Healthcare Recruiting
CRNA Salary by State 2026: Where Nurse Anesthetists Earn the Most
CRNAs are among the highest-compensated advanced practice providers in US healthcare. The national median salary for a full-time W2 CRNA in 2026 sits at approximately $215,000, but state-level variation is substantial — the gap between the top and bottom quartile states exceeds $50,000 in base compensation. Geography, practice model, call burden, and setting type all drive the spread.
National CRNA Salary Benchmarks (2026)
| Setting | Median W2 Base | Top 25% | Typical Sign-On |
|---|---|---|---|
| Hospital-employed, ACT model | $210,000 | $240,000 | $20,000–$40,000 |
| Hospital-employed, CRNA-only model | $225,000 | $260,000 | $25,000–$50,000 |
| Outpatient surgery center (ASC) | $205,000 | $235,000 | $15,000–$30,000 |
| Critical access / rural hospital | $230,000 | $275,000 | $30,000–$60,000 |
| Locum tenens / 1099 | N/A | N/A | $170–$220/hr + housing |
Sources: AANA 2024 Practice Profile Survey, Medscape 2025 APP Compensation Report, BLS OES May 2024.
Top 15 Highest-Paying States for CRNAs (2026)
| Rank | State | Median W2 Salary | Practice Model |
|---|---|---|---|
| 1 | California | $270,000+ | CRNA-only / independent |
| 2 | New Hampshire | $260,000+ | CRNA-only |
| 3 | Montana | $255,000+ | CRNA-only (rural premium) |
| 4 | Oregon | $250,000+ | CRNA-only / independent |
| 5 | Wyoming | $248,000+ | CRNA-only (rural premium) |
| 6 | Iowa | $245,000+ | CRNA-only |
| 7 | Idaho | $244,000+ | CRNA-only |
| 8 | Washington | $242,000+ | CRNA-only / independent |
| 9 | Minnesota | $240,000+ | CRNA-only |
| 10 | Wisconsin | $238,000+ | CRNA-only |
| 11 | Nevada | $235,000+ | Independent |
| 12 | Colorado | $233,000+ | CRNA-only |
| 13 | Kansas | $232,000+ | CRNA-only |
| 14 | Nebraska | $230,000+ | CRNA-only |
| 15 | South Dakota | $228,000+ | CRNA-only |
Why Practice Model Drives State-Level Pay
The single biggest driver of CRNA salary variance by state is practice model — specifically whether CRNAs can practice independently without physician oversight.
- CRNA-only / independent practice states (26 states have opted out of Medicare physician supervision requirement): These states, concentrated in the Midwest and rural West, have higher CRNA salaries because CRNAs run anesthesia departments independently. The supply constraint is more acute, and hospitals pay premium compensation to attract and retain.
- ACT (Anesthesiologist Care Team) model states: These include large markets like Florida, Texas, New York, and Pennsylvania. CRNAs in ACT settings earn well — typically $195,000–$230,000 — but the anesthesiologist oversight structure creates a ceiling on independent practice value and reduces the rural premium effect.
W2 vs. 1099 CRNA Earnings
The W2 vs. 1099 comparison requires after-tax, after-expense math to be meaningful:
| W2 ($225K base) | 1099 ($145/hr, 40 hrs/wk) | |
|---|---|---|
| Gross annual | $225,000 | $301,600 |
| Self-employment tax | Employer pays half (~$8K) | ~$21,000 (net SE tax) |
| Health insurance | Employer-provided (~$12K value) | Self-pay (~$9,600/yr) |
| Malpractice | Employer-provided (~$3K value) | Self-pay (~$3,000/yr) |
| Retirement match | ~$10,000 (3–4% match) | None (self-funded) |
| Effective total comp equivalent | ~$258,000 | ~$268,000 |
The break-even point varies by state tax situation, but at roughly $145–$155/hr, a 1099 CRNA and a $225,000 W2 CRNA have similar total comp. Above $160/hr, 1099 wins meaningfully — below $130/hr, W2 wins.
Key Markets: What CRNAs Actually Earn
Florida
Florida is a major CRNA market with above-average compensation driven by large surgical volumes at health systems like HCA, Advent Health, BayCare, and Naples-area facilities. ACT-model salaries typically range from $200,000–$235,000. Rural northwest Florida facilities (Pensacola, Panama City) pay higher to compensate for perceived isolation. Locum demand in Florida is high, with $155–$190/hr being the typical 1099 range for independent CRNA-only coverage at ASCs.
Texas
Texas is an ACT-model state. CRNAs in the major metros (Houston, Dallas-Fort Worth, San Antonio, Austin) earn $195,000–$230,000 W2. Rural Texas facilities, particularly in the Panhandle and Rio Grande Valley, offer $230,000–$260,000 with significant sign-on bonuses ($30,000–$50,000) to offset location.
Rural Midwest (Iowa, Wisconsin, Minnesota, Nebraska)
These states represent the highest rural CRNA compensation in the country. CRNA-only models are standard, facilities are small (critical access hospitals), and CRNAs serve as the sole anesthesia provider. Compensation frequently exceeds $240,000 W2 with generous benefit packages, flexible scheduling, and lower cost of living.
CRNA Salary Growth Trend
CRNA compensation has increased approximately 4–6% annually since 2020, outpacing both inflation and most other healthcare roles over the same period. Key drivers:
- Slow pipeline growth (CRNA programs are highly selective with 2–3 year wait lists at many schools)
- Retiring boomer CRNAs being replaced by a smaller graduating cohort
- Post-pandemic surgical volume recovery driving increased OR demand
- Rural hospital closures concentrating CRNA demand in fewer facilities
Browse CRNA positions at app.avahealth.co or source CRNA candidates at providers.avahealth.co.
Related: CRNA Salary Guide 2026, CRNA Interview Questions, How to Recruit CRNA Candidates, NP Salary by State.
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