Top Nursing Jobs According to Salary
Nursing is a rewarding profession that enables people to provide compassionate care for individuals who are going through difficult situations. It is also one of the highest-paying professions in the United States. In fact, as of 2025, advanced practice and specialized nursing roles continue to command impressive salaries. Let’s take a look at the national average salaries for the highest-paid nursing specialties and highlight states where nurses in these roles earn top pay. All figures are the latest available and are sourced from the U.S. Bureau of Labor Statistics (BLS) or reputable industry analyses.
1. Certified Registered Nurse Anesthetist (Average Salary: $212,650)
A certified registered nurse anesthetist is responsible for prescribing and administering anesthesia to patients. These nursing professionals typically administer general anesthesia for major operations, and their duties can also include the administration of epidurals, spinal anesthesia, and nerve blocks.
Nurse anesthetists work in many different clinical settings, including hospitals, military medical facilities, and outpatient surgical centers. While they have a large degree of autonomy, nurse anesthetists could choose to work alongside dentists, podiatrists, plastic surgeons, or pain management specialists to provide anesthesia services at these clinics. Health assistance employment can help make this work setup possible.
In addition to administering anesthesia, the nurse anesthetist must take the patient’s complete health history to identify any potential allergens or medical issues that could affect the dosage, type, or administration route for the anesthesia. The nurse anesthetist provides patient care before, during, and after the procedure in which the anesthesia is used. He or she answers the patient’s questions prior to the operation, monitors the patient’s vital signs during the surgery, and accompanies the patient to the recovery room after the procedure.
Due to the advanced clinical skills required for this specialty, nurse anesthetists normally complete at least two or three more years of training than registered nurses or licensed practitioner nurses. While graduate degrees are not specifically required for registered nurses or licensed practitioner nurses, certified registered nurse anesthetists are required to be licensed as registered nurses, and they must have at least one year of nursing experience in an acute care setting such as an emergency room or an intensive care unit. They must have a master’s degree from an accredited nurse anesthesia program, and the degree can take between 24 to 36 months to complete. In addition, nurse anesthetists must pass the national certification exam, and they must earn at least 100 continuing education credits every four years to maintain their certification.
CRNAs remain the highest-paid nursing professionals. Nationally, the median annual salary for nurse anesthetists is about $212,650, with mean salaries exceeding $210K. This reflects the extensive education (often a doctorate) and critical responsibilities of CRNAs in administering anesthesia. In many states, CRNAs can earn well above these averages, especially in areas with high demand or cost of living.
- Illinois: Approximately $281,240 average annual salary, the highest in the nation.
- Massachusetts: Around $272,510 per year on average.
- New York: Roughly $256,160 per year, also among the top-paying states for CRNAs.
(Other states like Montana and Vermont offer CRNA salaries in the mid-$250K range as well. Even in states not in the very top tier, six-figure salaries are the norm for this role.)
2. Nurse Practitioner (Average Salary: $128,000)
Nurse practitioners are among the highest-paid nurses in the country. Individuals in this specialty typically work in family medicine clinics and provide basic preventative care to patients. Nurse practitioners can perform physical examinations, diagnose and treat conditions, and prescribe medication like physicians. Depending on the state in which the nurse practitioner works, he or she may be able to do all of these tasks with complete autonomy. In certain states, including New York, nurse practitioners operate under reduced practice rules. They must collaborate with a second healthcare provider in at least one of these aspects of patient care. In California, Texas, Florida, and other restricted practice states, nurse practitioners must work with direct supervision or under the management of a team for certain aspects of patient care.
Roughly 55 percent of nurse practitioners specialize in family medicine, and they provide primary care services to patients of all ages. More than 20 percent of nurse practitioners choose gerontology as their specialty, providing care for seniors. Other popular specialties include pediatrics, acute care, women’s health, and psychiatric mental health. Nurse practitioners have an especially wide variety of specializations available to them, and many professionals working in this field have reported that the versatility of the position was one of their main reasons for choosing to become a nurse practitioner. In addition to the abovementioned specializations, nurse practitioners can specialize in cardiology, neurology, neonatology, oncology, surgery, occupational health, dermatology, and many other disciplines.
