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.
How Much Money do Nurses Make a Year?
Nurse Pay Scales: Low Ranges
So, how much does a nurse make a year? This really depends on what state a nurse is working in. While some lower-paying states average in the $28s 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”
Nurse Pay Scales: High Ranges
Nursing 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 $176,686 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.
Average Nurse Salaries Vary By State
Location, location, location
As of May 2018, the BLS reported that RN salaries across various states varied massively but according to these latest stats, the average American RN makes about $34.48 an hour, or about $71,730 a year. The image below shows the average nurse salary by state.
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 $51.42/hour, or about $106,950/year, RNs in the modest city of Watsonville, CA, typically make more than $61.27/hour, or about $127,440 per year.
RN Salary in California
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 |
| Salinas, CA | $131,710 |
| San Francisco-Oakland-Hayward, CA | $128,990 |
| San Jose-Sunnyvale-Santa Clara, CA | $128,610 |
| Santa Cruz-Watsonville, CA | $127,440 |
| Sacramento-Roseville-Arden-Arcade, CA | $120,530 |
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-Paid Nurses By State
Below is a table of the highest paid nurses by state.
| State | Hourly / Annual Pay |
| 1. California | $41.42 / $106,950 |
| 2. Hawaii | $47.16 / $98,080 |
| 3. District of Columbia | $44.40/ $92,350 |
| 4. Massachusetts | $44.30/ $92,140 |
| 5. Oregon | $43.79/ $91,080 |
Contrast that with what you’d be making as an RN in the five lowest-paying states in America:
Lowest Paying States for Nurses
Below is a table of the 5 lowest paying states for nurses (Not including statistics for Guam or Puerto Rico).
| State | Hourly / Annual Pay |
| 50. South Dakota | $28.05/ $58,340 |
| 49. Mississippi | $28.12 / $58,490 |
| 48. Iowa | $28.43/ $59,130 |
| 47. Alabama | $28.59 / $59,470 |
| 46. Arkansas | $29.22 / $60,780 |
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 $69,290) to Philadelphia, you’d have to be making $87,737 a year to have the same lifestyle you had back at the “crossroads of America”. Unfortunately, a typical RN salary in Philadelphia is about $77,680 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 PayScale.com’s Cost Of Living Calculator.
Nurse Pay Rates Are Also Influenced by Training, Specialization, 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
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.
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