Cost-adjusted RN pay in best, worst states for healthcare

Of the 10 best states for healthcare per U.S. News & World Report, five rank in the bottom half of all states for nurse pay, according to Becker's analysis. 

To assess nurse pay trends for U.S. News' best and worst states for healthcare, Becker's calculated the cost of living-adjusted hourly mean wage for nurses using May 2023 salary data from the Bureau of Labor Statistics and 2024 cost of living index data from the World Population Review. 

Hawaii was named the best state for healthcare in 2024, but it has the lowest cost of living-adjusted hourly mean wage for registered nurses of any state. In contrast, Oklahoma was ranked the second-worst state for healthcare but the 10th highest for nurse pay.

The data shows a discrepancy in nurse compensation and healthcare quality rankings, which may underscore variations in healthcare policy, state budget priorities and other factors affecting labor markets.

10 best states for healthcare

RN hourly mean wage, adjusted by cost of living

State pay rank out of 50



1. Hawaii

$32.15

50

2. Massachusetts

$35.26

49

3. Connecticut

$43.29

16

4. New Jersey

$42.96

18

5. Rhode Island

$41.37

29

6. California

$49.22

1

7. Maryland

$37.05

45

8. New York

$40.98

33

9. Delaware

$44.36

12

10. Washington

$46.38

8

 

10 worst states for healthcare

RN hourly mean wage, adjusted by cost of living

State pay rank out of 50

50. Mississippi 

$42.56

20

49. Oklahoma 

$45.91

10

48. West Virginia

$40.45

35

47. Arkansas

$38.82

40

46. Louisiana

$42.21

23

45. Missouri 

$42.19

24

44. Alabama

$38.64

41

43. South Dakota 

$35.38

48

42. Tennessee 

$41.60

28

41. Indiana

$43.45

15

 

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