Compare Nursing Salaries by State: A Data-Driven Analysis of RN, LPN, and NP Pay Across America

When professionals and students set out to compare nursing salaries by state, the raw figures from job postings rarely tell the complete story. According to the Bureau of Labor Statistics Occupational Employment and Wage Statistics release for May 2025, published May 15, 2026, the national mean annual wage for registered nurses reached $101,420, with a median of $97,550 per year ($48.76/hour). 1 Yet that single national figure masks a geographic spread so wide that the same credential can yield nearly double the gross income depending on where a nurse chooses to practice.

National Salary Benchmarks by Nursing Role

The nursing profession spans a wide credential ladder, and each rung carries a distinct compensation range. According to BLS OEWS May 2025 data, certified nursing assistants earn a national mean of $42,700 per year, licensed practical nurses earn $67,050, staff registered nurses earn $101,420, nurse practitioners earn $137,300, certified nurse midwives earn $136,980, and certified registered nurse anesthetists earn $248,320 annually. 2 That progression from CNA to CRNA represents a 482% salary increase across the career ladder.

The NP credential has attracted particular labor market attention due to projected job growth of 40% from 2024 to 2034, ranking it as the third fastest-growing occupation in the entire U.S. economy. 3 The BLS national mean for RNs is pulled above the median by high earners concentrated in coastal states; roughly half of all U.S. registered nurses earn less than $93,600 per year, even though headline averages frequently exceed $100,000. 4

Top-Paying States for Registered Nurses: Raw Salary Rankings

Pacific and Northeast states dominate the upper tier of RN compensation. California leads the nation with a mean annual RN wage of $150,280 and a median of $140,270, employing 338,940 registered nurses statewide. 5 Hawaii follows at $124,340 mean and a $136,320 median, while Oregon ranks third at $123,140 mean. Washington posts $121,540, Massachusetts $117,960, Alaska $114,870, New York $113,440, and New Jersey $110,100 to complete the top eight states above $110,000. 5

At the lower end of the distribution, Alabama reports the lowest average RN salary at $77,020. 5 The gap between California and Alabama amounts to approximately 2.0 times the lower-paying state's figure, a differential driven by union contracts, staffing ratio mandates, and structural differences in state healthcare funding rather than any single variable.

Cost-of-Living Adjusted Pay: Where Purchasing Power Actually Lands

Gross salary rankings shift considerably once regional cost-of-living indices are applied. A nurse earning $155,000 in San Francisco and a nurse earning $88,400 in Houston may hold nearly equivalent real purchasing power after accounting for rent, taxes, and daily expenses. 6 When cost-of-living-adjusted rankings are applied, Oregon overtakes California, posting an adjusted effective hourly rate of $51.71 compared to California's $49.25. Minnesota ranks second on adjusted metrics at $50.28 per hour. 2

A concrete illustration: Massachusetts mandates no more than four patients per nurse in most acute care settings, creating structural wage pressure that sustains its high gross salaries. A Boston nurse paying approximately $2,800 per month in rent requires the state's $96,450-plus salary to approximate the real spending power of a $57,840 salary in Mississippi, where monthly rent averages roughly $950. 7 States like Texas and Georgia, with cost-of-living indices below the national baseline of 100, rank significantly higher on purchasing power metrics than their gross salary positions would suggest.

LPN and Nursing Assistant Salaries Across States

Licensed practical nurse and nursing assistant compensation follows geographic patterns broadly similar to RN pay but at materially lower absolute levels. Alaska reports the highest LPN/LVN average at $63,850 annually, followed by California at $60,240 and Massachusetts at $60,340. 8 Louisiana records one of the lowest LPN averages at $40,300 per year. For nursing assistants, North Dakota stands out with an adjusted median of $49,652, making it the strongest state for CNA purchasing power despite its lower gross salary profile. 9 At the BLS national mean level, CNAs earn $42,700 annually across the country. 2

The BSN credential carries a documented wage premium over the ADN pathway of between $6,000 and $10,000 per year, while the NP credential commands approximately $37,000 more than a staff RN position at the national average level. 10 Nurses with ten or more years of experience typically earn 40 to 60 percent more than new graduates holding the same credential in the same role and state. 11

Nurse Practitioner and CRNA Pay by State

Nurse practitioners earn the highest NP salaries in California at $167,000 per year, followed by New Jersey at $150,000 and Alaska, New York, and Oregon each at $145,000. 12 Rural states also feature prominently in NP rankings when adjusted for cost of living; New Mexico, Iowa, and Oklahoma rank near the top for NP purchasing power because high rural demand sustains competitive gross pay against lower living costs. According to the National Rural Health Association, nearly half of all rural primary care practices employ at least one nurse practitioner. 9

Certified registered nurse anesthetists represent the ceiling of nursing compensation at every geographic level. The BLS OEWS May 2025 data places the national CRNA mean at $248,320 annually, roughly 145% above the staff RN mean. 2 Travel nursing arrangements, which have stabilized following earlier pandemic-era surges, currently generate estimated annual earnings of $95,000 to $150,000 depending on assignment location and specialty. Union membership adds a documented 18.8% premium over non-union counterparts, with union hourly rates averaging $33.50 versus $28.20 for non-union nurses. 4

Workforce Demand, Shortage Context, and Salary Trends

The structural backdrop for all state-level salary comparisons is a nationwide nursing shortage. HRSA estimates place the current RN shortfall at approximately 100,000 positions, while a separate analysis projects an 8% RN vacancy rate, equivalent to 263,870 open positions, in 2026. 4 The BLS projects approximately 189,100 RN job openings per year through 2034, driven primarily by retirements and replacement demand rather than net employment growth alone. 1 South Dakota, despite ranking last among states for gross RN pay at approximately $69,510, reports the highest RN-to-population ratio in the country at 16 nurses per 1,000 residents, demonstrating that high nurse density does not automatically correlate with high wages. 9

Year-over-year RN wage growth from May 2023 to May 2024 reached approximately 4.2%, outpacing headline consumer price inflation for the same period. 4 Hospital-based NP wages rose 4.3% in the same interval to $144,760, while hospital RN pay climbed 3.3% to $104,420. Nurses evaluating geographic relocation should account for state income tax structures as well: states including Texas, Florida, Washington, Tennessee, Nevada, Wyoming, South Dakota, and Alaska impose no state income tax, a factor that materially alters effective take-home pay when comparing otherwise similar gross salary offers across state lines. 13

Sources

1. open-exam-prep.com - Registered Nurse Salary by State and Specialty (2026)
2. thenursingdirectory.com - Nursing Salary and Career Data 2026
3. wealthvieu.com - Average Nurse Salary by State (2026): RN, LPN, NP, and More
4. salario.io - Nurse Salary by State 2026: How Much Do RNs Really Make?
5. mappr.co - Registered Nurse Salary by State (2025), Mapped and Ranked
6. goodnurse.com - 2026 Nursing Salaries by State: Adjusted for Cost of Living
7. nursesalarydata.com - Nurse Salary by State 2026, Highest Paying States
8. worldpopulationreview.com - Nursing Pay by State 2026
9. smartasset.com - Where It Pays to Be in Nursing, 2026 Study
10. nursesalaryintel.com - Nurse Salary Data 2026: All 50 States and Specialties
11. nurselicenseguide.com - Nursing Salary by State 2026
12. salarybystate.com - Nurse Practitioner Salary 2026, Average Salary by State
13. jobsnearme.career - Registered Nurse Salary 2026, By State, City and Experience Level