Nurse Practitioner Salary by State in 2026: Full BLS Breakdown With Cost-of-Living Context
By NurseComp Editorial · May 21, 2026 · 15 min read
NP salaries range from $92,000 to $163,000 depending on state, specialty, and practice authority. Here is the BLS data for every state, adjusted for what your dollar actually buys.
Nurse practitioners are the second-highest-paid nursing role behind CRNAs. But NP compensation is more variable than most guides acknowledge, because it depends heavily on three factors: which state you work in, what specialty you practice, and whether your state grants full practice authority.
National NP Salary Data (BLS, May 2024)
Bureau of Labor Statistics Occupational Employment and Wage Statistics for Nurse Practitioners (SOC 29-1171):
- Mean annual wage: $126,260
- Median annual wage: $121,610
- Mean hourly wage: $60.70
- 10th percentile: ~$92,000
- 25th percentile: ~$105,000
- 75th percentile: ~$143,000
- 90th percentile: ~$163,000
Source: BLS OEWS, SOC 29-1171, May 2024.
NP Salary by State: Top and Bottom
Highest-paying states for NPs (mean annual wage):
| State | Mean Annual Wage |
|---|---|
| California | ~$158,000 |
| New Jersey | ~$145,000 |
| Washington | ~$143,000 |
| New York | ~$140,000 |
| Massachusetts | ~$138,000 |
| Oregon | ~$137,000 |
| Connecticut | ~$136,000 |
| Nevada | ~$135,000 |
| Hawaii | ~$133,000 |
| Minnesota | ~$131,000 |
Lowest-paying states for NPs (mean annual wage):
| State | Mean Annual Wage |
|---|---|
| Alabama | ~$101,000 |
| Tennessee | ~$104,000 |
| Mississippi | ~$106,000 |
| Arkansas | ~$107,000 |
| Kentucky | ~$108,000 |
Source: BLS OEWS state-level data.
After Cost of Living: The Map Changes
When you adjust NP salaries by Bureau of Economic Analysis Regional Price Parities (RPPs), the rankings shift substantially:
States where NPs have the best purchasing power (salary adjusted for cost of living):
- Nevada — high nominal pay + moderate cost of living (RPP ~102)
- Minnesota — $131,000 with below-average housing costs outside Twin Cities
- Texas — ~$120,000 mean with RPP around 97
- Indiana — ~$115,000 with RPP around 92
- Iowa — ~$113,000 with RPP around 89
States where NPs have lower purchasing power despite high nominal pay:
- California: $158,000 nominal but RPP ~114 (housing much higher in metros)
- New York: $140,000 nominal but RPP ~116 in NYC metro
- Hawaii: $133,000 nominal but RPP ~118 (highest cost state)
The lesson: a $115,000 NP salary in Indianapolis often provides better material quality of life than a $145,000 salary in northern New Jersey.
Source: BEA Regional Price Parities by State.
Full Practice Authority and Its Effect on Pay
As of 2025, approximately 26 states plus Washington, D.C. grant nurse practitioners full practice authority (FPA) — meaning NPs can evaluate, diagnose, interpret diagnostic tests, and initiate treatment including prescribing, without physician oversight or a collaborative agreement.
The remaining states have either reduced practice (requires a career-long collaborative agreement with a physician) or restricted practice (requires supervision).
Does FPA affect salary?
The relationship is complex and debated in the literature. What the data suggests:
- FPA states have slightly higher average NP compensation after controlling for cost of living, but the effect is modest (~3–7% in most analyses)
- The bigger effect is on employment options: FPA allows NPs to own independent practices, do direct billing, and practice in settings (rural clinics, retail health) that restricted states make difficult
- FPA states tend to have more NP employment per capita, which in theory could suppress wages through supply effects — but persistent primary care shortages have prevented this
Source: AANP State Practice Environment map; Xue Y et al., "Impact of State Nurse Practitioner Scope-of-Practice Regulations on Health Care Delivery," Nursing Outlook, 2015; multiple state-level analyses.
NP Salary by Specialty
AANP's National NP Compensation Survey and recruiter data show substantial specialty variation:
| Specialty | Estimated Mean Salary |
|---|---|
| Psychiatric/Mental Health NP | $135,000–$160,000 |
| Acute Care NP (hospital-based) | $125,000–$145,000 |
| Dermatology NP | $120,000–$145,000 |
| Orthopedic NP | $115,000–$135,000 |
| Family Practice NP | $110,000–$130,000 |
| Pediatric NP | $105,000–$125,000 |
| Women's Health NP | $105,000–$120,000 |
Psychiatric NPs (PMHNP) have seen the largest salary growth in recent years, driven by the behavioral health provider shortage and telehealth expansion. Some PMHNPs in private practice report gross revenues exceeding $250,000 (self-employed, pre-overhead).
Source: AANP 2024 National NP Compensation Survey; Medscape Advanced Practice Compensation Report 2024.
NP vs. PA vs. Physician: The Comparison Everyone Asks About
For common primary care roles:
| Role | Mean Annual Wage (BLS) | Training Length | Independent Practice? |
|---|---|---|---|
| Nurse Practitioner | $126,260 | 6–8 years post-HS | 26 states + DC |
| Physician Assistant | $130,020 | 6–7 years post-HS | No (all states require physician relationship) |
| Family Medicine Physician | ~$235,000 | 11–12 years post-HS | Yes (all states) |
NPs and PAs earn similarly for similar work. The NP advantage is independent practice authority in FPA states; the PA advantage is specialty flexibility without retraining (PAs can switch specialties without new certification).
Source: BLS OEWS; AAPA salary survey.
The NP Oversupply Question
HRSA projects NP supply adequacy at 140% in 2026, growing to 175% by 2038. This means the country is projected to produce significantly more NPs than the workforce models predict demand for.
What this means practically:
- The NP job market in saturated metro areas (particularly primary care in the Southeast and Midwest) is becoming competitive
- New NP graduates in some markets report difficulty finding first positions
- Salary growth may moderate compared to the 2018–2023 boom period
- Specialty NPs (psych, acute care) remain in high demand; family practice NPs face the most saturation
This does NOT mean NP is a bad career choice. It means that geographic flexibility, specialty selection, and willingness to work in underserved areas are increasingly important for maximizing NP earning potential.
Source: HRSA Nurse Workforce Projections 2023–2038.
How to Maximize NP Compensation
Evidence-based strategies from compensation data:
- Specialize in shortage areas. Psychiatric, acute care, and emergency NPs face less saturation than primary care NPs.
- Practice in FPA states. More employment options, potential for practice ownership, and modestly higher average pay.
- Consider rural and underserved markets. NHSC loan repayment sites often offer above-market compensation specifically because they cannot recruit in urban markets.
- Negotiate with data. The BLS numbers above are public. Use them.
- Evaluate total compensation. CME stipends, loan repayment, malpractice coverage, retirement match, and schedule flexibility can add $15,000–$40,000 in value beyond base salary.
Sources: All as cited throughout.