Key Takeaways
- Nurse practitioners average about $132,000 a year nationally, among the highest pay in nursing.
- California pays the most at $166,610; Alabama pays the least at $106,930.
- Alaska posted the largest yearly jump, with average pay up 13% from 2023 to 2024.
This guide breaks down NP pay by state, adjusts it for cost of living, and shows where earnings are climbing fastest.
Nurse Practitioner Salaries by State
Pay varies widely across the country. Western and Northeastern states dominate the top of the list, while southern states sit at the bottom. California leads at an average $166,610 a year, nearly $60,000 above last-place Alabama.
Cost of living drives much of the gap. High-cost states pay the most, while lower-cost southern states like Tennessee, Alabama, and Arkansas land between $107,000 and $114,000. Within any state, urban areas pay more than rural ones. California's Bay Area reports the highest metro pay for NPs, according to the BLS.
Highest-Paying States Adjusted for Cost of Living
Where you practice changes what your paycheck is worth. The U.S. Bureau of Economic Analysis (BEA) cost-of-living index, or regional price parity, measures how far earnings stretch against local prices for housing, food, utilities, healthcare, and transportation, with 100 set as the national average.
Even after adjusting for cost of living, NP pay clears six figures in all 50 states. Adjusted pay in the top ten ranges from about $141,000 to $153,000. California still ranks in the top ten despite the highest cost of living, and New Mexico's low cost of living pushes it to the top adjusted spot.
Top 5 States by Change in NP Salary (2023-2024)
NP pay rose in almost every region, led by Alaska. About one in three states saw average pay slip from 2023 to 2024, most by less than 5%.
- Alaska: 13.26%
- Missouri: 7.67%
- Florida: 7.21%
- Montana: 6.73%
- West Virginia: 6.73%
The primary care provider shortage, an aging population, and nurse retirements all push demand and pay higher. More states keep expanding NP practice authority to widen access and cut costs, which makes NPs more valuable across the system.
Complete List of States by NP Salary
| Rank | State | Average Annual Salary (2024) | Cost of Living Index | Adjusted for Cost of Living |
|---|---|---|---|---|
| 1 | California | $166,610 | 112.6 | $147,991 |
| 2 | New Jersey | $149,620 | 108.9 | $137,414 |
| 3 | Alaska | $145,450 | 101.7 | $142,998 |
| 4 | New York | $145,390 | 107.6 | $135,088 |
| 5 | Oregon | $144,600 | 104.7 | $138,081 |
| 6 | Washington | $140,220 | 108.6 | $129,161 |
| 7 | Connecticut | $138,960 | 103.7 | $134,016 |
| 8 | Massachusetts | $138,890 | 108.2 | $128,319 |
| 9 | New Mexico | $138,440 | 90.4 | $153,165 |
| 10 | Arizona | $133,790 | 101.1 | $132,328 |
Note: Salary data not available for Nevada. Sources: BLS and BEA, 2024.
Methodology
State NP salary data comes from the BLS Occupational Employment and Wage Statistics program, released April 2, 2025, reflecting May 2024 wages. States are ranked by average annual salary. Cost-of-living data comes from the BEA Real Personal Income series, last updated February 20, 2025. Adjusted pay divides each state's NP salary by its regional price parity as a multiple of 100.
Frequently Asked Questions
What is the average nurse practitioner salary? The national mean NP wage was about $132,000 in May 2024, and the median was $129,210, per the BLS. Most NPs fall between those figures and the higher end of six figures depending on state and setting.
Which state pays nurse practitioners the most? California leads on nominal pay at an average $166,610 a year, well ahead of other top payers like New Jersey, Alaska, and New York.
Which state pays the least? Alabama posts the lowest average NP pay at $106,930, with other lower-cost southern states such as Tennessee and Arkansas close behind.
Does the highest-paying state give you the most buying power? Not always. After adjusting for cost of living with BEA regional price parities, New Mexico tops the list at about $153,165 because its low prices stretch a $138,440 salary further than California's higher nominal pay.
Why is NP pay rising? A primary care provider shortage, an aging population, nurse retirements, and the spread of full practice authority all push demand and wages higher. Alaska saw the steepest one-year jump, up about 13% from 2023 to 2024.