Nationally, registered nurses earn a median wage of $93,600 a year and an average (mean) of $98,430, according to the U.S. Bureau of Labor Statistics May 2024 Occupational Employment and Wage Statistics. Every state figure below is the BLS May 2024 average annual wage. The cost-of-living index uses 100 as the national average: above 100 means a more expensive state, below 100 means cheaper. Watch that column, because a big paycheck in a high-cost state does not always go further than a smaller one in a cheap state.
One caveat: BLS excluded Colorado from the May 2024 release over data-quality problems tied to the state's unemployment insurance system, so Colorado is not ranked here.
The Ranking
- California, $148,330. The clear national leader and home to the largest RN workforce and systems like Kaiser Permanente and the University of California hospitals. Cost-of-living index 144.8, among the highest in the country.
- Hawaii, $123,720. Second in raw pay but the most expensive state to live in by a wide margin, with a cost-of-living index of 186.9. The high wage barely keeps pace with housing and goods.
- Oregon, $120,470. Strong pay with a more moderate index of 112, which makes Oregon the top earner once you adjust for cost of living. Portland anchors the state's largest hospitals.
- Washington, $115,740. The third Pacific Coast state in the top five. The Seattle-Tacoma metro concentrates much of the workforce and the highest pay. Index 114.2.
- Massachusetts, $112,610. A biotech and academic-medicine hub built around Boston. Pay is high, but so is the cost of living at 145.9.
- Alaska, $112,040. High wages offset a high cost of living (index 123.8) driven by remoteness. A small workforce and few nursing schools keep demand strong.
- New York, $110,490. New York City's pay and cost of living both run high (index 123.3). The state hosts some of the largest hospitals in the country.
- Washington, D.C., $109,240. Not a state, but one of the top-paying jurisdictions in the nation, with a cost-of-living index of 141.9.
- New Jersey, $106,990. East Coast pay close to its neighbors, with a more manageable index of 114.6.
- Connecticut, $103,670. Solid pay and a moderate index of 112.3. Yale New Haven anchors the state's largest health system.
- Nevada, $102,280. The highest-paying interior West state, with a cost-of-living index just above average at 101.3. Las Vegas and Reno lead on pay.
- Rhode Island, $99,770. The smallest state pays well, with Providence-Warwick as its only metro and an index of 112.2.
- Minnesota, $99,460. Home to the Mayo Clinic. With an index of 95.1, below the national average, Minnesota offers some of the best real earning power of any top-paying state.
- Maryland, $96,650. Anchored by Johns Hopkins and the University of Maryland Medical Center, with an index of 115.3 reflecting its proximity to D.C.
- Delaware, $95,450. Rounds out the list with pay near the national average and a roughly average cost of living (index 100.8).
Cost of Living Changes the Picture
Rank by raw pay and the coasts dominate. Adjust for what a dollar actually buys and the order shifts. Oregon moves to the front, Minnesota and Nevada climb, and high-cost leaders like Hawaii, Massachusetts, and Washington, D.C. drop sharply. Hawaii's index of 186.9 erases much of its second-place wage.
The takeaway for nurses weighing a move: compare the offer against local housing and living costs, not just the headline number. A state in the middle of this list can leave you with more spendable income than one at the top.
Frequently Asked Questions
Which state pays registered nurses the most?
California, at an average annual wage of $148,330 (BLS May 2024), the highest in the nation and well above the national mean of $98,430.
What is the national average salary for a registered nurse?
The Bureau of Labor Statistics reports an RN median wage of $93,600 and a mean of $98,430 for May 2024.
Does a high nursing salary always mean more money in my pocket?
Not always. Cost of living changes the picture. Hawaii ranks second in raw pay but carries the highest cost-of-living index in the country, so the wage barely keeps pace with housing and goods.
Which state offers the best pay after adjusting for cost of living?
Oregon. Its average wage of $120,470 paired with a moderate cost-of-living index makes it the top real earner once you account for what a dollar actually buys.
Why is Colorado not on the list?
BLS excluded Colorado from the May 2024 release over data-quality problems tied to the state's unemployment insurance system, so it is not ranked here.
Do these figures include nurse practitioners?
No. These are wages for registered nurses (BLS occupation 29-1141). Advanced practice roles like nurse practitioners are tracked separately and earn a higher median, $129,210 in May 2024.