Like nurse anesthetists, nurse practitioners must complete a master’s degree, and it is now recommended that they complete a doctoral degree in nursing practice to be competitive within the field. Prospective nurse practitioners must be certified as registered nurses and gain one to two years of nursing experience in their chosen specialty before applying to graduate school. After completing their graduate degree, nurse practitioners must obtain a regional license and a specialty certification.
So, how much does a nurse practitioner make? That depends on the specialty. Nurse Practitioners, including those in primary care and various specialties, also rank among the best-paid nurses. The median NP salary nationwide is about $126,260 per year, reflecting the high demand for advanced practice providers. Many NPs earn well above this in certain regions or specialties. The average NP salary across the U.S. is roughly $128,000, and compensation is rising with the growing need for healthcare services. Top-paying states offer significantly higher pay:
- California: About $161,540 average annual salary for NPs (the highest in the U.S.).
- New Jersey: Approximately $145,030 per year on average.
- Oregon: Around $144,950 per year on average.
Other high-paying states for NPs include Nevada and Washington, which also report average salaries in the mid-$140K range. By contrast, lower-paying states (often in parts of the South) may average closer to $110K, though even those are well into six figures.
3. Certified Nurse Midwife (Average Salary: $131,570)
A certified nurse midwife is a nursing professional who specializes in obstetrics and gynecology. These professionals provide family planning services, perform gynecological exams, and attend births. They care for patients before, during, and after childbirth and treat newborns. They measure and monitor fetal development and educate expectant and new parents on newborn nutrition and health.
Certified nurse midwives are typically salaried employees at hospitals, physician’s offices, outpatient care centers, specialty clinics, or universities. Physician’s offices are the largest employer for certified nurse midwives, and hospitals are the second-largest employer. To become a nurse midwife, one must have a bachelor’s degree and be certified as a registered nurse. After gaining at least one year of experience as a registered nurse, students can apply to a master’s program in nurse midwifery.
The program generally takes two years to complete. Enrolling in a program accredited by the Accreditation Commission of Midwifery Education is advisable so that students are eligible to take the national certification exam that is offered by the American Midwifery Certification Board. Many employers require this certification as a condition of practice, and it can be renewed every five years by retaking the certification exam or by completing continuing education.
Certified Nurse Midwives are advanced practice nurses specializing in women’s health and childbirth. They are among the top earners in nursing, with an average annual salary around $131,570 nationwide. The median salary is roughly $129,650, but in the highest-paying states CNMs can earn substantially more, reflecting both higher demand and cost of living differences:
- California: About $183,740 mean annual salary, the highest for CNMs.
- Hawaii: Approximately $161,820 per year on average.
- Massachusetts: Around $154,080 per year on average.
Significant regional gaps exist — for example, CNMs in Idaho average about $78.5K, whereas those in California make over $180K. States like Maine and Oregon also offer salaries in the $140K range, making the West and Northeast particularly lucrative for this role.
4. Clinical Nurse Specialist (Average Salary: $124,374)
Clinical nurse specialists provide patient care and serve as leaders and managers for other nurses. In addition to assessing patients, ordering diagnostic tests, and developing a treatment plan, clinical nurse specialists serve as supervisors for nursing staff. They can set policies and are responsible for maintaining compliance with patient care regulations. These professionals work in hospitals, rehabilitation centers, clinics, and other medical facilities, and they can choose from a number of specialization areas. For example, some clinical nurse specialists focus on pediatrics or community health, and others might choose to become experts in cardiology, behavioral health, critical care, or hospice.
