The honest answer has two halves. On the paycheck, nursing assistants make the most money in Washington, Oregon and California, where the mean wage is $7,490 to $9,530 a year above the national average. Once you ask what that money buys, the map changes: California's wage buys less than North Dakota's, and small Midwestern and northern New England states climb into the top ten. This guide ranks every state both ways, using the Bureau of Labor Statistics' wage estimates for nursing assistants (May 2025) and the Bureau of Economic Analysis' regional price parities (2024), and then looks at the settings that pay CNAs the most wherever they live. Nothing here comes from self-reported salary sites.
The short answer
- Highest wages: Washington ($52,230 a year, $25.11 an hour), Oregon ($52,160) and California ($50,190). The lowest is Louisiana at $32,250.
- Pay that goes furthest: Oregon, Maine, Washington, North Dakota and Vermont. Measured at national prices, a nursing assistant in North Dakota ($43,330 on paper) is better off than one in California ($50,190).
- Best-paid setting: the federal executive branch ($54,690), then outpatient care centers ($48,460) and staffing agencies ($48,160). General hospitals pay about $1,000 a year more than skilled nursing facilities, where more CNAs work than anywhere else.
- National picture: 1,448,910 nursing assistants, a mean wage of $42,700 ($20.53 an hour) and a median of $42,260. The top 10% earn more than $51,980.
Open CNA postings from hospital and health-system career sites are on the CNA jobs hub; every state in the tables below links to its own page there.
Which states pay CNAs the most on paper?
By the BLS mean annual wage, the ten highest-paying jurisdictions, the District of Columbia among them, all average above the national 75th percentile of $47,220. Washington leads, Oregon is $70 behind, and the rest of the top ten is the Pacific coast, the Northeast and Colorado:
- Washington: $52,230 a year ($25.11 an hour), median $49,180
- Oregon: $52,160 a year ($25.08 an hour), median $49,830
- California: $50,190 a year ($24.13 an hour), median $47,630
- New Hampshire: $49,290 a year ($23.70 an hour), median $47,870
- Alaska: $48,920 a year ($23.52 an hour), median $46,370
- New York: $48,800 a year ($23.46 an hour), median $48,590
- District of Columbia: $47,930 a year ($23.04 an hour), median $47,700
- Massachusetts: $47,700 a year ($22.93 an hour), median $46,680
- Maine: $47,510 a year ($22.84 an hour), median $47,070
- Colorado: $47,400 a year ($22.79 an hour), median $47,380
Every state's mean, median and hourly wage, in headline order, is in our CNA pay by state guide. The table below ranks the same states a second way.
Where CNA pay goes furthest
A wage is only worth what it buys. The Bureau of Economic Analysis publishes a regional price parity for every state: how much goods, housing and services cost there compared with the national average, which is set at 100. California is the most expensive state at 110.7 and Arkansas the cheapest at 86.9. Dividing each state's mean CNA wage by its parity gives "pay at national prices": what the wage would be worth in a state with average costs. The table ranks all 50 states and the District of Columbia by that figure, with the headline (unadjusted) rank next to it so you can see who moves.
