Nurse Practitioner Salary Guide
Nurse practitioners earn a national median of $126,260 per year ($60.70 hourly) according to O*NET, with top earners pulling in over $168,000 annually depending on state, specialty, and work setting.
Nurse practitioners earn a national median of $126,260 per year ($60.70 hourly) according to O*NET, with top earners pulling in over $168,000 annually depending on state, specialty, and work setting.
Nurse practitioners are one of the fastest-growing occupations in the U.S., with O*NET projecting 46% job growth this decade — more than ten times the average for all occupations and reflecting roughly 30,000 new openings each year.
Nurse practitioners earn a national median salary of $126,260 per year, or about $60.70 per hour, according to O*NET. Entry-level NPs at the 10th percentile earn around $94,530, while top earners at the 90th percentile pull in $168,030 or more. With roughly 280,140 NPs employed nationwide and a projected growth rate of 46% this decade, NP pay sits well above the U.S. median for all occupations — but the headline number masks real variation by state, setting, and specialty choice.
Several forces create the spread. Geography is the single biggest factor, with state-level gaps exceeding $55,000 between the top and bottom markets. Specialty selection is the biggest long-term lever, and it's largely decided at NP school enrollment — PMHNPs and the CRNA pathway pay substantially more than family practice. Work setting comes next: outpatient care centers and psychiatric hospitals lead, while physician offices typically pay the least. Experience, productivity bonuses, and on-call differentials round out the picture.
How NP annual pay spreads from entry-level (10th percentile) to top earners (90th percentile), based on O*NET national wage data.
| Percentile | Annual Wage | Hourly Wage |
|---|---|---|
| 10th | $94,530 | $45.45/hr |
| 25th | $108,530 | $52.18/hr |
| 50th (Median) | $126,260 | $60.70/hr |
| 75th | $146,970 | $70.66/hr |
| 90th | $168,030 | $80.78/hr |
Geography is the single biggest pay driver for nurse practitioners, with a gap exceeding $55,000 between top and bottom states. Keep in mind that high-paying states often come with steep cost-of-living offsets.
| Rank | State | Median Salary | vs National |
|---|---|---|---|
| 1 | California | $161,540 | +28% |
| 2 | New Jersey | $143,250 | +13% |
| 3 | Washington | $140,560 | +11% |
| 4 | Nevada | $138,630 | +10% |
| 5 | Oregon | $136,250 | +8% |
| 6 | Massachusetts | $134,680 | +7% |
| 7 | New York | $133,910 | +6% |
| 8 | Minnesota | $130,520 | +3% |
| 9 | Hawaii | $129,640 | +3% |
| 10 | Arizona | $128,710 | +2% |
| Rank | State | Median Salary | vs National |
|---|---|---|---|
| 41 | South Dakota | $112,830 | -11% |
| 42 | Iowa | $112,150 | -11% |
| 43 | Mississippi | $110,490 | -12% |
| 44 | Kansas | $109,820 | -13% |
| 45 | Arkansas | $108,940 | -14% |
| 46 | Kentucky | $107,560 | -15% |
| 47 | West Virginia | $106,820 | -15% |
| 48 | Alabama | $105,470 | -17% |
| 49 | Tennessee | $104,580 | -17% |
| 50 | Oklahoma | $103,920 | -18% |
Metro-level pay can vary widely even within the same state. California Bay Area metros dominate the top of the O*NET rankings, and several push median NP pay above $180,000, with top earners reaching well past $230,000. Just remember that housing costs in these regions can absorb a significant portion of the premium, so factor in cost of living before relocating.
Four levers drive nurse practitioner pay: where you work, what setting you work in, how long you've practiced, and which specialty you chose at NP school.
Where you practice matters more than any other factor. O*NET data shows a gap of more than $57,000 between the highest-paying state (California at $161,540) and the lowest (Oklahoma at $103,920). Even within a single state, metro-level differences can exceed $30,000. Additional state and metro wage breakdowns are available through the BLS OEWS.
Outpatient care centers and psychiatric facilities typically pay NPs the most, often $15,000–$25,000 above the national median. Hospitals fall near the middle with strong benefits, while physician offices — the most common employer — typically pay the least, often near the 25th percentile.
New NPs typically start near the 10th–25th percentile ($94,500–$108,500), while seasoned NPs with 10+ years and full panels reach the 75th–90th percentile. Productivity bonuses tied to RVUs or patient volume commonly add 10–25%, with on-call and shift differentials boosting hospital-based pay further.
Specialty is the biggest long-term earnings lever, and it's largely decided when you enroll in NP school. PMHNPs (psychiatric mental health) typically out-earn FNPs by $10,000–$20,000. The CRNA pathway — a separate APRN role — pushes median pay above $210,000, making it the highest-earning advanced practice nursing route.
If you want a quick pay bump, the fastest lever is geographic — relocating from a bottom-quartile state to a top-quartile state can mean a $40,000–$55,000 raise overnight. Beyond that, target outpatient care centers or psychiatric facilities over physician offices, and negotiate productivity-based contracts tied to RVUs or patient volume rather than flat salary. Locum tenens work is another high-leverage option, often paying $90–$130 per hour for travel NPs willing to cover short-staffed regions. Keep in mind that state scope-of-practice authority, as documented by the AANP, also shapes how independently — and lucratively — NPs can practice in a given state.
The long-term play is specialty selection at NP school enrollment. Choosing PMHNP over FNP locks in a $10,000–$20,000 annual premium thanks to the severe nationwide shortage of mental health prescribers. If you're open to a longer training path, the CRNA pathway — a separate APRN credential requiring a DNP in nurse anesthesia — pushes median pay above $210,000, the highest in advanced practice nursing. Switching specialties later requires a post-master's certificate, so choose thoughtfully upfront.
Explore how NP pay varies across states and metro areas, and see where your target market ranks against the national median.
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California leads in raw NP pay, but Texas and Nevada NPs may have stronger purchasing power due to no state income tax and lower housing costs. Always compare cost-of-living-adjusted figures.
Choosing PMHNP over FNP can add $10K–$20K to median annual pay. The CRNA pathway, a related advanced practice role, pushes median earnings above $200,000 per year.
Temporary or locum NP assignments routinely pay 30–50% above permanent positions in the same market. The tradeoff is benefits, contract length, and travel logistics.