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Updated July 2026 · 10 min read

This article was created with AI assistance.

CRNA Salary by State 2026

Financial Disclaimer: Salary figures are based on BLS data, AANA salary surveys, and industry sources. Actual compensation varies by employer, practice model, case mix, and experience. Verify with current AANA or BLS data before making career decisions.

CRNAs are consistently among the highest-paid advanced practice providers in the United States, with a national median salary well above $200,000. But the spread between the highest- and lowest-paying states exceeds $100,000, and practice model — independent vs. anesthesiologist-supervised, solo vs. group practice — creates even wider variation than geography alone. Here is the full breakdown for 2026.

National median: Certified Registered Nurse Anesthetists earn a national median of approximately $212,000 to $230,000 per year in 2026, according to BLS and AANA data. Top earners in independent states with rural recruitment incentives regularly exceed $350,000 to $400,000+.

CRNA Salary by State — Top 15 Highest Paying

StateMedian CRNA SalaryKey Factor
Montana$280,000–$320,000Full opt-out state; rural premium; physician shortage
Wyoming$275,000–$315,000Full opt-out; rural critical access hospitals
Iowa$265,000–$300,000Full opt-out; rural demand; low cost of living
Nebraska$260,000–$295,000Full opt-out; rural hospital dependency
North Dakota$255,000–$295,000Full opt-out; physician shortage; remote premium
Alaska$260,000–$310,000Remote premium; no state income tax; full scope
Wisconsin$250,000–$285,000Opt-out state; strong rural hospital market
Minnesota$245,000–$280,000Strong rural presence; competitive academic market
California$240,000–$290,000High cost of living; competitive hospital market
Oregon$235,000–$270,000Opt-out; Portland market plus rural
Washington$230,000–$265,000No state income tax; Seattle and rural markets
Texas$220,000–$260,000No state income tax; large hospital systems
Florida$215,000–$255,000No state income tax; growing market
Arizona$210,000–$250,000Opt-out state; growing Phoenix metro
Colorado$210,000–$248,000Opt-out; rural mountains; Denver market

Why Opt-Out States Pay More

States that have opted out of the federal Medicare anesthesiologist supervision requirement — allowing CRNAs to practice independently without physician oversight — typically have higher CRNA salaries for two reasons. First, CRNAs in these states carry the full anesthesia responsibility and are billed as the sole provider, capturing the full anesthesia fee rather than splitting it with a supervising anesthesiologist. Second, opt-out states are disproportionately rural, where physician (and anesthesiologist) shortages create strong demand and scarcity-driven premiums. As of 2026, approximately 20 states have exercised the opt-out option. See our CRNA opt-out states guide for the complete list.

Independent Practice vs. Anesthesia Care Team

In Anesthesia Care Team (ACT) models — where an anesthesiologist medically directs 2 to 4 CRNAs — CRNA compensation is typically lower because billing is shared and the anesthesiologist captures a portion of the professional fee. In independent practice settings (common in rural critical access hospitals and ambulatory surgery centers in opt-out states), the CRNA bills as the sole anesthesia provider and retains the full fee. For self-employed or group-practice CRNAs, gross billings can reach $500,000 to $700,000 per year; after overhead and malpractice insurance, net income exceeds $300,000 to $400,000.

Locum / Travel CRNA Pay

Locum tenens and travel CRNAs consistently earn premium rates — often $200 to $350 per hour plus housing and travel stipends. For a CRNA willing to take 13-week travel contracts, total annual compensation can reach $350,000 to $500,000 or more. The trade-off: no benefits, self-employment tax on 1099 income, licensing fees in multiple states, and the administrative overhead of managing your own taxes and retirement accounts as an independent contractor.

CRNA vs. Anesthesiologist Income

ProviderMedian Annual PayTraining DurationEducation Cost
CRNA$212,000–$230,0007–8 years (BSN + ICU + CRNA school)$60,000–$200,000
Anesthesiologist (MD)$330,000–$400,00012–14 years (undergrad + med school + residency + fellowship)$250,000–$400,000+

CRNAs earn roughly 55 to 70 percent of an anesthesiologist's median salary with dramatically less training time and debt. The ROI calculation strongly favors the CRNA path for most nurses who want to specialize in anesthesia. See our detailed CRNA school cost vs. ROI analysis.

Highest CRNA income scenario: A CRNA in a full opt-out rural state, working independently or in a small group practice, in a critical access hospital or ambulatory surgery center, billing their own cases. This combination — independent billing, rural scarcity premium, no state income tax if in Wyoming, Alaska, or similar — can produce $300,000 to $450,000 in net income with a lifestyle that's more autonomous than urban hospital employment.

Related: CRNA job outlook 2026-2030, CRNA school cost vs ROI, CRNA moonlighting income potential, ICU to CRNA transition guide.

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