To become a clinical nurse specialist, one must be a registered nurse and obtain a master’s degree or doctoral degree in nursing. Doctoral degrees are required for those who want to focus primarily on research. The candidate must also pass a certification exam in a specific patient population area. Currently, certification exams are offered in adult care, gerontology, neonatology, and pediatrics. Additional requirements may be in place in certain states.
While the BLS groups CNS roles under registered nurses, industry data show average salaries well into six figures. One 2025 report cites an average CNS salary of about $124,374 per year, though other sources (e.g. Indeed) suggest it can be higher (~$140K+) when additional compensation is factored. Pay for CNSs varies widely by region and healthcare setting:
- California: Around $182,000 average annually – one of the highest paying locations for CNSs. (Indeed data shows California pays roughly 29% above the national average for this role.)
- Washington: Approximately $158,000 average, reflecting top-end pay in this specialty.
(By comparison, some lower-paying states like Louisiana see averages around $95K for CNSs, illustrating the geographic disparity in earnings.)
5. Pain Management Nurse (Average Salary: $121,916)
Pain management nurses specialize in caring for patients with chronic pain. They assist patients in managing pain caused by a variety of conditions, including fibromyalgia, diabetic neuropathy, cancer, strokes, and headaches. They also help individuals who are recovering from accidents and injuries. Pain management nurses are qualified to administer intravenous, intramuscular, and intrathecal pain relievers, and they often administer medications used for conscious sedation.
They are responsible for monitoring patients who have been sedated, and they assist patients in the recovery room after sedation. In addition to medication administration, pain management nurses may use alternative treatment techniques such as acupuncture, massage, relaxation techniques, and transcutaneous electrical nerve stimulation.
Nurses who specialize in pain management often work in oncology, sports medicine, and rehabilitation. They are primarily employed in hospitals, outpatient clinics, rehabilitation centers, and private medical offices.
To become a pain management nurse, individuals must have an associate’s or bachelor’s degree in nursing. They must then pass the NCLEX-RN exam to become licensed as a registered nurse. To obtain board certification in pain management, registered nurses are required to have an active, current registered nurse license, and they must have at least two years of full-time work experience as a registered nurse. Their work experience must be in a position that incorporates pain management in some way, and they must have accumulated at least 2,000 hours of experience in the previous three years.
In addition, candidates must show that they have completed at least 30 hours of continuing education within the past three years, and 15 of the 30 hours must have been completed in the area of pain management. Once these requirements are met, the candidate can take the computer-based exam for board certification in pain management. Certification is valid for five years. Pain management nurses who hope to perform invasive pain management techniques may need to have additional certifications in the areas of sedation and advanced cardiac life support.
This specialty has gained attention as a high-paying RN role. The average annual salary for a pain management nurse is about $121,916 (approximately $52.35/hr). Given that this role may not require advanced practice certification, that salary is notably high for an RN specialty. State-by-state differences align with general RN pay trends:
- Washington: Identified as one of the top-paying states for pain management nurses. (Some analyses show Washington state at the very top for this role.)
- District of Columbia: Also reported among the highest-paying locations for pain management nursing.
In general, states that pay RNs well (California, Massachusetts, Hawaii, etc.) tend to offer higher salaries for pain management nurses too. For instance, salary data for Washington, D.C. show an average around $110–$146K for this role, which is above the national RN average. In lower-paying regions, pain management nurses might earn closer to the $90K–$100K range, still exceeding many other RN positions.
Sources
- U.S. Bureau of Labor Statistics: https://www.bls.gov
- Nurse.org: https://nurse.org/articles/15-highest-paying-nursing-careers/
- Indeed/Glassdoor salary analyses: https://www.indeed.com/career/nurse/salaries
- ASRN (American Society of Registered Nurses): https://www.asrn.org
- Nightingale College: https://nightingale.edu/blog/highest-paying-nursing-jobs.html
- IntelyCare: https://www.intelycare.com/jobs/
All salary figures represent the most recent available annual averages or medians for each role. Values are stated in U.S. dollars.
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Original Post: February 10, 2020 4:42 pm CST
