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Sonographers are in hot demand, so knowing where you can maximize your earnings and advance your career and your livelihood is essential. If you’re a sonographer or exploring a career in sonography and aiming to maximize your earnings, Vivian Health is here to help.
We provide an in-depth look at the factors impacting sonography salaries, highlighting states with high demand and competitive pay. We also examine how specialization and certification can boost earnings, and explore emerging niches and technological advancements in sonography that signal future growth in the field.
Role of Sonographers in Healthcare
Sonographers, also known as ultrasound technicians or diagnostic medical sonographers, play a critical role in healthcare by using ultrasound equipment to create images of internal organs, tissues and blood flow. These images help physicians diagnose, monitor and treat medical conditions. Sonography is a critical healthcare field that can profoundly impact patient well-being. Moreover, sonography is a highly in-demand and well-paying allied healthcare profession.
Sonographer duties often include preparing patients, operating ultrasound machines, interpreting preliminary findings and collaborating with doctors to ensure accurate diagnoses. They can focus on various areas such as obstetrics and gynecology, abdominal, cardiac and vascular imaging to become imaging experts in specialized fields. Their work is non-invasive, making it a vital tool in the early detection and monitoring of many conditions.
How Location Affects Sonography Salaries and Job Demand
Geographic factors are crucial in career planning for sonographers, especially regarding salary and job demand. Regional demand for sonographers can vary widely, influenced by population density, healthcare infrastructure, local medical needs and other elements. For example:
Urban vs. Rural Areas
Urban areas typically offer more job opportunities due to a larger concentration of hospitals and medical centers, but the competition for those jobs can be higher. High-population states with large urban areas tend to employ the most sonographers. For example, the Bureau of Labor Statistics (BLS) reports that California employed the most Diagnostic Medical Sonographers in May 2023 at 8,600. Conversely, rural areas may have fewer positions, but the demand for sonographers can be greater because providers often prefer working in larger cities. This demand can increase job security and sometimes lead to better pay incentives to attract professionals.
Cost of Living
Sonographer salaries often align with regional living costs. Higher-cost areas may offer elevated wages to offset expenses. In some cases, working in regions with lower living costs and competitive pay can provide greater financial advantages for sonographers. The Missouri Economic Research and Information Center listed California as having the third-highest cost of living in the third quarter of 2024 at nearly 45% above the national average, and West Virginia as having the lowest living costs at about 15% less than average. The BLS reported average sonographer wages in California at $122,670 annually compared to $70,730 in West Virginia in may 2023.
State and Regional Demand
Certain states or regions may have a higher demand for healthcare professionals, including sonographers, based on population growth, aging demographics or healthcare expansion. In particular, states with rapidly growing populations have a stronger demand for diagnostic services like sonography. Again, California is a prime example where a larger population often creates a greater need for sonographers than less populated states.
Understanding local market conditions and cost-of-living dynamics is crucial for informed career planning.
Medical Sonography Is in Demand and Offers Good Pay
Sonography is growing much faster than the average of all jobs in the United States. The BLS provides estimates for the likely job growth of various occupations, including diagnostic medical sonographers growth, between 2023 and 2033. While that period started with 84,900 sonographers nationwide, the BLS estimates that the number of sonography jobs will grow by 12,800, or 15%, by 2033. Due to sonographers retiring or leaving the occupation, O*NET projects the average annual hiring for sonographers during this period to be 5,700 per year.
| Region | Base # Jobs (2023) | Projected Jobs (2033) | Net Increase | Percent Increase | Avg. Annual Jobs |
| United States | 84,900 | 97,700 | 12,800 | 15% | 5,700 |
As for sonographer salaries, as of May 2023, the latest month for which BLS statistics are available, sonographers earned an average annual wage of $89,020, or $42.80 hourly, while the top 25% of sonographers earned over $100,000 per year. In a comparison of work settings, 60% worked in hospitals, 21% in doctors’ offices, 11% in medical labs and 4% in outpatient centers.
