Nursing Wiki

Registered Nurse Pay

Registered nursing crossed six figures nationally for the first time in the federal wage data covering May 2025: an average annual wage of $101,420 across 3,379,720 employed registered nurses. The median, a better guide to a typical career than the average, was $97,550.

The milestone arrived on a slowing trend. The last three annual increases, in order, were 6.2 percent, 4.2 percent, and 3.0 percent. The average across all United States occupations rose 2.7 percent over the same period, so nursing remains ahead of the wider economy by about three tenths of a point, having been well ahead of it a year earlier. The emergency premium the labour market paid in 2022 and 2023 is being withdrawn.

The spread inside the occupation

National averages hide the more useful fact, which is how wide the range is for one licence.

The bottom tenth of registered nurses earned $68,940 or less. The top tenth earned $137,470 or more, a spread of $68,530, with the best-paid decile earning roughly double the least-paid.

Geography explains a large part of that, specialty and setting another part, and seniority another.

A meaningful remainder is explained by none of those. Two nurses with similar experience in the same city and the same kind of unit can sit thousands of dollars apart, largely according to whether and when they last changed employers. Internal raises are budgeted; outside offers are competitive. When the market is rising 6 percent a year an employer has to move to hold someone, and when it is rising 3 percent the gap between internal and external pay tends to widen.

Hours are the other half of annual earnings, and how they are paid depends on whether a post is hourly or salaried and on which overtime system the employer uses. See nurse overtime.

The advanced practice tier

Advanced practice roles are counted as separate occupations in federal data, and the step up is the largest single move available inside nursing. On the May 2025 figures the group median is $134,920 across about 399,000 jobs, and it splits sharply by role: nurse anesthetists at a median of $236,590 in 54,500 jobs, nurse midwives at $134,040 in 8,200 jobs, and nurse practitioners at $132,300 in 336,300 jobs.

Employment in the group is projected to grow 36 percent between 2025 and 2035, against 6 percent for registered nurses. What the roles require and how state law limits them is covered under levels of nursing.

By state

On the May 2024 data, which gives the fullest published state and metro breakdown:

  • Highest: California at $148,330, then Hawaii $123,720, Oregon $120,470, Washington $115,740, Massachusetts $112,610, Alaska $112,040, New York $110,490, the District of Columbia $109,240, New Jersey $106,990, Connecticut $103,670.
  • Lowest: South Dakota at $72,210, Alabama $74,970, Arkansas $77,720, Iowa $77,780, Kansas $79,430.

California to South Dakota is a gap of $76,120, more than double, for the same licence and the same work. California's lead has since widened rather than narrowed: on the May 2025 data it pays an annual mean of $150,280, roughly $26,000 clear of second-place Hawaii.

One pattern runs against intuition. South Dakota pays least of any state and has more nurses per thousand jobs than anywhere else, at 32 per 1,000. West Virginia is second at 31. Nursing being a large share of the local labour market does not raise wages. If anything the places most dependent on nurses pay them least.

Where pay is high is not where the contracts are

Staff pay and contract demand run on different logic, and conflating them produces bad career decisions.

Across NurseRecruiter's full archive of travel job listings, the states advertising the most travel assignments per employed registered nurse are Idaho, Alaska, New Mexico, Maine and Vermont. Only Alaska is in the top ten for staff pay. California and Hawaii, the two best-paying states, rank twenty-second and twenty-sixth of fifty-one on that measure. Rates on a contract are set by how hard a particular rota is to cover, not by the local wage table. See where the assignments are.

Willingness runs its own way as well. Among the registered nurse profiles held on this site, nurses in Montana, Mississippi and Hawaii are the most likely to say they will take travel work, and nurses in New Jersey and Connecticut the least. Hawaii is the highest-paid state on that list and one of the most willing to leave it, so this is not a simple story about low wages pushing nurses out.

Adjusted for what a dollar buys

A California wage buys California groceries. Dividing state wages by the federal regional price parity measure, which covers rent, food, transport and medical care, converts pay into buying power.

The correction is large and does not overturn the ranking. The $76,120 gap between California and South Dakota narrows to $50,290 in buying power, so about a third of it disappears. South Dakota's $72,210 lives like $81,918. Arkansas gains most, from $77,720 to the equivalent of $89,529, overtaking three states that pay more on paper. California still leads on buying power at $132,208, and every one of the five lowest-paying states still trails every one of the five highest. Cost of living is a real deduction from the coastal premium, not a refutation of it.

By metro area

The twelve best-paying metropolitan areas for registered nurses in the country are all in California. San Jose leads nationally at $189,880, followed by San Francisco $178,450, Vallejo $175,620, Santa Rosa $171,490 and Sacramento $163,020.

Adjusting for local prices reorders them in a way that matters when choosing between Bay Area posts. San Jose stays first at an adjusted $167,948, but Vallejo overtakes San Francisco, $160,590 against $151,806. The two are an hour apart, and the cheaper city is worth nearly nine thousand dollars a year more in real terms. Santa Rosa also passes San Francisco once prices are counted.

Where the jobs are is a different list. New York, Newark and Jersey City together employ 195,470 registered nurses at an average of $115,650, Los Angeles 107,340 at $138,010, and Chicago 100,620 at $94,580. By state, California employs the most at 326,720, then Texas 261,050, Florida 218,100, New York 204,120 and Pennsylvania 146,840.

What these figures are not

They are staff wages. Contract work through an agency is priced differently and is not bounded by them. See travel nursing.

They lag. The federal survey describes a reference month roughly a year before publication, which makes it a benchmark rather than a live quote.

Year-to-year changes are not pure wage growth. The statistical agency itself cautions that survey samples and job coding shift between releases. The direction is solid; the decimal places are approximate.

Averages are not offers. They describe what employers already pay, which is what makes them useful as a floor when judging a posting or preparing for a review.

Two federal counts of the same workforce also differ, which trips people up. The wage survey counts 3,379,720 employed registered nurses for May 2025, while the occupational handbook, which uses a broader employment measure, gives 3,465,400 jobs for the same year. Neither is wrong; they are counting slightly different things.

When the market is not really a market

Published averages assume employers compete. Sometimes they have agreed not to.

A settlement given final approval in March 2026 resolved claims that a hospital system suppressed registered nurse wages between 2014 and 2020: $28.5 million, covering 11,252 nurses and other staff, with payments averaging about $1,457 each. That per-person figure is real money for a years-old wrong, and a fraction of what six years of suppressed wages is worth to any individual.

A no-poach arrangement is an agreement between employers who ought to be competing for the same workers not to recruit from each other. Sometimes it is a clause in a contract with a staffing agency, sometimes an understanding between executives. Such agreements are treated as antitrust violations, and enforcement in health care has increased. They bite particularly hard in nursing because licences are tied to states and hospital jobs to metro areas, so the practical market for most nurses is the handful of large employers within commuting distance.

The individual defence is not a legal one. It is a live outside offer, which is the only reliable test of whether current pay reflects a real market. Collective bargaining is the other route, and recent settlements have landed a few points above the national trend. See nurse strikes and bargaining.

Current openings by state and metro are listed on the locations pages.

Sources

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