Career Resources

Top 5 Highest Paying Staff RN Locations

Nurses make up the largest group of healthcare professionals nationwide, but there’s still not enough of them to go around. This is good news for staff nurses looking for a change of scenery because they’ll have numerous job location options. While some states pay higher salaries than others, it’s important to consider whether it’s a livable wage. A higher wage won’t matter if it isn’t consistent with the region’s cost of living. Personal preferences are also factors in determining whether a position is in a desirable location. Consider these top 10 states with the highest paying permanent RN positions available on Vivian Health during the first week of August 2021.

1. California 

Staff nurses in California earned an average annual wage of $120,560, or $57.96 per hour, in May 2020 per the Bureau of Labor Statistics (BLS). However, permanent positions posted on Vivian Health in August 2021 were paying as much as $100 per hour. Some nursing specialties pay more than others, but even entry-level positions typically pay more in California.

Top paying specialties:

  • $75 to $100 for nurse managers
  • $73 to $81 for clinical, med surg, ED, and ICU nurses
  • $67 to $81 for NICU nurses

Top paying cities:

  • Greenbrae
  • Palo Alto
  • Riverside
  • San Diego
  • San Jose

Unfortunately, the state’s cost of living can put a big dent in even the heftiest paychecks. California’s cost of living is about 50% higher than the national average and the largest expense is housing. Average housing costs in the state are more than double the national average.

Despite inflated costs, the Golden State is one of the most beautiful places in the country to call home. Living in California offers numerous perks, especially the sunny weather and mild winters found in much of the state. It offers a vibrant food culture and thriving entertainment scene, nine National Parks, acres of vineyards, and 3,400 miles of scenic coastline. It’s also home to the “Happiest Place on Earth” where Micky Mouse lives, a spectacular bonus for nurses with children.With the tons of other theme parks, zoos, beaches, and other activities popular with kids from tots to teens, California is the ultimate family-fun zone combined with a cool chic places for single people of all ages.

2. Massachusetts 

BLS listed an average annual salary of $96,250 for Massachusetts nursing salaries in May 2020, equaling an average hourly rate of $46.27. Permanent nursing jobs in Massachusetts posted on Vivian Health were paying up to $87 in August 2021. Boston, affectionately known as Beantown, generally has the most nursing openings and some of the highest salaries.

Top paying specialties:

  • $76 to $87 for nurse managers
  • $60 to $66 for ICU and ED nurses
  • $52 to $60 for med surg/telemetry nurses
  • $35 to $70 for OR nurses
  • $48 to $56 for psychiatric/behavioral health and float nurses

Top paying cities:

  • Boston
  • Brockton
  • Concord
  • Harvard
  • Worcester

The cost of living in Massachusetts is less than in California, but it’s still about 27% higher than the national average. Housing can also be pricey with costs about 75% higher than the national average.

Residents of the Bay State enjoy exceptional summers, colorful autumns, and world-famous seafood. Massachusetts has an eclectic mix of geological features, including a dazzling coastline. Cape Cod features glorious beaches, bluffs, dunes, lighthouses, and sunsets while the Berkshires is the state’s mountainous area and where ski resorts and mountain sports reign supreme. Massachusetts is also home to several of the world’s top universities and colleges, quintessential small towns and coastal villages, and remarkable cultural and historic sites, such as Plymouth Rock, the Mayflower’s landing spot.

3. Oregon

Wages for RNs in Oregon in May 2020 averaged $96,230 per year for staff nurse positions. This annual rate breaks down to $46.27 an hour, but top specialties posted on Vivian Health in August 2021 were paying up to $60 per hour for permanent positions.

Top paying specialties:

  • $37 to $60 for float, orthopedics, oncology, labor and delivery, ICU, rehabilitation, and ED nurses

Top paying cities:

  • Burns
  • Lake Oswego
  • Medford

The cost of living in the Beaver State is lower than many of the highest paying states, but it’s still about 13% higher than the national average. Housing is nearly 50% higher, but utilities are cheaper and there aren’t any state sales taxes.