Which States Have the Greatest Demand for Sonographers
Source: Projections Central (sponsored by the U.S. Department of Labor), Data between 2022-2032
There are two ways to think about where the demand for sonographers will be strongest over the coming years. One approach is to simply look at which states that Projections Central projects will have the most average annual sonography job openings between 2022 and 2032. The chart above and the table below include the states where Projections Central estimates there will be at least 100 sonographer job openings each year through 2032. California, Texas and Florida stand out among these high-job-opening states, each expected to see over 500 sonographer job openings annually.
These top-ranking 19 states have one thing in common: They’re among the most populated in the United States, meaning they have an ongoing demand for sonographers to treat patients of all ages. Jobs in healthcare get created where there are the most people potentially needing care.
| State |
Average Annual Openings |
| California |
710 |
| Texas |
580 |
| Florida |
520 |
| North Carolina |
290 |
| New Jersey |
260 |
| Ohio |
240 |
| Pennsylvania |
210 |
| Georgia |
200 |
| Illinois |
190 |
| Michigan |
190 |
| New York |
180 |
| Tennessee |
170 |
| Arizona |
160 |
| Washington |
160 |
| Virginia |
140 |
| Colorado |
120 |
| Minnesota |
110 |
| Missouri |
100 |
| Wisconsin |
100 |
In addition to identifying states with the highest overall demand for sonographers, we can take a closer look at where job growth is accelerating most rapidly. By examining the states with the fastest-growing sonography job markets relative to their current job base, we can see the projected percentage increase in sonography roles across states through 2032, according to Projections Central’s data.
Source: Projections Central The projected percent growth in the number of sonography jobs for all states and Washington D.C. (2022-2032). The dashed red line at 14.3% indicates the national average for sonographer job growth during this period.
The chart above and the table below show states Projections Central predicts will have the greatest percent increase in sonography jobs from their current levels. Whether a state has a high population like Texas or a low population like Idaho, the percent change in sonography jobs is highest in states with a growing population, which Idaho and Texas both have.
Certain states in the Sunbelt and Mountain regions of the U.S., including Utah, Arizona, Idaho, New Mexico and Texas, top the list of states with the highest percentage growth in sonography. Projections Central estimates that each of these states will see sonography job growth roughly double the national average through 2032.
| State | Projected % Increase |
| Utah | 35.7% |
| Arizona | 33.3% |
| Idaho | 32.3% |
| New Mexico | 29.4% |
| Texas | 28.3% |
| Delaware | 28.0% |
| Montana | 27.8% |
| New York | 27.0% |
| Colorado | 27.0% |
| Georgia | 26.6% |
| North Carolina | 26.5% |
| Tennessee | 26.4% |
| Wyoming | 25.0% |
| California | 24.1% |
| Florida | 22.2% |
| Nevada | 22.0% |
| South Dakota | 21.9% |
| Iowa | 20.3% |
| Arkansas | 20.0% |
| North Dakota | 20.0% |
| Oregon | 19.6% |
| Wisconsin | 19.4% |
| Vermont | 18.2% |
| Missouri | 17.7% |
| New Jersey | 17.6% |
| South Carolina | 17.2% |
| Massachusetts | 17.1% |
| Connecticut | 17.0% |
| Washington | 16.9% |
| Alabama | 16.3% |
| Louisiana | 16.2% |
| Maryland | 15.9% |
| Minnesota | 14.8% |
| Kentucky | 14.7% |
| New Hampshire | 14.7% |
| Mississippi | 14.5% |
States with the Highest Sonographer Pay
Regarding which states pay sonographers the most, it seems to be a mix of states with a high cost of living—California, New York and Alaska—or states with high population growth—New Mexico and Nevada. Statistics from DATA USA (a Deloitte/Datawheel collaboration) reveal that diagnostic medical sonographers earned an average annual salary of $113,000 or more in Massachusetts, Rhode Island, New York, South Carolina, Minnesota, New Mexico, Nevada, Oregon, California, Alaska and Hawaii in 2022.
