Most of the top-paying states for nurses, adjusted for cost of living, are in the Midwest or the West, according to Bureau of Labor Statistics data.
Becker’s used the latest BLS data, released May 15 and up to date as of May 2025, to determine the hourly pay rate by state and adjusted it by cost of living in each state. The bureau collects only the annual wage for nursing instructors and teaching, so they are not included on this list.
West Virginia continues to be the top-paying state for nurse anesthetists, when adjusted for cost of living. Last year, the top-paying state for nurse midwives was Arizona, for nurse practitioners it was Iowa, for registered nurses it was California and for nursing assistants it was Wisconsin.
Here are the top-paying states for six nursing positions with their adjusted hourly wage.
| Position | State | Hourly pay, adjusted by cost of living |
| Nurse anesthetists | West Virginia | $149.78 |
| Nurse midwife | Arkansas | $85.80 |
| Nurse practitioner | Oklahoma | $75.02 |
| Registered nurse | Oregon | $52.95 |
| Licenced practical and licenced vocational nurses | Illinois | $37.28 |
| Nursing assistant | Minnesota | $23.39 |
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