Nurse Salary in the USA in 2026: Pay by State, Specialty and Setting

The nurse salary in the USA in 2026 for a registered nurse typically centres on a national median of around USD 93,000 to USD 95,000 a year, but the useful range is much wider, roughly USD 70,000 to over USD 130,000 depending on state, city, setting and specialty. California nurses earn far more than nurses in lower-cost states, and critical care, emergency and operating theatre nurses generally earn more than general medical-surgical nurses.

This guide explains state-by-state variation, how hospitals, specialties and experience change pay, what differentials and overtime add, and what licensing, tax and living costs mean for the headline figure. US nursing pay is set by employers and labour markets, not by a national scale, so every figure here is a typical range that varies by employer and contract.

There is no national nurse pay scale in the United States. Each hospital, health system and state sets pay according to local labour supply, union contracts where they exist, and the cost of living. The Bureau of Labor Statistics publishes a national median for registered nurses each year, and state medians sit far above or below it. California's median is typically the highest in the country, often above USD 130,000, while medians in states such as Arkansas, Mississippi, Kansas and South Dakota are typically in the low 70,000s to low 80,000s.

City pay follows the same pattern. Nurses in San Francisco, San Jose, New York City and Boston earn more than nurses in smaller cities in the same state, but housing costs in those cities are also far higher. A USD 110,000 salary in a high-rent coastal city can leave less spare income than a USD 85,000 salary in a lower-cost city. When comparing offers, look at rent, state income tax and commuting costs alongside the salary, and ask whether the employer offers housing help or a relocation payment.

Newly qualified registered nurses typically earn below the national median, often in a broad range of about USD 65,000 to USD 90,000 depending on state and setting. Pay rises steadily with experience, and nurses with five to ten years of experience in the same specialty typically earn near or above the median for their state. Charge nurses, preceptors and nurses with specialty certification generally earn more than staff nurses at the same seniority.

Specialty is a strong pay driver. Intensive care, emergency, labour and delivery, operating theatre and neonatal intensive care nurses typically earn above general ward nurses, because their skills are scarcer and their patient loads are more acute. Advanced practice roles sit well above staff nurse pay: nurse practitioners typically earn around USD 120,000 to USD 150,000 or more, and nurse anaesthetists earn substantially more again, but both require graduate education and additional licensing. Licensed practical nurses earn less than registered nurses, typically in a broad range of about USD 55,000 to USD 70,000, reflecting the shorter training and narrower scope.

Hospital pay is usually structured as an hourly rate plus differentials. A registered nurse earning USD 45 an hour on a 36-hour week earns about USD 84,000 in base pay, while USD 60 an hour on the same hours is about USD 112,000. Many nurses work 12-hour shifts on a three-day week, and overtime beyond the scheduled shift is generally paid at time-and-a-half. Night, evening, weekend and holiday differentials add a few dollars an hour each, and a nurse working mostly nights can add several thousand dollars a year from differentials alone.

Other additions include the following, each varying by employer: sign-on bonuses, often paid in instalments over one or two years • retention bonuses for staying in a hard-to-fill unit • certification pay for specialty credentials • overtime and extra-shift bonuses during staffing shortages • shift differentials for nights, weekends and holidays • employer retirement contributions, typically a percentage match. Travel nursing contracts quote weekly pay that often looks much higher, but the figure bundles housing and meal allowances, the contract is temporary, and benefits and paid leave are weaker, so compare total compensation over a year, not one week's gross.

Benefits form a large part of US compensation. Most hospital employers offer health insurance, dental and vision cover, paid time off, sick leave and a retirement plan, usually a 403(b) or 401(k) with an employer match. The quality of health cover matters: a plan with low premiums but a high deductible can cost a nurse thousands more in a year with a hospital visit. Ask for the benefits summary, the deductible, the employer's retirement match and the paid time off allowance before accepting.

Deductions reduce gross pay to take-home pay, including federal income tax, state income tax where it applies, Social Security and Medicare contributions, health insurance premiums and retirement contributions. States such as Texas, Florida and Washington levy no state income tax, while California and New York levy some of the highest rates. A higher gross salary in a high-tax, high-rent state is not automatically better than a lower salary in a low-tax, low-rent state, so run the numbers on net pay and housing before deciding.

International nurses must pass the NCLEX-RN, obtain a licence from a state board of nursing, meet English language requirements where they apply, and complete the VisaScreen credential assessment for immigration purposes. The process takes many months and involves fees at each stage, including examination, licensing and credential assessment fees set by the relevant bodies. Start early, keep certified copies of every document, and be wary of any recruiter who promises a shortcut or asks for large upfront payments.

US immigration for nurses runs mainly through employer-sponsored routes, and visa availability varies by country of birth and by year, so timelines are unpredictable. Some employers and recruiters cover part of the licensing and immigration costs, but terms differ widely, and any repayment or contract obligation should be read carefully. A reputable employer will put the offer, the salary, the location, the shift pattern and any cost support in writing before you resign your current job.

If the USA is your target, compare live nursing vacancies on SteadStaff by state, hospital and specialty, and check the hourly rate, the shift pattern, differentials and the benefits summary rather than the headline salary alone. Ask whether the employer supports NCLEX preparation, VisaScreen and relocation, and get every promise in writing.

Browse current vacancies and submit your application through SteadStaff, with a CV that shows exact employment dates, hours, clinical duties and any specialty certification. A complete, verifiable CV speeds up shortlisting and the licensing steps that follow.