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Healthcare Salaries

Registered Nurse Salary by Metro 2026: 40 Metros Ranked (BLS)

11 min read

Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 — Registered Nurses, SOC 29-1141. Tables computed by Salario from the published metro estimates; take-home estimates use 2026 tax rules.

No large occupation has a wider geographic pay gap than registered nursing. The BLS median for an RN is $216,740 in San Jose, CA and $66,360 in Florence, AL — a 3.3x spread for the same license. This guide ranks the 328metropolitan areas with a published RN median, isolates the 25 largest job markets so small-metro outliers don't distort the picture, and estimates what the medians are worth after 2026 taxes.

Quick answer

  • National RN median: $97,550 ($46.90/hour); mean $101,420; 3,379,720 RNs employed (BLS OEWS May 2025).
  • Highest-paying metro: San Jose, CA$216,740, 122% above the national median. The entire top 10 is in California or Hawaii.
  • 23 of the top 40 metros are in California; the first metro outside the West Coast, Hawaii or Nevada is New York, NY-NJ at #32 ($119,720).
  • Lowest published RN median: Florence, AL at $66,360 — about 32% below the national median but still 30% above the U.S. all-occupations median of $50,980.

The 40 highest-paying metros for registered nurses

Ranked by the BLS median annual wage for Registered Nurses in each metropolitan statistical area. “Premium” compares the RN median with the same metro's all-occupations median. Click a metro for its full salary and cost-of-living page.

#Metro areaMedian (annual)HourlyPremium vs. all jobsEst. take-home 2026
1San Jose-Sunnyvale-Santa Clara, CA$216,740$104.20+158%$145,191
2Vallejo, CA$203,290$97.74+247%$136,536
3San Francisco-Oakland-Fremont, CA$186,610$89.72+151%$125,682
4Santa Rosa-Petaluma, CA$174,550$83.92+207%$118,430
5Sacramento-Roseville-Folsom, CA$171,460$82.43+187%$116,605
6Santa Cruz-Watsonville, CA$170,960$82.19+212%$116,310
7Yuba City, CA$149,320$71.79+199%$103,531
8Kahului-Wailuku, HI$144,350$69.40+150%$100,641
9San Diego-Chula Vista-Carlsbad, CA$139,520$67.08+138%$97,745
10Urban Honolulu, HI$139,260$66.95+143%$97,564
11San Luis Obispo-Paso Robles, CA$138,820$66.74+173%$97,331
12Santa Maria-Santa Barbara, CA$137,360$66.04+166%$96,469
13Los Angeles-Long Beach-Anaheim, CA$135,560$65.17+143%$95,406
14Bend, OR$135,010$64.91+147%$92,224
15Salinas, CA$134,910$64.86+185%$95,022
16Stockton-Lodi, CA$134,580$64.70+175%$94,828
17Redding, CA$134,350$64.59+175%$94,692
18Riverside-San Bernardino-Ontario, CA$133,940$64.39+177%$94,450
19Modesto, CA$132,590$63.75+162%$93,652
20Salem, OR$131,750$63.34+138%$90,318
21Merced, CA$131,620$63.28+179%$93,080
22Oxnard-Thousand Oaks-Ventura, CA$131,160$63.06+150%$92,808
23Portland-Vancouver-Hillsboro, OR-WA$130,310$62.65+115%$89,477
24Bakersfield-Delano, CA$128,810$61.93+171%$91,420
25Seattle-Tacoma-Bellevue, WA$128,260$61.66+77%$98,932
26Hanford-Corcoran, CA$128,160$61.62+164%$91,037
27Chico, CA$127,360$61.23+165%$90,564
28Medford, OR$127,030$61.07+155%$87,550
29Fresno, CA$125,420$60.30+167%$89,419
30Visalia, CA$125,180$60.18+177%$89,277
31Olympia-Lacey-Tumwater, WA$125,020$60.11+102%$96,717
32New York-Newark-Jersey City, NY-NJ$119,720$57.56+95%$87,030
33Walla Walla, WA$116,970$56.24+120%$91,118
34Eugene-Springfield, OR$113,720$54.67+129%$79,455
35Wenatchee-East Wenatchee, WA$112,280$53.98+128%$87,819
36Albany, OR$111,920$53.81+125%$78,346
37Spokane-Spokane Valley, WA$111,750$53.73+104%$87,446
38Reno, NV$107,520$51.69+117%$84,470
39Bremerton-Silverdale-Port Orchard, WA$107,220$51.55+70%$84,259
40Mount Vernon-Anacortes, WA$106,730$51.31+79%$83,915