Impact of Specializations and Certifications on Sonography Salaries
Certain specializations offer sonography pay that goes above the average in the field. Vivian recently covered seven top-paying sonography specialties, particularly concerning travel roles. The table below reflects the average pay for various sonography specialties based on jobs posted to Vivian during the week of October 7, 2024.
| Specialty or Certification | Average Hourly Pay |
| Registered Ultrasound Technologist | $50 (Max $89) |
| Vascular Sonographer | $41 (Max $66) |
| Cardiac Sonographer | $41 (Max $67) |
| Breast Sonographer | $41 (Max $62) |
| OB-GYN Sonographer | $41 (Max $62) |
| Echo-Vascular Tech | $36 (Max $49) |
Aspiring sonography specialists should consider not only current salary trends but also potential shifts in demand over time. For example, demand for pediatric sonographers may slow as U.S. birth rates decline. In contrast, the aging population and rising number of older adults may drive up overall demand for sonographers, especially those specializing in cardiac and vascular sonography or serving geriatric patients.
As with any specialization in healthcare, your job prospects may improve considerably by getting the relevant certification from an accredited certification board. The American Registry of Radiologic Technologists, Cardiovascular Credentialing International and the American Registry for Diagnostic Medical Sonography offer certifications in a range of specialties such as:
- Advanced Cardiac Sonographer
- Breast Sonography RT
- Registered Diagnostic Medical Sonographer in Breast
- Certified Diagnostic Ophthalmic Sonographer
- Registered Diagnostic Medical Sonographer in Pediatrics
- Registered Diagnostic Medical Sonographer in Obstetrics and Gynecology
- Registered Musculoskeletal Sonographer
- Vascular Sonography RT
These are just a few of the many certifications sonographers have available to them by specializing in specific medical imaging fields or patient populations.
Emerging Markets and Considerations for Sonographers
The field of diagnostic medical sonography is on the brink of significant transformation, driven by technological advancements and evolving healthcare policies. Here are a few insights into how these factors could shape the future of the profession.
Technological Advancements
- Artificial Intelligence (AI) and Automation: Medical imaging technologies are increasingly incorporating AI to enhance speed and processing. In sonography, AI assists with image interpretation, pattern recognition and even automating certain measurements. This technology has the potential to ease the diagnostic workload on sonographers, enabling them to focus more on patient care and complex cases. However, it also means that future sonographers may require advanced training to effectively work with AI-based tools, including the review and validation of AI-generated results.
- Portable Ultrasound Devices: Advances in miniaturization have led to the development of more portable ultrasound devices, some of which providers can connect to smartphones or tablets. This technology allows providers to deploy these tools in a wider range of settings, such as rural clinics or even patients’ homes. As these technologies evolve, sonographers might need to adapt to more dynamic work environments, including community-based or remote diagnostics.
- 3D/4D and High-Resolution Imaging: Improved resolution in ultrasound technology, including the widespread use of 3D and 4D (i.e., video) imaging, enhances diagnostic capabilities. Future sonographers may need to be more skilled in capturing and interpreting these advanced images, which could offer more precise diagnostics but require more specialized training.
- Telemedicine and Remote Consultations: The rise of telemedicine may lead to an increase in remote diagnostic services. Sonographers could find themselves part of a remote healthcare team, performing scans in one location while specialists in other locations analyze the results. This shift might create new roles for sonographers in supporting these remote diagnostic processes and collaborating with other healthcare providers virtually.
Healthcare Policies
- Value-Based Care and Preventive Health Initiatives: Many healthcare systems are shifting toward value-based care, which focuses on patient outcomes rather than the volume of services provided. This shift may increase demand for sonography as part of early detection and preventive healthcare initiatives. Routine ultrasound screenings could become more common in regular health check-ups, especially for high-risk populations, leading to greater demand for sonographers.
- Regulation and Credentialing: As ultrasound technology becomes more advanced and specialized, regulatory bodies may implement stricter credentialing and certification requirements to ensure that sonographers can safely and effectively operate complex equipment. More stringent guidelines could mean more ongoing education requirements for sonographers to stay current with the latest technologies and techniques.
- Increased Emphasis on Patient Safety: Policies focusing on patient safety and reducing medical errors may result in more stringent guidelines for sonography practice. There could be more emphasis on standardizing procedures, reducing variability in diagnostic accuracy and ensuring that sonographers have access to continuing education in these areas.
Sign up for Vivian to start your search for the perfect sonography job in states with high pay and strong job prospects today.