Oregon’s incredible weather and amazing scenery add to the quality of life that many nurses seek. Although it’s known for having lots of rain, Oregon has a diverse, relatively mild climate overall with lower humidity than many other states on the east coast and in the midwest. Pleasant weather encourages getting outdoors to enjoy the state’s unusually diverse geography from its picturesque Pacific Ocean coastline on one side and desert and mountains on the other. Oregon also boasts the deepest lake in the nation inside Crater Lake National Park and the docile, but not dormant, volcano called Mount Hood. The state’s stunning tree lines are another example of its beautiful landscape and they also provide some amazing treetop adventures the whole family will love. 

4. Alaska

Alaska’s average salary for staff nurses in May 2020 was $95,270 per year, which works out to an hourly rate of $45.81. On Vivian Health, permanent positions within various nursing specialties were paying as much as $66 per hour in August 2021.

Top paying specialties:

  • $30 to $66 for cardiac cath lab, orthopedics, progressive care unit, acute care, ICU, float, and neurology nurses

Top paying cities:

  • Anchorage
  • Kodiak
  • Seward
  • Valdez

Alaska’s overall cost of living is about 26% higher than the national average, partially because groceries and other necessary goods must be shipped from a great distance. Housing is about 34% higher, but options tend to be plentiful. However, there are perks to offset these higher costs, such as no state sales tax or state income tax and Alaska actually pays full-time residents an annual royalty to live there.

Barring financial considerations, Alaska is often overlooked as a stunningly beautiful place to live, but it’s called the Last Frontier for a reason. It takes an adventurous, relatively hardy disposition to live in the state known for its cold weather, harsh tundra, and months of eternal darkness or daylight in some regions. However, it’s never boring, offering endless recreational activities, nearly 34,000 miles of coastline, abundant wildlife, and awe-inspiring northern lights. Alaska also provides an excellent opportunity to try something new, such as dog mushing, gold panning, ice fishing, or viewing the splendid snow-covered peak of Denali, the tallest mountain in North America.

5. Texas

Staff nurses in Texas earned an average annual salary of $76,800 in May 2020, translating to an hourly wage of $36.92. The highest-paying nursing positions posted on Vivian Health in early August 2021 were directors of nursing with an hourly wage of up to $68, but several specialties earn bigger paychecks in Texas.

Top paying specialties:

  • $45 to $68 for directors of nursing
  • $36 to $53 for PICU nurses
  • $31 to $53 for neuro ICU and med surg/telemetry nurses
  • $39 to $45 for nurse managers and home health, palliative care, and clinical nurses

Top paying cities:

  • Austin
  • DeSoto
  • Fort Worth
  • Houston
  • San Antonio

Staff nurses tired of paying ridiculously expensive housing costs may want to head to the Lone Star State to find affordable homes (even in major cities). Housing costs are about 15% less than the national average and the overall cost of living is about 6% lower. Texas also doesn’t charge any personal income tax, making it even easier for nurses to hold onto their hard-earned money.

Besides affordability, Texas appeals to nurses who love backyard BBQ and plenty of unique attractions to stay entertained. From 3,300 miles of coastline along the Gulf of Mexico to popular cultural attractions like the San Antonio River Walk, Big Bend National Park, Johnson Space Center, and The Alamo, there’s lots to see and do. It’s also a great place to raise a family with numerous kid-friendly events, outdoor areas, animal adventures, waterparks, and museums to keep everyone happy.

Browse jobs in these and other amazing locations across the country on Vivian Health.

Moira K. McGhee

Moira K. McGhee is Vivian’s Content Writer & Editor. As part of the Vivian Health team, she strives to help support the empowerment of nurses and other medical professionals in their pursuits to find top-notch travel, staff, per diem and local contract positions.

Comments (6)

I am looking at Alaska. I didn’t realize even finding housing was going to be an issue as well as getting there. That is difficult and seem expensive. Even though I will be traveling to states that don’t have state taxes my home state is going to take their portion.


Interested in working in Nor-cal


Thanks for reaching out, Maribel. Please browse our current job posts at to view and apply for positions in the northern California area. We currently have over 9,500 travel jobs throughout the state of California. We also have permanent, per diem and local contract jobs posted for the Golden State. Good luck in your job search!


What about Tennessee. Is it one of the lowest?


Texas affordable, LOL. Wit til ya have to pay property tax or sales tax. The pay is garbage down there.


It’s still cheaper than other states. My mortgage with tax is still a lot cheaper than renting an apartment in California. You can easily rent a room here in Texas for only 300$. Owning a house here in TX is much easier to afford than other states.


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