APRN Salary Comparison: NP vs CRNA vs CNM vs CNS \u2014 Complete Compensation Data by Role and Specialty (2026)
By NurseCompensation Research Team · 2026-07-25 · 14 min read
The four APRN roles have wildly different pay: CRNAs earn a median $212,650, NPs $126,260, CNMs $129,650, and CNSs $110,900. Here is the complete comparison with specialty breakdowns and required education.
The Four APRN Roles: Same Foundation, Very Different Pay
Advanced Practice Registered Nurses (APRNs) are RNs with graduate-level education in one of four recognized roles. Despite similar educational requirements, compensation varies by nearly $100,000 between roles.
Core Data (BLS OES May 2023)
| APRN Role | BLS Occupation Code | Median Annual | Mean Annual | 90th %ile | Employed |
|---|---|---|---|---|---|
| Nurse Anesthetists (CRNA) | 29-1151 | $212,650 | $214,200 | $258,760 | 47,940 |
| Nurse Midwives (CNM) | 29-1161 | $129,650 | $131,570 | $174,900 | 7,830 |
| Nurse Practitioners (NP) | 29-1171 | $126,260 | $128,490 | $172,570 | 280,140 |
| Clinical Nurse Specialists (CNS) | Included in 29-1141 | $110,900 (est) | $114,200 (est) | $148,600 (est) | 72,000 (est) |
Nurse Practitioner (NP): The Largest APRN Group
NPs represent 78% of all APRNs. Compensation varies enormously by population focus (specialty area):
NP Compensation by Specialty (AANP 2023 Compensation Survey, n=15,822)
| Specialty | Median Base Salary | Median Total Comp (with production/bonus) |
|---|---|---|
| Psychiatric Mental Health (PMHNP) | $148,000 | $168,000 |
| Acute Care (ACNP-Adult-Gerontology) | $132,000 | $148,000 |
| Neonatal (NNP) | $136,000 | $152,000 |
| Cardiology | $128,000 | $146,000 |
| Oncology | $126,000 | $142,000 |
| Emergency (ENP) | $132,000 | $150,000 |
| Family (FNP) | $118,000 | $130,000 |
| Adult-Gerontology Primary Care | $118,000 | $128,000 |
| Pediatric Primary Care (PNP-PC) | $114,000 | $124,000 |
| Women's Health (WHNP) | $112,000 | $122,000 |
NP Compensation by Setting
| Setting | Median NP Salary |
|---|---|
| Hospital-owned specialty clinic | $138,000 |
| Hospital inpatient service | $132,000 |
| Emergency department | $148,000 |
| Retail clinic (CVS MinuteClinic, Walgreens) | $124,000 |
| Private physician practice | $118,000 |
| Federally Qualified Health Center | $112,000 |
| VA/military | $128,000 |
| Telemedicine | $126,000 |
| Home health/hospice | $108,000 |
| Long-term care | $104,000 |
NP Compensation by State (Top 10)
| State | Median NP Salary |
|---|---|
| California | $158,130 |
| New Jersey | $143,250 |
| Massachusetts | $138,700 |
| Oregon | $136,250 |
| Washington | $135,170 |
| Alaska | $134,590 |
| Minnesota | $132,410 |
| New York | $133,940 |
| Rhode Island | $129,700 |
| Hawaii | $128,310 |
Certified Registered Nurse Anesthetist (CRNA): The Highest-Paid APRN
CRNAs administer anesthesia and manage patients through surgical procedures. The compensation premium reflects the highest-risk clinical decision-making in nursing.
CRNA Compensation by Setting (AANA 2024 Member Survey)
| Setting | Median Base Salary | Total Comp with Call Pay |
|---|---|---|
| Rural/critical access hospital | $228,000 | $278,000 |
| Community hospital | $218,000 | $258,000 |
| Academic medical center | $206,000 | $248,000 |
| Ambulatory surgery center | $212,000 | $232,000 |
| Independent practice (own group) | $256,000 | $312,000 |
| Locum tenens (per diem CRNA) | $312,000 | $312,000 (no benefits) |
| VA/military | $198,000 | $224,000 |
CRNA Compensation by State (Highest-Paying)
| State | Median CRNA Salary |
|---|---|
| Illinois | $268,780 |
| Connecticut | $258,120 |
| Wisconsin | $254,910 |
| New Jersey | $252,690 |
| California | $250,660 |
| Massachusetts | $248,110 |
| Delaware | $246,540 |
| Rhode Island | $244,220 |
| New York | $243,860 |
| Minnesota | $241,320 |
CRNA vs Anesthesiologist Compensation
| Provider | Median Salary | Training Length | Debt at Graduation |
|---|---|---|---|
| CRNA (DNP) | $212,650 | 7-8 years total | $122,000 |
| Anesthesiologist Assistant | $172,000 | 6-7 years total | $148,000 |
| Anesthesiologist (MD) | $339,470 | 12+ years total | $282,000 |
CRNAs achieve 63% of anesthesiologist compensation with 4-5 fewer years of training and $160,000 less debt.
Certified Nurse Midwife (CNM): The Smallest APRN Group
CNMs provide primary care to women across the lifespan, with a focus on gynecologic and obstetric care. Practice models range from birth centers to hospital-based labor and delivery.
