to buy, and a hearing test as part of your first visit
- Five premium brands, Phonak, ReSound, Starkey, Unitron and Oticon, recommended for your hearing and your life
- Options for every budget, so cost never decides whether you get help
- A 10-day trial so you can wear your hearing aids at home, at work, and out with people before you decide, with a 30-day trial on the Phonak Virto
- Return them inside your trial window for a full refund if your hearing aids are not right for you
- A price match guarantee, so you will not overpay locally: if a nearby clinic beats our price on a comparable device, we meet it
- 12 months no-interest financing, subject to credit approval
- In-network with all major insurance providers, including Medicare Advantage, with your benefits verified before your appointment
- Hands-on care from testing to fitting to follow-up adjustments, with remote care available
Come in with questions and leave with a plan. Schedule a free consultation and we will read your results with you, line by line.
Audiogram Questions We Hear Most
Is the hearing test at Stanford Hearing free?
Yes. Stanford Hearing includes a hearing test in your free consultation, with no obligation to buy anything. A diagnostic evaluation is a separate appointment billed to insurance. We verify your benefits before you come in.
Will Stanford Hearing push me to buy hearing aids after my test?
No. Stanford Hearing offers free consultations with no pressure to buy. Some patients leave with a plan to monitor their hearing and come back later. We would rather earn your trust over several visits than rush a decision on the first one.
Can my audiogram look normal while I still struggle in noise?
It can. A tone test measures detection. Following speech in a noisy room asks more of your hearing than that. Stanford Hearing runs comprehensive hearing evaluations that include speech testing, so we see how well you understand words as well as tones.
How often should I get a new audiogram?
Get one whenever you notice a change, and on the schedule your provider sets with you. Stanford Hearing compares each new chart against your earlier results. If your hearing drops suddenly, see a licensed medical professional promptly rather than waiting for a routine visit.
Does Stanford Hearing fit hearing aids straight from my audiogram?
Your results set the starting prescription. Stanford Hearing then measures what the hearing aids deliver inside your ear and fine-tunes them to your targets. Most people notice a difference right away, and your brain keeps adjusting over the first few weeks.