| # | State | Mean annual wage | Price level (U.S. = 100) | Pay at national prices | Headline rank | Change |
|---|---|---|---|---|---|---|
| 1 | Oregon | $52,160 | 103.4 | $50,464 | 2 | +1 |
| 2 | Maine | $47,510 | 97.0 | $48,954 | 9 | +7 |
| 3 | Washington | $52,230 | 107.0 | $48,807 | 1 | -2 |
| 4 | North Dakota | $43,330 | 89.0 | $48,708 | 22 | +18 |
| 5 | Vermont | $46,850 | 98.0 | $47,827 | 11 | +6 |
| 6 | Alaska | $48,920 | 102.4 | $47,793 | 5 | -1 |
| 7 | Wisconsin | $44,600 | 94.1 | $47,399 | 20 | +13 |
| 8 | New Hampshire | $49,290 | 104.2 | $47,319 | 4 | -4 |
| 9 | Iowa | $41,490 | 87.8 | $47,276 | 28 | +19 |
| 10 | Nebraska | $42,390 | 90.1 | $47,046 | 25 | +15 |
| 11 | Minnesota | $46,030 | 98.6 | $46,674 | 14 | +3 |
| 12 | Colorado | $47,400 | 103.1 | $45,996 | 10 | -2 |
| 13 | Montana | $43,160 | 94.6 | $45,602 | 24 | +11 |
| 14 | California | $50,190 | 110.7 | $45,331 | 3 | -11 |
| 15 | Rhode Island | $46,360 | 102.3 | $45,327 | 13 | -2 |
| 16 | Illinois | $45,230 | 100.0 | $45,249 | 17 | +1 |
| 17 | New York | $48,800 | 107.9 | $45,218 | 6 | -11 |
| 18 | Massachusetts | $47,700 | 105.8 | $45,103 | 8 | -10 |
| 19 | Pennsylvania | $43,960 | 97.6 | $45,054 | 21 | +2 |
| 20 | Nevada | $44,900 | 100.0 | $44,909 | 18 | -2 |
| 21 | New Mexico | $41,400 | 92.2 | $44,897 | 31 | +10 |
| 22 | Wyoming | $41,470 | 92.7 | $44,740 | 30 | +8 |
| 23 | South Dakota | $39,510 | 88.6 | $44,601 | 36 | +13 |
| 24 | Arizona | $44,820 | 100.7 | $44,519 | 19 | -5 |
| 25 | Kansas | $39,730 | 90.1 | $44,111 | 35 | +10 |
| 26 | Connecticut | $45,440 | 103.6 | $43,857 | 16 | -10 |
| 27 | Ohio | $40,520 | 92.8 | $43,676 | 32 | +5 |
| 28 | District of Columbia | $47,930 | 109.9 | $43,612 | 7 | -21 |
| 29 | Kentucky | $39,170 | 90.2 | $43,445 | 38 | +9 |
| 30 | Michigan | $41,490 | 96.2 | $43,121 | 29 | -1 |
| 31 | Indiana | $40,200 | 93.3 | $43,073 | 34 | +3 |
| 32 | New Jersey | $46,810 | 108.8 | $43,022 | 12 | -20 |
| 33 | Delaware | $42,290 | 99.8 | $42,371 | 26 | -7 |
| 34 | Missouri | $38,410 | 90.8 | $42,294 | 43 | +9 |
| 35 | West Virginia | $37,490 | 89.5 | $41,890 | 45 | +10 |
| 36 | Virginia | $42,160 | 101.1 | $41,700 | 27 | -9 |
| 37 | North Carolina | $39,280 | 94.3 | $41,643 | 37 | 0 |
| 38 | Tennessee | $38,230 | 91.9 | $41,613 | 44 | +6 |
| 39 | Hawaii | $45,710 | 110.0 | $41,573 | 15 | -24 |
| 40 | Maryland | $43,310 | 105.0 | $41,264 | 23 | -17 |
| 41 | Idaho | $39,100 | 95.5 | $40,945 | 40 | -1 |
| 42 | Utah | $40,450 | 98.9 | $40,915 | 33 | -9 |
| 43 | Oklahoma | $35,920 | 87.8 | $40,891 | 47 | +4 |
| 44 | Georgia | $38,760 | 96.3 | $40,252 | 42 | -2 |
| 45 | Texas | $38,780 | 97.1 | $39,956 | 41 | -4 |
| 46 | South Carolina | $37,390 | 93.7 | $39,883 | 46 | 0 |
| 47 | Arkansas | $33,970 | 86.9 | $39,074 | 48 | +1 |
| 48 | Alabama | $33,670 | 88.8 | $37,907 | 49 | +1 |
| 49 | Florida | $39,160 | 103.4 | $37,867 | 39 | -10 |
| 50 | Mississippi | $32,890 | 87.0 | $37,825 | 50 | 0 |
| 51 | Louisiana | $32,250 | 88.2 | $36,562 | 51 | 0 |
The wages are the BLS May 2025 estimates; the price levels are BEA's figures for 2024, the newest year published. A state's parity is a statewide average, so a nursing assistant in a big city faces higher prices than the state figure and one in a rural county lower.
