CRNA Salary by State: Complete 2026 Compensation Guide

Top 10 Highest-Paying States for CRNAs

The gap between the highest and lowest-paying states for CRNAs can exceed $80,000 per year. Geography alone accounts for a substantial portion of total compensation, making location one of the most important career decisions a CRNA will make.

California leads the nation by a wide margin, with CRNAs averaging $267,420 annually. The state's combination of high healthcare demand, strong unions in some facilities, and a cost of living that pushes wages upward all contribute to that figure. Oregon follows at $256,830, driven by a favorable scope of practice environment and growing demand in both Portland metro and rural areas.

The presence of Wyoming at number nine may surprise some readers. Despite having one of the smallest populations in the country, Wyoming's limited supply of anesthesia providers and strong demand from regional hospitals drive salaries well above the national average. Texas rounds out the top ten at $236,220, combining no state income tax with a large and growing healthcare market, particularly in Houston, Dallas, and Austin.

Cost-of-Living Adjusted Salary Rankings

Raw salary figures tell only part of the story. A CRNA earning $267,000 in San Francisco faces a very different financial reality than one earning $237,000 in Cheyenne, Wyoming. When adjusting for regional price parities published by the Bureau of Economic Analysis, the rankings shift considerably.

Wyoming jumps from 9th in nominal pay to the top tier on an adjusted basis. With a cost of living roughly 8% below the national average, the state's $237,330 average salary stretches further than California's $267,420 in practical terms. Oregon similarly gains ground; while Portland is not inexpensive, the state's overall cost of living remains below coastal Northeast levels, making its $256,830 average salary highly competitive in adjusted terms.

On the flip side, California and New York drop several positions once housing costs, taxes, and general living expenses factor in. A CRNA in the New York City metro area faces housing costs 2-3 times the national median, along with state and city income taxes that can reduce take-home pay by 10-12% before federal taxes even enter the picture.

States That Gain Most After Adjustment

• Wyoming: Low cost of living (8% below average) plus $237K salary creates strong purchasing power
• Oregon: No sales tax, moderate cost of living outside Portland, and $256K salary
• Texas: No state income tax, housing 10-15% below coastal averages, and $236K salary
• Nevada: No state income tax, lower housing costs than California, and $248K salary

States That Drop After Adjustment

• California: Housing costs 50-80% above national average in major metros erode the $267K advantage
• New York: High state/city taxes and extreme housing costs in NYC reduce effective compensation
• Massachusetts: Above-average cost of living in Boston metro reduces the value of $241K
• Connecticut: High property taxes and living costs offset the $254K salary

CRNA Salary by Practice Setting

Where you work matters nearly as much as where you live. The practice setting shapes not just your daily responsibilities but also your earning potential, schedule flexibility, and long-term career trajectory.

Hospital-based CRNAs represent the largest employment segment and typically earn around $210,000. This figure often includes base salary plus additional compensation for call shifts, overtime, and weekend differentials. A hospital CRNA working a moderate call schedule can push total compensation well above the base.

Outpatient and ambulatory surgery centers offer a compelling combination: higher base pay (averaging $225,000), more predictable schedules, and fewer overnight or emergency cases. The growth of outpatient surgery has expanded these opportunities significantly over the past decade.

Academic medical centers tend to pay the least at approximately $195,000, though they compensate with other advantages. These positions offer teaching opportunities, access to research, strong benefits packages, and the prestige that comes with university-affiliated practice. For CRNAs interested in shaping the next generation of providers, the trade-off may be worthwhile.

Private practice and group partnerships offer the highest earning ceiling. CRNAs in independent or group practices regularly exceed $240,000 in annual income, with some earning $280,000 to $300,000 or more. These positions carry more business risk and administrative responsibility, but the financial upside is substantial, particularly in states with full practice authority.

CRNA Salary by Experience Level

Experience remains one of the strongest predictors of CRNA compensation. The field rewards longevity with significant salary growth, especially during the first decade of practice.

