Top 5 Highest Paying Staff RN Locations in 2024

• Share Story
• 
• 
• 

High-paying locations are often highlighted for travel nurses who move around frequently, but what about top-paying spots for staff nurses? Registered nurses (RNs) working in permanent staff positions may consider moving to pursue promotions, better benefits, lucrative sign-on incentives or significantly higher salaries. For those seeking higher pay, this article is for you.

Now is an opportune time for RNs to seek better-paying staff roles. Vivian recently analyzed nurse salary data and found that during 2023, pay for travel nurses fell slightly while wages for staff jobs rose. While nurses make up the largest group of healthcare professionals, with 4.3 million RNs nationwide, there are never enough of them to go around. Healthcare systems have begun to offer higher pay to try and attract nurses to staff positions.

In this article, Vivian Health highlights the five states offering the highest pay opportunities for non-managerial staff RNs. Primarily driven by high-paying jobs in metro New York City, metro Washington D.C. and the major metros of the West Coast, the five states with top-paying jobs are California, Virginia, Washington, Oregon and New York.

Top Five States for Staff RN Pay

Nationwide, RNs earn an average of $43.89 per hour. However, all five states on our list feature RN salaries well above the national average, and some jobs offer as much as twice the norm.

The chart below breaks down the five states where employers offered the highest paying staff RN jobs as of the first week of December 2023, along with the average pay in each of those states and the percent premium of the state average above the national average. All salary data comes from our RN salary guide and is based on active jobs posted on Vivian.

Source: Vivian Health (December 6, 2023)

1. California

The average staff RN salary in California was $67.79 an hour on December 6, 2023, about 35% higher than the national average. However, some non-managerial RN jobs offered as much as $94 an hour for the right candidate, the highest we saw nationally on that date. However, these above-average wages reflect the state’s above-average cost of living, about 50% higher than the national average overall, per Sperling’s Best Places. Our California RN salary page provides the most recent details.

California Cities with Top-Paying Staff RN Jobs:

• Los Angeles
• Santa Rosa
• Glendale
• Clearlake
• Marysville

Top-Paying Specialties in California:

• $51 to $94 for Operating Room (OR) RNs
• $55 to $86 for Emergency Department (ED) RNs
• $42 to $86 for Intensive Care Unit (ICU) RNs
• $50 to $85 for Telemetry RNs
• $42 to $85 for Labor and Delivery RNs
• $41 to $85 for Care Manager RNs

California has a reputation for its incredible variety and high quality of life. It’s the third-largest state and the most populous. It also has the largest state economy, surpassing all but four countries worldwide. Silicon Valley and Hollywood have made the state synonymous with digital technology and entertainment, respectively.

Living in the Golden State offers stunning scenery, including deserts, mountains, 33 million acres of forests and 3,400 miles of ocean vistas. The state also boasts nine National Parks and is home to Disneyland and Universal Studios, a bonus for nurses with children. Meanwhile, the state’s Central Valley produces some of the country’s best fruits, vegetables, nuts and wines. Much of the state has a Mediterranean-type climate with ample sunshine and mild winters.

Many of the state’s top-paying healthcare jobs are in the San Diego, Los Angeles and San Francisco metropolitan regions. Unfortunately, these areas have some of the highest costs of living in the nation and the state, which puts a dent in the higher pay offered for these jobs. On the flip side, these metros are major centers of cultural amenities with a mix of high-quality urban and suburban areas to call home. However, it’s also possible to find high-paying jobs in California a bit further outside these major areas, where costs are lower.

2. Virginia

In Virginia, the average staff registered nurse salary was $53.48 per hour in early December, a nice 18% premium above the national average. However, some non-managerial RN jobs in the Old Dominion state offered as much as $81 per hour. Our Virginia RN salary page provides the most recent details.

Virginia Cities with Top-Paying Staff RN Jobs:

• Fairfax
• Falls Church
• Leesburg
• Alexandria
• Reston

Top Paying Specialties in Virginia:

• $44 to $81 for First Assist Nurses
• $40 to $76 for Cardiovascular Operating Room (CVOR) Nurses
• $31 to $65 for Medical Surgical (Med Surg) Nurses

From Appalachia in the west to the Hampton Roads coastal region in the east, and major metros in between, living in Virginia offers a variety of lifestyle options. The state also has an overall cost of living roughly on par with the national average, per Sperling’s. However, averages can mask the sharp divide between the state’s north and south in terms of opportunities and cost of living.

Virginia is a major center for healthcare, especially in the Northern Virginia (NOVA) region that abuts Washington, D.C. Many health systems have hospitals in Arlington, just across the Potomac River from D.C. and in neighboring Alexandria. During our recent analysis, most of Virginia’s top-paying staff nurse jobs were in the NOVA region. Unfortunately, this area has the highest cost of living in the state, with Arlington’s overall cost of living about 60% more than the state average and Alexandria’s about 40% more.

Despite higher living costs, the NOVA area is an attractive place to call home and a hubbub of activity in both the private and public sectors. It boasts many high-quality urban and suburban places to live, numerous excellent schools and plenty of attractions, including exciting outdoor adventures and cultural venues. Residents of Virginia also have access to a mix of mountains and beaches just a few hours away.

3. Washington

In Washington State, the average staff RN salary was $66.72 per hour, a whopping 34% above the national average. Additionally, some non-managerial staff RN jobs in the Evergreen State offered as much as $77 an hour. Our Washington RN salary page provides the most recent details.

