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Updated July 14, 2026 with May 2025 BLS wage data and 2026 Q1 cost-of-living index data.
Imagine earning a six-figure salary as a nurse, only to struggle to make ends meet. Or taking a pay cut to move to a new city but suddenly feeling flush with cash. Welcome to the complex world of nursing salaries, where your paycheck's true value isn't just about the numbers on your stub. It's about how far those dollars stretch in your hometown.
Choosing where to practice can impact your financial future in an era of nursing shortages and soaring costs of living. But which cities and states offer the best deal for nurses? Our investigation reveals surprising answers that could change how you think about your next career move.
Although the job requirements are generally the same across the country, registered nurse salaries vary greatly depending on location. For example, California nurses earn $150,280 per year on average, while those in Alabama make $77,020 (BLS, May 2025). However, the cost of living in California is roughly 40% above the national average, meaning the same salary won't stretch nearly as far as it would in a lower-cost state.
We compared nurse salaries adjusted for the cost of living using the Council for Community and Economic Research's Cost of Living Index (COLI) to get an accurate picture of the best places for RNs to live and work. The COLI score represents the cost of living in each place relative to the national average. The higher the COLI score, the lower the purchasing power of a dollar there. Our final ranking was determined by each location's COLI-adjusted salary, representing the purchasing power of its average RN wage relative to the national cost of living.
Key Findings
- Oregon is the best state for nurses. Average RN salaries are 21% above the national average ($123,140 vs. $101,420), while its cost of living is only 9.6% above average — the best trade-off in the country, worth $112,354 in COLI-adjusted salary ($54.02 hourly).
- Oakland and the East Bay are the best metro for nurses. RNs in the San Francisco–Oakland–Fremont metro earn 74% more than the average U.S. nurse ($176,900 per year), while Oakland's cost of living is 39.5% above the national average — the highest COLI-adjusted wage in the country at $126,810 ($60.97 hourly).
- Ten states now clear a six-figure adjusted salary. Oregon, Minnesota, California, Washington, New Mexico, Texas, Nevada, Georgia, Oklahoma and Indiana all deliver COLI-adjusted average wages above $100,000 — up from just one state (Minnesota) in our May 2023 analysis.
- Hawaii is the worst state for nurses. It has the highest cost of living in the country, 84.8% above the national average, while salaries are only 22.6% above average — leaving nurses in the Aloha State with a COLI-adjusted wage of $67,284 ($32.35 hourly).
Why do nurse salaries vary in the U.S.?
There are many reasons, but here are a few key factors:
- Nursing shortage: Due to a shortage of nursing educators, an aging population, increasing nurse retirement rates, and other trends, the United States needs 78,610 more nurses. Overworking the insufficient workforce leads to poor job satisfaction and stress, driving some to other careers and exacerbating the shortage. In states like Washington, Georgia, and California, the supply and demand of qualified nurses has driven up salary rates and will continue as long as the shortage exists.
- Unions: Nurse union participation in the United States rose steadily between 1995 and 2006, with union and nonunion wages mirroring changes. Like other industries, nursing unions demand higher wages, better working conditions, and standardization. Areas with heavier union participation often see higher wages due to stronger bargaining power. Union-led strikes more than tripled between 2020 and 2023 as the nursing shortage grows.
- Cost of living: The prices of housing, goods and services vary significantly across the United States due to factors such as population density, housing stock, and food costs. A city's average cost of goods, services, and housing (excluding taxes) measures its cost of living. Purchasing power, or the value of money in the marketplace, is used to understand it. For example, a dollar in Indianapolis may buy a 20-ounce soda, while a dollar in Los Angeles may only buy a 12-ounce soda. Therefore, Indianapolis has a higher purchasing power compared to Los Angeles.
What are the best states for nurses?
The table below ranks the top 10 states by COLI-adjusted average RN salary, using May 2025 BLS wages and the 2026 Q1 cost of living index.
| Rank | State | Average RN Salary | COLI | COLI-Adjusted Salary |
|---|---|---|---|---|
| 1 | Oregon | $123,140 | 109.6 | $112,354 |
| 2 | Minnesota | $103,420 | 93.4 | $110,728 |
| 3 | California | $150,280 | 140.5 | $106,961 |
| 4 | Washington | $121,540 | 114.6 | $106,056 |
| 5 | New Mexico | $95,290 | 89.9 | $105,996 |
| 6 | Texas | $95,380 | 90.7 | $105,160 |
| 7 | Nevada | $105,710 | 100.7 | $104,975 |
| 8 | Georgia | $95,080 | 90.6 | $104,945 |
| 9 | Oklahoma | $85,060 | 83.5 | $101,868 |
| 10 | Indiana | $89,150 | 88.3 | $100,963 |
1. Oregon
Average Salary: $123,140
Hourly Salary: $59.20
COLI: 109.6
COLI-Adjusted Annual Salary: $112,354
COLI-Adjusted Hourly Salary: $54.02
Oregon takes the top spot in our May 2025 analysis. Its average RN salary is 21% above the national average, while its cost of living is only 9.6% above average — the best salary-to-cost trade-off in the country. The state's high wages are supported by strong union participation and staff-to-patient ratio regulations, which increase demand for nurses amid the ongoing shortage.
