Nursing Pay Rates, Explained

per diem work

Online lists stating the average pay for nurses nationwide can vary wildly and often suggest that huge rises or drop have occurred, but what’s the final word on how (and what) nurses actually get paid under various circumstances? We take a look at the most up-to-date numbers and what the statistics can – and can’t – tell us.

What do nurses make per year?

Pay scales, low ranges

While some lower-paying states average in the $27s for per-hour pay, stats show that some areas within the top ten highest paying states also average as low as $28.62. This raises the question that these lists may not be averaging just RN pay into these salary numbers.

A registered nurse working at a big city hospital – on average – can earn more than $40/hour, though a licensed practical nurse in a small-town rest home might not make half that wage.

It’s important to remember that hourly wages don’t reflect the extra hours and higher pay of overtime, which almost all nurses work voluntarily and/or as part of their contract, “as needed.” We spotted one salary site poster, who identified themselves as an RN say: “you might have to work 80 hours a week but even at $20-25/hour, you can still bring in $100K a year”

Pay scales, high ranges

nursing pay rates explained staffNursing in America is a vast profession, covering millions of people employed in thousands of different positions and hundreds of job types: a chief nurse anesthetist can make more than $173,740 a year, five times what some LPNs bring home in the same time.

Keep in mind that, while some scales may be brought down in average hourly pay by including LPNs with RNs, other scales from job sites and the like may be raised by including numbers from higher-paid senior and specialist nurses. These lists also tend to be perpetuated over many other sites and blogs which may not verify the source or accuracy of the information for themselves or put the information in its proper context.

Location can affect a nurse’s salary. 

Location, location, location

As of May 2017, the BLS reported that RN salaries across various states varied massively but according to these latest stats, the average American RN makes about $35 an hour, or about $73,550 a year.

Nurse Salary Map

However, RNs working in the highest paying states can earn far more than nurses elsewhere and among the highest-paying regions of those states, RNs can earn even more. For example, while the median pay for RNs in California is $49.37/hour, or about $96,470/year, RNs in the modest 51,000-resident city of Watsonville, CA, typically make more than $59.84/hour, or about $124,470 per year.

Here’s how annual salaries in the highest-paying areas of America’s highest-paying state for RNs play-out:

Area of California Average RN Annual Wage 2017
San Francisco-San Mateo-Redwood City CA Metropolitan Div $139,700
Salinas CA $129,940
San Jose-Sunnyvale-Santa Clara CA $129,140
Santa Cruz-Watsonville CA $124,470
Vallejo-Fairfield CA $119.830

If you think that’s astronomical for a non-specialist RN, a nurse in rural Soldad, CA made $331,346 in 2008, including $211,257 in overtime. Between 2006 and 2013, she was paid nearly $2 million and was one of 42 nurses in California to make more than a million dollars in the 6 years between 2006 and 2012. While that is an extreme example, here’s how much a typical RN in the five highest paying states brings in:

Highest paying states for nurses in 2017 (median pay):

State Hourly / Annual Pay
1. California $49.37 / $102,700
2. Hawaii $46.63 / $96,990
3. District of Columbia $43.32 / $90,110
4. Massachusetts $42.95 / $89,330
5. Oregon $42.68 / $88,770

Contrast that with what you’d be making as an RN in the five lowest-paying states in America:

Lowest paying states for nurses in 2017* (median pay):

(*Not including statistics for Guam or Puerto Rico)

State Hourly / Annual Pay
50. South Dakota $27.40 / $57,010
49. Mississippi $27.74 / $57,700
48. Alabama $27.83 / $57,890
47. Iowa $27.85 / $57,930
46. Arkansas $28.27 / $58,810

Nurse pay rates by training, specialty, and type of work environment

Nursing salaries vary not only between states and cities, but also between specialized knowledge and skills, positions, and the environment. For example, while a staff nurse in an occupational health department might make a medium annual salary of $78,060, a transplant coordinator can bring in an average $81,333.

Nurses in clinics typically earn less than nurses working in hospitals, while nurse administrators, nurse practitioners, and specialists such as anesthetists make significantly more than general RNs. Here’s a look at some typical annual salaries for such positions:

  • Clinical Nurse Specialist: $102,843
  • Head Nurse:$106,162
  • Nurse Practitioner:$105,165
  • Nurse In Charge of Intensive Care Unit:$106,962
  • Certified Nurse Midwife: $106,187
  • Nursing Director:$142,964
  • Certified Nurse Anesthetist:$179,015
  • Chief Nurse Anesthetist: $209,872

Nurses at work

Overall pay -vs- regional cost-of-living

Having said all that, it’s useful to bear in mind that the highest-paying nursing job may not necessarily give you the highest standard of living. By moving from an RN position in Indianapolis, Indiana (earning an average annual salary of $59,633) to Philadelphia, you’d have to be making $80,148 a year to have the same lifestyle you had back at the “crossroads of America”. Unfortunately, a typical RN salary in Philadelphia is about $65,993  a year.

Wondering what your quality of life will be if you’re earning a particular nursing salary in a particular state or city? Check out’s Cost Of Living Calculator.

Nursing – One of America’s largest profession

With more than 3 million RNs alone (more than 4 million nursing and nursing-related staff, including nurse aides and assistants), nursing is one of the most common professions in America, and there is still a shortage in the profession. It’s no wonder then that nursing salaries and hourly wages seem to vary so widely across regions, workplaces, and employment circumstances and that the official statistics are so hard to decipher.

Click here to view our nursing jobs by state.

How do the official salary figures for nursing pay rates compare to your experiences? Let us know what you think in the comments.