Washington Cities with Top-Paying Staff RN Jobs:

• Spokane
• Vancouver
• Issaquah
• Renton
• Bellvue

Top Paying Specialties in Washington:

• $41 to $77 for Neurology RNs, ICU Nurses, Obstetrics and Gynecology (OB/GYN) Nurses and OR Nurses
• $39 to $75 for Med Surg Nurses
• $41 to $74 for Labor and Delivery RNs

Washington has a bit of an east/west divide, with most major urban centers and development located in the western third of the state, including the Seattle metropolitan area. Seattle is one of the nation’s major tech and manufacturing hubs, and it’s where you’ll find most of the state’s highest-paying jobs. It also has an above-average cost of living. According to Sperling’s Best Places, Seattle’s overall living costs are 58% higher than the national average and just over 36% more than the statewide average.

Meanwhile, the eastern two-thirds of the state are more rural overall. There are abundant and dense forests, earning its Evergreen State nickname, and the majestic Cascade mountain range. In the state’s northeast corner, the mid-sized city of Spokane is also home to some of the state’s best-paying RN jobs. However, it has a more moderate cost of living, just 3% higher than the national average but nearly 19% less than the state average.

Those who thrive on sunshine should keep in mind that the Famer’s Almanac lists Washington as the number one state with the least sunny days in the nation. However, the state’s climate is considered moderate overall, with below-average snowfall. Meanwhile, Washington is the only state in our top-five list that doesn’t collect state-level personal income tax, and groceries are tax-exempt, potentially saving nurses working there some income compared to other states on our list.

4. Oregon

Oregon boasted average staff RN salaries of $57.84 per hour, a generous 24% premium over the national average. Some top jobs in the Beaver State offered as much as $69 for non-managerial staff RN positions. Our Oregon RN salary page provides the most recent details.

Oregon Cities with Top-Paying Staff RN Jobs:

• Portland
• Coos Bay
• Hillsboro
• Gresham
• Corvallis

Top Paying Specialties in Oregon:

• $43 to $69 for Med Surg RN
• $40 to $65 for ICU Nurse
• $35 to $65 for ED Nurse
• $32 to $65 for OR Nurse

Overall, Oregon’s cost of living is only slightly above average, about 14% overall, though prices are higher in metro Portland compared with the rest of the state. Like Washington, Oregon has a notable east-west divide in which the western third of the state has more development and an above-average cost of living for the state, while the west is more rural and features lower prices. 

With an unofficial mantra of “Keep Portland Weird,” in recent years, Oregon’s main city has earned a reputation as a hip and slightly counter-cultural place to live. It’s a bike-friendly,  sustainability-minded city with a broad array of natural attractions, from beautiful park trails to majestic mountain views. However, like Seattle and other parts of the Pacific Northwest, be prepared for plenty of rain.

Beyond Portland, the state features an unusually diverse geography, from its picturesque Pacific Ocean coastline on one side to the high desert and mountains on the other. While Oregon does have a state income tax, it’s one of just five U.S. states that don’t collect sales tax, which helps contribute to its moderate cost of living compared to the rest of the West Coast.

5. New York

In New York, average registered nurse salaries were $53.48 an hour, an 18% premium over the national average. Some non-managerial staff jobs offered $59 per hour in the Empire State during early December. Our New York RN salary page provides the most recent details.

New York Cities with Top-Paying Staff RN Jobs:

• Glens Falls
• Rye
• Watertown
• East Setauket 
• Hauppauge

Top Paying Specialties in New York:

• $32 to $59 for Psychiatric Nurses, Telemetry RNs, OR Nurses and ED RNs
• $52 to $55 for Skilled Nursing Facility RNs
• $35 to $50 for Progressive Care Unit (PCU) RNs

New York is a state of regional diversity, anchored by the iconic New York City (NYC) and its suburbs in the “downstate” region to the south. Conversely, the larger “upstate” region to the North and West boasts a mix of medium-sized and smaller cities and rural areas. 

There are occasionally high-paying jobs in the upstate region, where costs are typically lower. However, following a period of stunning fall foliage, be prepared for cold and snowy winters. Upstate New York features scenic wonders such as Niagra Falls, two of the Great Lakes and the Adirondack and Catskill mountain ranges.

Many top-paying jobs and large hospitals and health systems are located downstate in the NYC metropolitan area. This region has a cost of living that, per Sperling’s, is a hefty 73% higher than the national average in NYC, so nurses must consider this when weighing higher wages. 

Despite the costs, many are drawn downstate due to NYC’s vibrant economy as the nation’s financial and media capital, plus its stunning variety of food, culture and entertainment. The region is also marked by incredible ethnic diversity, with the NYC borough of Queens ranked as the most ethnically diverse large county in the U.S., with nearly half of residents being foreign-born.

Tips for Choosing the Best Location

Whether you’re looking for a higher-paying staff nursing job or simply a change of scenery, you should make sure your move is good for you overall, not just for the money. As you can see from our list, states with higher-paying RN jobs often have higher costs of living. Be sure to compare states with lower wages and living costs to see how much difference it makes.

However, just because a state has a higher-than-average cost of living doesn’t mean there aren’t cities within the state offering more affordable lifestyles. Rural areas tend to have lower housing costs than urban areas, but these areas may lack the amenities important to your quality of life.

Personal preferences should also factor into determining whether a position is in a desirable location. If you’re not a fan of winter, a state known for above-average snow and cold temperatures probably wouldn’t be an ideal fit. Since you’re taking a permanent position and not a temporary travel gig, you’ll likely live in this location for some time. If you’re extremely uncomfortable and unhappy, no amount of money will make the location worthwhile.

Use Vivian’s job search tool to find staff RN jobs in the state that checks all your boxes. Explore our travel guides to learn more about various locations and top employers that might appeal to you.

Editor’s Note: This blog post was originally published in August 2021 and has been updated annually to reflect the most recent data. The staff RN job locations currently listed were the highest-paying as of this publication.