Who climbs
Oregon keeps a top spot either way: its wage is the second highest in the country and its prices are only a little above average, so it ends up first. The big climbers are states that pay a middling wage where living is cheap:
- Iowa: $41,490 on paper, $47,276 at national prices, up from #28 to #9
- North Dakota: $43,330 on paper, $48,708 at national prices, up from #22 to #4
- Nebraska: $42,390 on paper, $47,046 at national prices, up from #25 to #10
- Wisconsin: $44,600 on paper, $47,399 at national prices, up from #20 to #7
- South Dakota: $39,510 on paper, $44,601 at national prices, up from #36 to #23
- Montana: $43,160 on paper, $45,602 at national prices, up from #24 to #13
North Dakota, Vermont, Wisconsin, Iowa and Nebraska make the adjusted top ten from outside the headline top ten: ordinary wages, below-average prices.
Who falls
The states with the highest prices lose the most ground. Hawaii pays the 15th highest wage in the country and ranks 39th once prices are counted, and California drops from #3 to #14:
- Hawaii: $45,710 on paper, $41,573 at national prices, down from #15 to #39
- District of Columbia: $47,930 on paper, $43,612 at national prices, down from #7 to #28
- New Jersey: $46,810 on paper, $43,022 at national prices, down from #12 to #32
- Maryland: $43,310 on paper, $41,264 at national prices, down from #23 to #40
- California: $50,190 on paper, $45,331 at national prices, down from #3 to #14
- New York: $48,800 on paper, $45,218 at national prices, down from #6 to #17
Florida deserves a note of its own: it has the second-largest CNA workforce in the country, a wage below the national mean and prices above it, so at national prices a Florida nursing assistant's pay ($37,867) is close to Louisiana's ($36,562), the lowest in the table. Washington, California, New York and Massachusetts still sit in the upper half after the adjustment; their wages are high enough to carry their prices. The states to be careful with are the ones whose wage looks good only next to the national average: Hawaii, District of Columbia, New Jersey and Maryland.
Where the jobs are, and what they pay
Pay and headcount rarely line up. The six states with the most nursing assistants hold more than a third of the national total, and only two of them are in the headline top ten on pay:
- California: 110,060 CNAs, mean $50,190, $45,331 at national prices (#14)
- Florida: 96,960 CNAs, mean $39,160, $37,867 at national prices (#49)
- Texas: 88,680 CNAs, mean $38,780, $39,956 at national prices (#45)
- New York: 87,990 CNAs, mean $48,800, $45,218 at national prices (#17)
- Illinois: 68,640 CNAs, mean $45,230, $45,249 at national prices (#16)
- Pennsylvania: 67,740 CNAs, mean $43,960, $45,054 at national prices (#19)
Illinois is the quiet winner of the six: a large market, a wage above the national mean and prices right at the national average, so it barely moves after the adjustment. Where the openings are by state and metro, and how concentrated the market is, is in where the CNA jobs are.
Which settings pay CNAs the most?
Inside any state the setting moves pay as much as the state line does. National mean annual wages for nursing assistants by industry, May 2025, best paid first:
| Setting | Mean annual wage | CNAs employed |
|---|---|---|
| Federal executive branch | $54,690 | 14,560 |
| Outpatient care centers | $48,460 | 15,440 |
| Employment services (staffing and agency work) | $48,160 | 48,300 |
| Specialty hospitals (except psychiatric and substance abuse) | $45,340 | 28,810 |
| State government (excluding schools and hospitals) | $45,150 | 12,830 |
| Local government (excluding schools and hospitals) | $44,760 | 19,500 |
| Psychiatric and substance abuse hospitals | $44,110 | 7,700 |
| General medical and surgical hospitals | $43,350 | 442,820 |
| Nursing care facilities (skilled nursing facilities) | $42,280 | 534,270 |
| Offices of physicians | $42,050 | 25,030 |
| Continuing care retirement communities and assisted living facilities | $41,090 | 161,150 |
| Home health care services | $39,420 | 70,770 |
| Individual and family services | $36,220 | 32,110 |
Three things to take from it. The federal executive branch, mostly the medical centers of the Department of Veterans Affairs, pays $11,990 above the national mean and more than any state's average; outpatient centers and staffing agencies are next. General hospitals ($43,350) pay more than skilled nursing facilities ($42,280), which pay more than assisted living and home health. And the settings that pay the most employ the fewest people: the federal government, outpatient centers and agencies together employ about 78,000 nursing assistants against 534,270 in nursing homes alone.
How CNAs earn more without moving
- Change the setting before the state. Moving from a home health agency ($39,420) to a general hospital ($43,350) is worth about $4,000 a year on the national averages, roughly the gap between a mid-table state and a top-ten one, with no change of address and no transfer of your certification.
