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Restructuring and integration expense (Tables)
9 Months Ended
Sep. 30, 2022
Restructuring and Related Activities [Abstract]  
Restructuring and integration expense
Restructuring and integration expense is reflected on the consolidated statements of comprehensive income as follows:

 Quarter Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2022202120222021
Total cost of revenue$131 $1,559 $216 $3,073 
Operating expenses15,188 12,335 46,614 38,012 
Restructuring and integration expense$15,319 $13,894 $46,830 $41,085 
Restructuring and integration expense for each period was comprised of the following:
 Quarter Ended
September 30,
Nine Months Ended
September 30,
(in thousands)2022202120222021
External consulting fees$7,670 $6,432 $24,670 $19,355 
Internal labor1,877 1,756 6,177 6,276 
Employee severance benefits3,826 1,293 8,232 3,167 
Other1,946 4,413 7,751 12,287 
Restructuring and integration expense$15,319 $13,894 $46,830 $41,085 
Changes in restructuring and integration accruals
Changes in our restructuring and integration accruals were as follows:
(in thousands)Employee severance benefits
Balance, December 31, 2021
$5,672 
Charges8,928 
Reversals(696)
Payments(7,502)
Balance, September 30, 2022
$6,402