2. Minnesota
Average Salary: $103,420
Hourly Salary: $49.72
COLI: 93.4
COLI-Adjusted Annual Salary: $110,728
COLI-Adjusted Hourly Salary: $53.23
Minnesota, our top state in the previous analysis, remains a standout. Average RN salaries are 2% above the national average while the cost of living runs 6.6% below — and it is home to two of the top 10 metros for nurses. The world-renowned Mayo Clinic and a robust health care infrastructure contribute, along with affordable cities and rural counties.
3. California
Average Salary: $150,280
Hourly Salary: $72.25
COLI: 140.5
COLI-Adjusted Annual Salary: $106,961
COLI-Adjusted Hourly Salary: $51.42
California pays nurses more than any other state — $150,280 on average, 48% above the national mean. Even after its cost of living (40.5% above average) eats into that premium, California RNs still land third in purchasing power. Credit the state's mandatory nurse-to-patient ratio law, the strongest nursing unions in the country, and a persistent statewide shortage.
4. Washington
Average Salary: $121,540
Hourly Salary: $58.43
COLI: 114.6
COLI-Adjusted Annual Salary: $106,056
COLI-Adjusted Hourly Salary: $50.99
Washington pays RNs 20% above the national average, enough to outrun a cost of living 14.6% above average. Strong union density in the Seattle area and high demand across the state's rural east keep wages elevated — and metros like Spokane and the Tri-Cities pair those wages with a much lower cost of living.
5. New Mexico
Average Salary: $95,290
Hourly Salary: $45.81
COLI: 89.9
COLI-Adjusted Annual Salary: $105,996
COLI-Adjusted Hourly Salary: $50.96
Nursing salaries in New Mexico are 6% below the national average, but the cost of living is 10.1% lower, ranking it fifth on our list. The state benefits from a favorable housing market and lower utility costs.
What are the best cities for nurses?
We updated each metro's wage with May 2025 BLS data and recalculated its adjusted salary. City-level COLI scores come from the most recent C2ER city index in our analysis (Q1 2024).
1. Oakland, California
Annual Salary: $176,900
Hourly Salary: $85.05
COLI Index: 139.5
COLI-Adjusted Annual Salary: $126,810
COLI-Adjusted Hourly Salary: $60.97
Oakland and the East Bay (part of the San Francisco–Oakland–Fremont metro area) rank highest in nurse salaries when adjusted for the cost of living. Nurses here earn 74% more than the average U.S. nurse — $176,900 per year versus $101,420 — while Oakland's cost of living, though high, is well below neighboring San Francisco's. Competitive Bay Area salaries, robust union support, and California's persistent nursing shortage all contribute.
2. Spokane, Washington
Annual Salary: $113,280
Hourly Salary: $54.46
COLI: 93.3
COLI-Adjusted Annual Salary: $121,415
COLI-Adjusted Hourly Salary: $58.37
Spokane jumps to second in our updated analysis. RN salaries are 12% higher than the national average, while the overall cost of living in Spokane is about 7% below the national average, thanks to its affordable housing market and low utility costs. That combination gives Spokane nurses more purchasing power than nurses in any other city outside the Bay Area.
3. Redding, California
Annual Salary: $133,700
Hourly Salary: $64.28
COLI: 111.9
COLI-Adjusted Annual Salary: $119,482
COLI-Adjusted Hourly Salary: $57.44
Redding, located 200 miles north of the Bay Area, earns third. Registered nurses in Redding earn 32% more than the national average while facing a cost of living only slightly above the national average — and far below California's statewide score. Like Oakland, Redding benefits from California's nursing shortage, while its rural location keeps living costs down.
4. Kennewick-Richland-Pasco, Washington
Annual Salary: $114,560
Hourly: $55.08
COLI: 97.2
COLI-Adjusted Annual Salary: $117,860
COLI-Adjusted Hourly Salary: $56.66
Kennewick, Richland and Pasco, known as the Tri-Cities, rank fourth. They are located in a rural region on the Oregon border and have a cost of living about 3% below the national average. Paired with an average salary 13% higher than the national average, registered nurses in the Tri-Cities take home one of the country's best real wages.
