2026 nursing salary guide. CNA, LPN, and RN pay by state.
How much do nurses actually make? This guide breaks down real numbers from the Bureau of Labor Statistics for CNAs, LPNs, and RNs. It also covers what moves your pay up or down, overtime rules, and how benefits change your total comp.
National salary averages (BLS data)
The Bureau of Labor Statistics Occupational Employment and Wage Statistics (OES) program publishes salary data for healthcare jobs every year. Here are the most recent national medians for the three main nursing levels:
Figures from BLS Occupational Employment & Wage Statistics, May 2024.
These are national medians, meaning half of nurses in each category earn more and half earn less. Your actual paycheck depends a lot on your state, metro area, facility type, experience level, and shift schedule.
Top paying states for nurses
Geography is one of the biggest factors in nursing pay. States with higher costs of living and bigger demand usually pay the most. Some states pay well relative to cost of living, which makes them especially attractive.
Top paying states for CNAs
- Alaska usually has the highest median CNA wage in the country.
- California, New York, Massachusetts, and Washington round out the top tier.
- Median CNA wages in these states generally run 10 to 15% above the national median ($39,530).
Top paying states for RNs
- California is consistently the top-paying state for RNs, with the state median around $135K+.
- Hawaii, Oregon, Washington, and Massachusetts round out the top tier, usually in the $105K to $120K range.
- These are the five highest-paying states for RNs based on BLS OES state tables.
For the current state-level medians, see BLS OES. Registered Nurses and BLS OES. Nursing Assistants.
Factors that affect your nursing salary
- Experience: Entry-level nurses usually start around the 25th percentile and reach the median within 2 to 3 years. Nurses with 10+ years can hit the 75th to 90th percentile.
- Shift differentials: Night shifts usually pay $2 to $4 more per hour. Weekend differentials run $1 to $3/hr. Holiday shifts can add $5 to $10/hr or more. Over a year, differentials can add $4,000 to $12,000 on top of your base.
- Facility type: Hospitals generally pay the highest base rates, then skilled nursing facilities, then assisted living and home health. SNFs usually have more consistent overtime available.
- Certifications: Specialty certifications like wound care (WCC/CWCN) or IV therapy can add $3,000 to $10,000 a year.
- Union status: Unionized facilities in California, New York, and Illinois tend to pay higher base rates and offer stronger benefits.
- Overtime: A lot of nurses lean on overtime to bump their income. At time-and-a-half, a CNA earning $18/hr makes $27/hr for overtime hours. Just 8 hours of OT per pay period adds roughly $11,000 a year. See our overtime rules guide for details.
Beyond base salary. Total compensation
Your base pay is only part of total compensation. When you're sizing up offers, look at the full package:
- Health insurance: Employer-sponsored health coverage can be worth $5,000 to $15,000 a year depending on the plan and how much the employer covers.
- Retirement contributions: A lot of facilities match 401(k) contributions, usually 3 to 6% of your salary. A 4% match on a $60,000 LPN salary is $2,400 a year in free money.
- Paid time off: Full-time nurses usually get 2 to 4 weeks of PTO a year. At LPN rates, two weeks of PTO is worth about $2,300.
- Tuition reimbursement: Many SNFs offer $2,000 to $5,250 a year toward continuing education, especially valuable if you're going CNA-to-LPN or LPN-to-RN.
- Sign-on bonuses: In high-demand areas, sign-on bonuses run $1,000 to $5,000 for CNAs and $5,000 to $15,000 for RNs. They're usually paid out over 6 to 12 months.
For a detailed breakdown, read our complete guide to nursing benefits.
Compare total compensation, not just hourly rates
A facility offering $19/hr with full benefits, tuition reimbursement, and consistent overtime may be worth a lot more than one offering $21/hr with no benefits. When you're weighing offers through CareGigs, we help you see the full compensation picture so you can make a real decision.
Salary growth. The career ladder
One of the strongest reasons to start in nursing is the clear pay jump at every step:
- CNA to LPN: From about $39,530 to about $62,340. A $22,810 jump (58% raise) with just 12 to 18 months of additional training.
- LPN to RN: From about $62,340 to about $93,600. A $31,260 jump (50% raise) with an ADN or BSN bridge program.
- RN to BSN-prepared RN: BSN-prepared RNs earn roughly 10 to 15% more than ADN-prepared RNs in many markets.
- RN to specialized roles: Nurse practitioners, clinical nurse specialists, and nurse anesthetists earn $120,000 to $210,000 a year.
From entry-level CNA to advanced practice nurse is more than $170,000 in annual earning power. That's one of the most accessible career ladders in any profession.
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