Source: BLS OEWS May 2025 (bls.gov/oes), SOC 29-1141, metropolitan statistical areas. Premium = RN median ÷ metro all-occupations median − 1. Computed by Salario.

Estimated take-home is for a single filer taking the 2026 standard deduction ($16,100): federal income tax, Social Security (6.2% up to $184,500) and Medicare (1.45%), plus estimated state income tax using the first state listed for multi-state metros. Local taxes, pre-tax benefits and credits are not modeled — use the paycheck calculator for your own situation.

What the ranking shows

This is a California ranking with a few neighbors. 23 of the 40 metros are in California, and every one of the other 17 is in Oregon, Washington, Hawaii, Nevada or New York. Inland agricultural metros — Visalia, Merced, Hanford-Corcoran, Bakersfield — have all-occupation medians below $49,000 yet RN medians above $125,000, which is why the premium column reaches +247% (Vallejo, CA). California's mandated nurse staffing ratios and high hospital union coverage are the factors most often cited; BLS publishes the wages, not the causes.

Seattle and New York pay well but carry a smaller premium. Seattle, WA (#25, $128,260) and New York, NY-NJ (#32, $119,720) are high-wage metros for every occupation, so the RN premium over local wages is only +77% and +95% respectively — versus +158% in San Jose.

After tax, no-income-tax states close part of the gap. Seattle's estimated take-home of $98,932 is only $11,902 above New York's despite a $8,540 higher gross median. Use the paycheck calculator with your own filing status and deductions.

RN pay in the 25 largest job markets

The national ranking is dominated by small and mid-sized Western metros. This table limits the comparison to the 25 largest metropolitan areas by total employment, which is where most nursing jobs are.

#Metro areaRN medianAll-jobs medianMetro employment
1San Francisco-Oakland-Fremont, CA$186,610$74,2602,373,920
2San Diego-Chula Vista-Carlsbad, CA$139,520$58,6901,538,060
3Los Angeles-Long Beach-Anaheim, CA$135,560$55,8506,271,560
4Riverside-San Bernardino-Ontario, CA$133,940$48,4001,716,760
5Portland-Vancouver-Hillsboro, OR-WA$130,310$60,6901,208,410
6Seattle-Tacoma-Bellevue, WA$128,260$72,6102,086,210
7New York-Newark-Jersey City, NY-NJ$119,720$61,4309,492,000
8Boston-Cambridge-Newton, MA-NH$106,180$66,6202,703,890
9Minneapolis-St. Paul-Bloomington, MN-WI$103,040$59,3201,951,650
10Washington-Arlington-Alexandria, DC-VA-MD-WV$102,710$71,0603,136,190
11Dallas-Fort Worth-Arlington, TX$101,420$51,4404,049,800
12Philadelphia-Camden-Wilmington, PA-NJ-DE-MD$101,180$54,3102,897,830
13Denver-Aurora-Centennial, CO$101,130$62,3201,609,350
14Phoenix-Mesa-Chandler, AZ$100,830$51,3802,375,760
15Chicago-Naperville-Elgin, IL-IN$100,490$54,7204,513,280
16Atlanta-Sandy Springs-Roswell, GA$100,490$51,1702,889,670
17Houston-Pasadena-The Woodlands, TX$99,830$49,4103,289,720
18Baltimore-Columbia-Towson, MD$99,550$59,0701,356,680
19Austin-Round Rock-San Marcos, TX$97,890$56,9501,293,690
20Detroit-Warren-Dearborn, MI$97,280$52,0801,904,530
21Miami-Fort Lauderdale-West Palm Beach, FL$91,380$48,6402,819,940
22Charlotte-Concord-Gastonia, NC-SC$90,620$49,9901,358,370
23Tampa-St. Petersburg-Clearwater, FL$85,470$48,9401,447,120
24Orlando-Kissimmee-Sanford, FL$83,550$46,6301,411,730
25St. Louis, MO-IL$83,180$49,9901,341,320

Source: BLS OEWS May 2025. Metro employment is total employment across all occupations. Computed by Salario.

