Healthcare Salaries 2026: Where RNs Earn $90k+ with Comparison

Registered Nurses (RNs) in 2026 are essential to the healthcare workforce, with the U.S. Bureau of Labor Statistics projecting ~6% growth, adding ~177,400 jobs annually.  Average RN salaries have risen to $89,010 in 2022 (national mean) and are expected to reach $94,000–$96,000 by 2026 with 4-5% growth.  High-demand states offer $90,000–$120,000+ for experienced RNs (5+ years), including $5,000–$10,000 bonuses ($417–$833/month). Entry-level RNs earn $65,000–$80,000 ($5,417–$6,667/month), mid-level $85,000–$100,000 ($7,083–$8,333/month), and senior RNs $100,000–$130,000 ($8,333–$10,833/month). Total compensation includes overtime ($5,000–$15,000/year, $417–$1,250/month) and benefits ($10,000–$20,000, $833–$1,667/month). Below, the top 10 states where RNs earn $90k+ (or more) in 2026 — ranked by average salary (projected from 2024/2022 BLS data +4%), with base salary, total comp, cost-of-living index (COL, US average = 100), and net monthly pay after a 25% federal-tax estimate plus state tax where applicable.

1. California

• Average Salary: $133,340/year (~$11,112/month) — based on May 2022 data for RNs in California: $133,340 mean annual wage.  
• Base Salary Range Estimate: $120,000–$140,000 ($10,000–$11,667/month)
• Total Compensation Estimate (including bonus/overtime): $130,000–$160,000 ($10,833–$13,333/month, + $10,000 bonus)
• Cost-of-Living Index: ~140
• Approximate Net Monthly Pay: $7,500–$9,000 (after ~25% federal + ~9.3% state taxes)
• Why $90k+: California leads with the highest average salary for RNs in the U.S., thanks to high cost regions, acute care hospitals, premium pay for shifts, and strong demand.

2. Hawaii

• Average Salary: $106,530/year (~$8,878/month) — using May 2022 state mean for RNs.  
• Base Range Estimate: $95,000–$115,000 ($7,917–$9,583/month)
• Total Compensation Estimate: $105,000–$130,000 ($8,750–$10,833/month, + $8,000 bonus)
• Cost-of-Living Index: ~180
• Approximate Net Monthly Pay: $6,000–$7,500 (after ~25% federal + ~4.1% HI tax)
• Why $90k+: Hawaii’s island location, healthcare staffing pressures (tourism, remote locations) and premiums make it one of the few states where RN salaries comfortably exceed $100k.

3. Oregon

• Average Salary: $106,610/year (~$8,884/month) — from May 2022 data.  
• Base Range Estimate: $95,000–$115,000 ($7,917–$9,583/month)
• Total Compensation Estimate: $105,000–$130,000 ($8,750–$10,833/month, + $8,000 bonus)
• Cost-of-Living Index: ~120
• Approximate Net Monthly Pay: $6,500–$8,000 (after ~25% federal + ~9.9% OR tax)
• Why $90k+: Oregon has strong demand in healthcare, particularly in urban and near-coastal hospitals. Shift differentials, premium pay for acute care units add to compensation.

4. Alaska

• Average Salary: $99,110/year (~$8,259/month) — reported mean for RNs.  
• Base Range Estimate: $90,000–$110,000 ($7,500–$9,167/month)
• Total Compensation Estimate: $100,000–$125,000 ($8,333–$10,417/month, + $7,000 bonus)
• Cost-of-Living Index: ~130
• Approximate Net Monthly Pay: $6,250–$7,750 (after ~25% federal + 0% AK state tax)
• Why $90k+: Remote location premiums, higher cost of living, and acute-care demand make Alaska one of the limited but strong markets for RNs with six-figure earnings.

5. Massachusetts

• Average Salary: $98,780/year (~$8,232/month) — state mean for RNs.  
• Base Range Estimate: $90,000–$110,000 ($7,500–$9,167/month)
• Total Compensation Estimate: $100,000–$125,000 ($8,333–$10,417/month, + $7,000 bonus)
• Cost-of-Living Index: ~140
• Approximate Net Monthly Pay: $6,000–$7,500 (after ~25% federal + ~5% MA tax)
• Why $90k+: With major academic medical centers in Boston and Eastern Massachusetts, senior RNs and specialists can command salaries near $100k+.