- Look at federal and agency work. Veterans Affairs medical centers hire nursing assistants in every state on the federal pay scale, and staffing agencies pay a premium for flexibility, usually without the benefits and the guaranteed hours of a staff job. Both are in the table above.
- Shifts and overtime. Night, weekend and holiday differentials and overtime are inside every average above. A hospital CNA on nights in a mid-ranked state routinely earns more than the state's mean; the BLS does not publish differentials separately, so ask about them in the interview.
- The next license. The BLS median for licensed practical nurses was $64,400 in the same survey, $22,000 above the nursing assistant median, and the registered nurse median ($97,550) is more than double it. Some hospitals pay for the bridge program; see the highest-paying nursing jobs.
Job outlook for nursing assistants
The BLS Occupational Outlook Handbook counts 1,505,900 nursing assistant jobs in 2025 and projects employment to grow 3% from 2025 to 2035, about as fast as the average for all occupations. The larger number is turnover: about 203,300 openings a year are projected for nursing assistants and orderlies together over the decade, most of them to replace workers who move into nursing school, change occupations or leave the labor force. The Handbook puts the nursing assistant median at $42,260 and the orderly median at $38,290 for 2025, and notes that nursing assistants typically complete a state-approved education program and pass their state's competency exam to be certified.
What the numbers don't tell you
- Means are not offers. The national spread from the 10th to the 90th percentile is $33,940 to $51,980, wider than the gap between most states. Years in the role, the setting and the shift decide where you land in that range.
- Prices are statewide. A regional price parity averages a whole state. California's coastal metros cost far more than its Central Valley, and New York is two different markets. The CNA pay calculator adjusts a salary for a specific city or ZIP code, its state income tax and its rent.
- Taxes are not in the table. Washington, Alaska, Nevada, Texas, Florida, South Dakota, Wyoming and Tennessee have no state income tax on wages, which widens their lead a little over neighbors that do; Oregon and California tax wages. The calculator handles that too.
- Your certification does not travel on its own. There is no multistate compact for nursing assistants. Each state keeps its own nurse aide registry, and most list a CNA who is active and in good standing elsewhere through a reciprocity application rather than a new program. Check the destination registry before you give notice; our guide to becoming an LPN or CNA in Florida walks through one state's process.
- Two different years. The wages are from May 2025 and the price parities from 2024, the newest year BEA has published. Prices rose everywhere in between, so treat the adjusted figures as a ranking, not a budget.
Sources
- U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, occupation profile for Nursing Assistants (31-1131), May 2025 national, state and industry estimates, read 22 October 2026.
- U.S. Bureau of Economic Analysis, Regional Price Parities by State and Metro Area, all items, 2024 (released February 2026), read 28 October 2026.
- U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Nursing Assistants and Orderlies, 2025 pay and 2025-35 projections, read 28 October 2026.
Frequently asked questions
Which state pays CNAs the most?
Washington. The BLS May 2025 mean annual wage for nursing assistants in Washington is $52,230 ($25.11 an hour), followed by Oregon ($52,160) and California ($50,190). The national mean is $42,700.
Where does a CNA's pay go furthest?
Oregon. Dividing each state's BLS mean wage by its BEA regional price parity, Oregon's $52,160 is worth $50,464 at national prices, ahead of Maine ($48,954), Washington ($48,807) and North Dakota ($48,708). California, the third-highest payer on paper, ranks 14th once its prices are counted.
Which setting pays CNAs the most?
The federal executive branch, with a national mean of $54,690 in May 2025, followed by outpatient care centers ($48,460) and staffing agencies ($48,160). General hospitals average $43,350 and skilled nursing facilities, the largest employer, $42,280.
Do CNAs in California really make the most money?
On paper California is the third-highest-paying state at $50,190, but it is also the most expensive state to live in (price level 110.7 against a national 100). At national prices its wage is worth $45,331, 14th of 51. North Dakota, which pays $43,330, comes out ahead at $48,708.
What is the average CNA salary in the United States?
The BLS May 2025 mean annual wage for nursing assistants is $42,700 ($20.53 an hour) and the median is $42,260. Half of nursing assistants earn between $37,260 and $47,220; the top 10% earn more than $51,980.
