The 15 Highest-Paying States for Registered Nurses

RN pay swings hard by geography. The same license earns a California nurse roughly twice what it earns a nurse in the lowest-paying states. Local labor demand, union strength, hospital concentration, and cost of living all push the number around.

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

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. New Jersey, $106,990. East Coast pay close to its neighbors, with a more manageable index of 114.6.
10. Connecticut, $103,670. Solid pay and a moderate index of 112.3. Yale New Haven anchors the state's largest health system.
11. 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.
12. Rhode Island, $99,770. The smallest state pays well, with Providence-Warwick as its only metro and an index of 112.2.
13. 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.
14. 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.
15. 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.