5. St. Paul, Minnesota
Annual Salary: $106,480
Hourly Salary: $51.19
COLI: 92.9
COLI-Adjusted Annual Salary: $114,618
COLI-Adjusted Hourly Salary: $55.10
Both Twin Cities made our top 10 list. They share the same above-average metro salary and a lower-than-average cost of living. St. Paul's lower cost of living gave it the edge over Minneapolis — 92.9 vs. 93.3 on the index — partly due to its lower population and housing costs.
6. Bakersfield, California
Annual Salary: $128,200
Hourly Salary: $61.63
COLI: 112.0
COLI-Adjusted Annual Salary: $114,464
COLI-Adjusted Hourly Salary: $55.03
Bakersfield, like the other California entries, benefits from the statewide nurse shortage. Registered nurses earn 26% more than the national average with a cost of living only 12% above it — a COLI score roughly 28 points below the state as a whole.
7. Minneapolis, Minnesota
Annual Salary: $106,480
Hourly Salary: $51.19
COLI: 93.3
COLI-Adjusted Annual Salary: $114,127
COLI-Adjusted Hourly Salary: $54.87
Minneapolis has a strong health care infrastructure similar to St. Paul. This infrastructure supports higher salaries and reasonable living costs. Its slightly higher cost of living, due to housing and utility costs, means nurses in Minneapolis have marginally less purchasing power than those in St. Paul.
8. Conroe, Texas
Annual Salary: $100,290
Hourly Salary: $48.22
COLI: 88.7
COLI-Adjusted Annual Salary: $113,067
COLI-Adjusted Hourly Salary: $54.36
Conroe, located 40 miles north of Houston in the greater Houston metro, has a cost of living 11.3% lower than the national average. Metro nursing salaries are roughly at the national average, resulting in a high COLI-adjusted wage. Conroe benefits from a connection to Houston's economic opportunities while keeping Texas-sized housing affordability.
9. South Bend, Indiana
Average Salary: $99,320
Hourly Salary: $47.75
COLI: 90.1
COLI-Adjusted Annual Salary: $110,233
COLI-Adjusted Hourly Salary: $53.00
South Bend, Indiana, is located 75 miles east of Chicago and next to the University of Notre Dame. Nurses there earn just under the national average and enjoy a cost of living 9.9% below it. Health care, transportation, and general goods and services all cost less than the state and national average.
10. Dalton, Georgia
Annual Salary: $85,060
Hourly Salary: $40.89
COLI: 85.7
COLI-Adjusted Salary: $99,253
COLI-Adjusted Hourly: $47.72
Dalton, Georgia — about 30 miles southeast of Chattanooga, Tennessee — rounds out the list. Registered nurses in Dalton earn 16% less than the national average, but the cost of living is 14.3% less, softening the gap. Dalton slipped from fourth in our previous analysis as its metro wage fell while other metros' wages climbed.
Methodology
We used mean salary data from the May 2025 Bureau of Labor Statistics (BLS) Occupational Employment and Wage Statistics (OEWS) survey and adjusted it using the 2026 Q1 state cost of living index (COLI) from the Council for Community and Economic Research (C2ER), as published by the Missouri Economic Research and Information Center (MERIC). City rankings use the same May 2025 metro-level wages with C2ER's city-level index (Q1 2024, the most recent city index in our analysis). The national average RN salary is $101,420 (May 2025).
The formula we used:
COLI-Adjusted RN Wage = (RN Wage / Cost-of-Living Index) × 100
Bottom Line
Nursing salaries across the United States are more complex than dollar figures suggest. Our analysis reveals that the most lucrative opportunities for nurses often lie in unexpected places, creating optimal financial conditions with higher-than-average salaries and reasonable living costs.
The Pacific Northwest stands out in this year's data: Oregon tops the state ranking and Washington places two metros in the top 5. Meanwhile, states like Minnesota, New Mexico and Texas show that a lower cost of living can be as valuable as a higher salary.
It's important to remember that these rankings can change due to economic conditions, policy changes, and shifts in the health care landscape — Oregon overtook Minnesota for the top spot in this update, and ten states now clear a six-figure adjusted wage. Nurses considering a move should watch for emerging trends, such as the nursing shortage, unionization efforts, and housing markets, which could reshape these rankings in the coming years.
Financial considerations are important, but not the only factor in career satisfaction. The quality of life, professional development opportunities, work-life balance, and personal preferences are crucial in determining the "best" place to work as a nurse.
This data is a valuable starting point for nurses evaluating their career options. Nurses can make informed decisions about where to build their careers by understanding how salaries measure up against living costs. Whether you're a new graduate or an experienced nurse, remember: in nursing salaries, context is everything. The biggest paycheck doesn't always lead to the most fulfilling life.
Related: one of the most reliable ways to move up these salary bands is a BSN. Our guide to online RN to BSN programs compares 10 options RNs can complete while working.