CNM Compensation by Setting (ACNM Member Survey 2024)
| Setting | Median Salary |
|---|---|
| Hospital-employed | $132,000 |
| Physician practice | $124,000 |
| Freestanding birth center | $108,000 |
| Home birth practice (self-employed) | $85,000-$140,000 (highly variable) |
| FQHC/community health | $118,000 |
| Academic teaching | $126,000 |
| Military/VA | $128,000 |
CNM Compensation by State
| State | Median CNM Salary |
|---|---|
| California | $176,860 |
| New York | $148,300 |
| Massachusetts | $146,220 |
| Minnesota | $142,110 |
| New Jersey | $138,470 |
| Oregon | $135,880 |
CNMs vs OB-GYNs
| Provider | Median Salary | Training | Scope of Practice |
|---|---|---|---|
| CNM (MSN/DNP) | $129,650 | 6-8 years total | Prenatal, birth, gyn care |
| OB-GYN (MD) | $296,210 | 12+ years total | Full scope including surgery |
Clinical Nurse Specialist (CNS): The Under-Recognized APRN
CNSs specialize in a defined patient population (adult-gero, pediatric, psych, women's) and function in clinical expert, educator, consultant, and researcher roles.
CNS Compensation by Focus Area (NACNS 2023 Survey)
| Population Focus | Median Salary |
|---|---|
| Adult-Gerontology Acute Care | $118,000 |
| Adult-Gerontology Primary Care | $108,000 |
| Pediatric | $112,000 |
| Neonatal | $124,000 |
| Psychiatric-Mental Health | $124,000 |
| Women's Health | $110,000 |
Why CNSs Earn Less Than NPs
Despite similar education (MSN required for both), CNSs earn approximately $16,000 less than NPs. Reasons:
- Role positioning: CNSs typically don't bill Medicare independently at NP/PA rates
- Recognition: Only 28 states + DC recognize CNS as an APRN role (vs 50 for NP)
- Prescriptive authority: More limited than NPs in many states
- Employment settings: More often hospital-employed in salaried consultative roles
The Education Investment vs Return Comparison
| APRN Role | Program Length | Total Debt (Median) | First-Year Salary | Payback Period* |
|---|---|---|---|---|
| NP (MSN) | 2-3 years | $56,400 | $118,000 | 4.2 years |
| NP (DNP) | 3-4 years | $88,000 | $124,000 | 6.1 years |
| CRNA (DNP required as of 2022) | 3 years | $122,000 | $212,000 | 4.8 years |
| CNM | 2-3 years | $68,000 | $128,000 | 4.6 years |
| CNS | 2-3 years | $52,000 | $110,000 | 4.2 years |
*Payback period = years to recoup lost RN wages during school + tuition, at the APRN salary premium
Prescriptive Authority: State-by-State Practice Environment
APRN pay correlates with practice authority. States with full practice authority (independent NP practice) see 8-15% higher NP salaries:
| State Type | Number of States | Avg NP Salary Premium |
|---|---|---|
| Full Practice Authority (FPA) | 27 states + DC | +8-15% |
| Reduced Practice | 12 states | Baseline |
| Restricted Practice | 11 states | -5-10% |
Full Practice Authority States (2024)
Alaska, Arizona, Colorado, Connecticut, Delaware, Hawaii, Idaho, Iowa, Kansas, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington, Wyoming, DC.
Total Compensation: Base + Production + Benefits
APRN compensation includes multiple components beyond base salary:
Typical NP Total Package
| Component | Value |
|---|---|
| Base salary | $126,260 |
| Production/RVU bonus (if eligible) | $8,000-$24,000 |
| Sign-on bonus (average, first year only) | $4,000-$12,000 |
| Loan repayment (some employers) | $0-$10,000/year |
| Health insurance (employer share) | $16,800 |
| Retirement match | $5,000-$8,000 |
| CME allowance | $2,500-$5,000 |
| Malpractice insurance (employer-paid) | $2,000-$8,000 |
| PTO (4-6 weeks typical) | $12,000-$18,000 |
| Total effective compensation | $180,000-$220,000 |
Typical CRNA Total Package
| Component | Value |
|---|---|
| Base salary | $212,650 |
| Call pay | $18,000-$48,000 |
| Overtime (some positions) | $12,000-$36,000 |
| Health insurance (employer share) | $16,800 |
| Retirement match | $12,000-$20,000 |
| CME allowance | $4,000-$8,000 |
| Malpractice insurance | $6,000-$18,000 |
| PTO (6-8 weeks typical) | $28,000-$36,000 |
| Total effective compensation | $310,000-$395,000 |
The APRN Job Market Outlook
BLS employment projections (2022-2032):
| APRN Role | Current Employment | Projected Growth | Annual Openings |
|---|---|---|---|
| NP | 280,140 | +45% | 29,200 |
| CRNA | 47,940 | +38% | 4,800 |
| CNM | 7,830 | +40% | 900 |
| CNS | ~72,000 | +38% | 6,800 |
All four APRN roles are BLS-designated "Bright Outlook" occupations — the fastest-growing category in the labor market. Combined, APRNs will add over 175,000 new positions by 2032.
Sources: BLS Occupational Employment and Wage Statistics (May 2023); AANP 2023 National NP Compensation Survey (n=15,822); AANA 2024 Practice Survey; ACNM Member Salary Report (2024); NACNS 2023 Compensation Survey; AAPA Salary Report (2024); BLS Employment Projections 2022-2032; AANP State Practice Environment Map (2024).