Entry Level (0-2 Years): $170,000 - $190,000

New graduates entering the workforce typically command starting salaries between $170,000 and $190,000. Some new grads in high-demand areas or high-cost states start above $200,000, but that remains the exception rather than the rule. Most employers structure new-grad offers with a slightly lower base salary offset by signing bonuses ranging from $10,000 to $50,000 and relocation assistance.

Mid-Career (5 Years): $210,000 - $230,000

By the five-year mark, CRNAs have built the clinical confidence and efficiency that employers value. Salaries in this range reflect competence across a broad case mix, the ability to handle complex patients independently, and often some degree of specialization. Many CRNAs at this stage begin negotiating more aggressively for schedule preferences, practice autonomy, or leadership roles that come with pay increases.

Experienced (10+ Years): $240,000 - $280,000+

Veteran CRNAs with a decade or more of experience represent the highest-earning segment of the profession. Beyond base salary increases, many experienced CRNAs supplement their income through locum tenens assignments, per diem shifts at multiple facilities, or ownership stakes in anesthesia group practices. The combination of clinical expertise, professional reputation, and negotiating leverage at this career stage pushes total compensation toward and sometimes beyond $300,000.

Factors That Affect CRNA Pay

Understanding the variables that influence compensation gives you leverage in career planning and salary negotiations. Here are the primary drivers, ranked roughly by impact.

Geographic Location

As the data above demonstrates, location accounts for the widest salary variance. The difference between the highest and lowest-paying states can exceed $80,000. Metro areas generally pay more than rural areas, though rural positions sometimes offer higher total packages to attract providers to underserved regions.

Practice Setting

Private practice and ambulatory surgery centers typically outpay hospitals, which in turn outpay academic medical centers. Locum tenens and travel CRNA positions often pay the highest per-diem rates, though they trade stability for higher compensation.

Experience and Specialization

Beyond general years of experience, specialization in high-demand areas like cardiac, pediatric, or obstetric anesthesia can command premium pay. CRNAs with niche expertise become harder to replace, strengthening their negotiating position.

Overtime, Call, and Weekend Differentials

Many CRNAs earn 15-30% above their base salary through call pay, overtime, and shift differentials. A CRNA willing to work nights, weekends, or heavy call schedules can significantly boost annual earnings. Some facilities pay $100-$200 per hour for call shifts, plus additional fees for cases performed during call.

Certifications and Credentials

While the NBCRNA certification is universal, additional credentials such as the Certified Surgical First Assistant (CSFA) or Nonsurgical Pain Management certification can differentiate a candidate and justify higher pay, particularly in specialized practice settings.

State Practice Authority

States with full practice authority often create market conditions that favor higher CRNA compensation. When CRNAs can practice independently, facilities rely more heavily on them, increasing demand and, by extension, salary potential.

States with Full Practice Authority

Practice authority refers to the degree of independence a CRNA has when administering anesthesia. In states with full practice authority (FPA), CRNAs can practice without physician supervision requirements, opening the door to independent practice, direct billing, and expanded roles in rural and underserved areas.

As of 2026, more than 20 states grant CRNAs some form of full practice authority or have opted out of the federal physician supervision requirement for Medicare anesthesia services. These states include Oregon, Wyoming, Montana, Idaho, Alaska, New Hampshire, Iowa, Nebraska, Kansas, and several others that have enacted legislation or regulatory changes in recent years.

Full practice authority affects earnings in several ways:

• Increased demand: Hospitals and surgery centers in FPA states can staff anesthesia departments more flexibly, often increasing the number of CRNA positions
• Rural practice premium: FPA states allow CRNAs to serve as sole anesthesia providers in rural facilities, which often pay premium salaries to attract and retain staff
• Independent practice revenue: CRNAs in FPA states can establish independent practices, bill directly for services, and retain a larger share of professional fees
• Negotiating leverage: When CRNAs can legally function independently, their value to any employer increases, strengthening their position in salary negotiations

Oregon and Wyoming, both FPA states, appear in the top 10 highest-paying list. While practice authority is not the sole factor driving their salaries, it contributes to the favorable market conditions CRNAs enjoy in those states.