Outside the West Coast the big-metro RN medians cluster tightly: Boston, MA-NH ($106,180), Dallas, TX ($101,420) and Houston, TX ($99,830) are all within about $9,000 of the $97,550 national median, and St. Louis, MO-IL ($83,180) is the lowest of the 25. For nurses in Texas and Florida, the lack of state income tax offsets some of the wage gap with the Northeast.

The 10 lowest-paying metros

Metro areaRN medianvs. national median
Florence-Muscle Shoals, AL$66,360-32%
Dothan, AL$67,430-31%
Decatur, AL$68,320-30%
Cleveland, TN$72,800-25%
Eagle Pass, TX$73,660-24%
Valdosta, GA$74,360-24%
Joplin, MO-KS$74,930-23%
Tuscaloosa, AL$75,250-23%
Panama City-Panama City Beach, FL$75,310-23%
Sioux Falls, SD-MN$75,350-23%

Source: BLS OEWS May 2025, lowest published metro medians for SOC 29-1141. Computed by Salario.

Four of the ten are in Alabama. Before comparing, remember that a $70,000 salary in a low-cost Southern metro can rent or buy far more housing than $120,000 in coastal California — check the cost of living calculator and the nurse salary guide for specialties, travel nursing and overtime, none of which appear in the BLS median.

How to read these numbers

  • Median straight-time wages. OEWS excludes overtime, shift differentials and non-production bonuses — all common in nursing — so actual RN earnings in a metro often exceed the median wage shown.
  • All settings. SOC 29-1141 covers hospital, outpatient, home-health, school, government and insurer nurses. Hospital-only pay in a metro can differ from the all-industry median.
  • Small metros move. A median for a metro with a few thousand RNs can shift several percent between releases; the large-metro table is the more stable comparison.
  • Reference period May 2025. These are the newest OEWS estimates, published by BLS in 2026.

Frequently asked questions

Which metro area pays registered nurses the most?

San Jose-Sunnyvale-Santa Clara, CA has the highest median wage for registered nurses in the country: $216,740 per year ($104.20 per hour) in the BLS OEWS May 2025 estimates — 122% above the national RN median of $97,550. Vallejo, CA ($203,290), San Francisco-Oakland-Fremont ($186,610), Santa Rosa-Petaluma ($174,550) and Sacramento-Roseville-Folsom ($171,460) complete the top five; all five are in Northern California.

What is the national median salary for a registered nurse?

The BLS OEWS May 2025 national median for Registered Nurses (SOC 29-1141) is $97,550 per year, or $46.90 per hour. The mean is $101,420. BLS counts 3,379,720 registered nurses employed nationally, making RNs one of the largest occupations in the country, and publishes metro medians for 328 metropolitan areas.

Why do California metros pay nurses so much more?

BLS publishes the wages, not the reasons, but the pattern is unmistakable: 23 of the 40 highest RN medians are California metros, and 39 of 40 are in California, Oregon, Washington, Hawaii or Nevada. Factors commonly cited include California's mandated nurse-to-patient staffing ratios, high union coverage in hospital nursing, and the region's high cost of living. Even inland California metros with modest all-occupation medians — Visalia, Merced, Hanford — post RN medians above $125,000.

How much of a big-city nurse salary is left after taxes?

Using Salario's 2026 single-filer estimate (federal income tax, FICA and state income tax), the San Jose RN median of $216,740 nets roughly $145,191, the San Francisco median of $186,610 about $125,682, and the New York median of $119,720 about $87,030. Seattle's $128,260 nets about $98,932 because Washington has no state income tax. Shift differentials and overtime — common in nursing — are not included in BLS median wages, so actual pay is often higher.

Turn a metro median into your own numbers

Convert any figure above to hourly pay, take-home pay or a cost-of-living-adjusted equivalent in another city.

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