CRNA vs. Anesthesiologist Salary Comparison

The salary comparison between CRNAs and physician anesthesiologists comes up frequently, and the raw numbers favor physicians. Anesthesiologists earn an average of $350,000 to $450,000 per year, with some exceeding $500,000 in private practice or high-demand specialties. That puts them roughly $150,000 to $250,000 ahead of CRNAs on an annual basis.

However, this comparison misses critical context. Anesthesiologists complete 12-14 years of post-secondary education and training (4 years medical school plus 4 years residency, often plus fellowship), compared to approximately 7-8 years for CRNAs (BSN, ICU experience, then 3 years doctoral program). Anesthesiologists also carry significantly more educational debt, often $250,000-$400,000 versus $100,000-$180,000 for CRNAs.

When researchers model lifetime earnings and factor in earlier career start, lower educational debt, and years of earning during the time an anesthesiologist is still in training, the gap narrows considerably. CRNAs begin earning a six-figure salary 5-7 years before their physician counterparts, accumulating substantial wealth during those years. For many, the CRNA path offers a stronger return on investment relative to the time and money invested in training.

Both professions offer excellent compensation, job security, and professional satisfaction. The right choice depends on individual goals, risk tolerance, and how much weight you place on practice independence versus the broader scope that comes with a medical degree. To explore the educational investment, see our CRNA school cost guide.

CRNA Salary Negotiation Tips

Whether you are a new graduate fielding your first offer or an experienced CRNA considering a move, negotiation directly impacts your lifetime earnings. A $10,000 improvement in starting salary compounds to over $300,000 in additional career earnings over 30 years. These strategies help you capture the compensation you deserve.

1. Research regional market rates before any conversation. Use BLS data, AANA salary surveys, and job postings to establish the going rate for your experience level in the target geography. Walk into negotiations with specific numbers, not vague expectations. Employers respect candidates who have done their homework.
2. Negotiate total compensation, not just base salary. Base pay is only one component. Evaluate signing bonuses, relocation packages, CME allowances, retirement matching, student loan repayment assistance, paid time off, and schedule flexibility. A lower base salary with a $40,000 signing bonus and $2,000/month student loan repayment may outperform a higher base with minimal benefits.
3. Quantify your call and overtime expectations upfront. Many CRNA contracts include call requirements that significantly affect both lifestyle and total pay. Ask specific questions: How many call shifts per month? What is the call rate? Is it beeper call or in-house? What is the average number of cases per call shift? These details can swing annual compensation by $20,000-$50,000.
4. Leverage competing offers respectfully. If you have multiple offers, use them as data points rather than ultimatums. A simple statement like "I have another offer in the range of X" provides the employer context to improve their offer without creating adversarial dynamics. Multiple offers also signal that you are a desirable candidate.
5. Negotiate a performance-based raise timeline. If the employer cannot meet your target starting salary, propose a 6- or 12-month review with a defined raise contingent on meeting performance benchmarks. This reduces the employer's risk while giving you a clear path to your target compensation. Get it in writing as part of your contract.
6. Consider non-compete clauses carefully. Many CRNA employment contracts include non-compete or non-solicitation clauses. These can limit your future earning potential if you need to leave. Negotiate the geographic radius, duration, and scope of any restrictive covenant before signing. A shorter non-compete or a narrower geographic restriction preserves your future flexibility.

Frequently Asked Questions

Data from Bureau of Labor Statistics, May 2024 Occupational Employment and Wage Statistics. Cost-of-living adjustments based on Bureau of Economic Analysis Regional Price Parities. Salary ranges for practice settings and experience levels reflect aggregated data from AANA surveys, job postings, and industry reports. Individual compensation may vary.