6. Washington

• Average Salary: $98,300/year (~$8,192/month) — data from recent national reporting.  
• Base Range Estimate: $90,000–$110,000 ($7,500–$9,167/month)
• Total Compensation Estimate: $100,000–$125,000 ($8,333–$10,417/month, + $7,000 bonus)
• Cost-of-Living Index: ~120
• Approximate Net Monthly Pay: $6,250–$7,750 (after ~25% federal + 0% WA state tax)
• Why $90k+: Strong healthcare systems (especially in the Seattle/Tacoma region), shift premiums and specialized roles enable senior RNs to exceed $90k.

7. New York

• Average Salary: $97,320/year (~$8,110/month) — mean for statewide RNs.  
• Base Range Estimate: $90,000–$110,000 ($7,500–$9,167/month)
• Total Compensation Estimate: $100,000–$125,000 ($8,333–$10,417/month, + $7,000 bonus)
• Cost-of-Living Index: ~130
• Approximate Net Monthly Pay: $6,000–$7,500 (after ~25% federal + ~6.85% NY tax)
• Why $90k+: New York City metro and surrounding areas offer premium wages, especially for critical care, travel-nurse, or hospital-based RNs.

8. Nevada

• Average Salary: $96,670/year (~$8,056/month) — indicated in broader salary surveys.  
• Base Range Estimate: $85,000–$105,000 ($7,083–$8,750/month)
• Total Compensation Estimate: $95,000–$120,000 ($7,917–$10,000/month, + $6,000 bonus)
• Cost-of-Living Index: ~105
• Approximate Net Monthly Pay: $6,250–$7,750 (after ~25% federal + 0% Nevada state tax)
• Why $90k+: Las Vegas tourism/hospital staffing, plus lower overall cost of living compared to other high-pay states make Nevada a notable opportunity state for RNs.

9. New Jersey

• Average Salary: $96,480/year (~$8,040/month) — based on state salary surveys.
• Base Range Estimate: $85,000–$105,000 ($7,083–$8,750/month)
• Total Compensation Estimate: $95,000–$120,000 ($7,917–$10,000/month, + $6,000 bonus)
• Cost-of-Living Index: ~125
• Approximate Net Monthly Pay: $6,000–$7,500 (after ~25% federal + ~5.525% NJ tax)
• Why $90k+: Proximity to NYC metro, strong hospital systems, and union-negotiated wages help push RN salaries toward six figures in many roles.

10. District of Columbia

• Average Salary: $96,330/year (~$8,028/month) — as indicated in salary maps.  
• Base Range Estimate: $85,000–$105,000 ($7,083–$8,750/month)
• Total Compensation Estimate: $95,000–$120,000 ($7,917–$10,000/month, + $6,000 bonus)
• Cost-of-Living Index: ~140
• Approximate Net Monthly Pay: $6,000–$7,500 (after ~25% federal + ~8.5% DC tax)
• Why $90k+: Federal hospital demand, specialized roles and high-cost metro area lead to salary levels above many nationwide averages for RNs.

Factors Influencing $90k+ RN Salaries

• Experience & seniority: RNs with 5+ years, specialties (ICU/ER/OR), leadership roles can add $10,000–$20,000 ($833–$1,667/month) to base salary.
• Overtime/shift premium: Many hospitals offer 1.5× pay for nights/weekends; overtime alone can add $7,000–$14,000/year ($583–$1,167/month) or more.
• Bonuses/allowances: Signing bonuses, retention incentives, rural or remote premiums range from $5,000–$10,000/year ($417–$833/month).
• Cost of living (COL): High salaries in high-COL states offset higher expenses; net purchasing power may be lower despite higher nominal pay.
• Unionization and hospital system size: Larger hospital systems and unionized environments often negotiate higher pay.
• Geographic demand and shortage areas: States with high demand for RNs in understaffed units/in remote locations often pay premiums.
• Specialization & certification: Additional credentials (e.g., CCRN, CNOR) and advanced education (BSN, MSN) contribute to higher pay and opportunities.

Visa & Sponsorship Notes for RNs

• For international RNs seeking work in the U.S., visa options exist though they are more limited than other occupations. The U.S. Citizenship and Immigration Services (USCIS) sometimes approves EB-3 green cards for nurses in shortage categories.
• H-1B sponsorship is less common for RNs (due to standard roles rather than “specialty occupation” criteria).
• State licensure (through the National Council of State Boards of Nursing, NCLEX exams) and credential verification are required before employment and visa sponsorship.
  (Note: Always check the latest USCIS and state nursing board guidelines.)

Tips for RNs Aiming for $90k+ Salary

1. Choose your state/region wisely: Target states listed above (or comparable pay states) where RN salaries exceed $90k.
2. Pursue specialization: ICU, OR, ER, oncology, travel-nurse roles often pay more.
3. Negotiate for bonuses/shift pay: Don’t just accept base salary — ask about weekend/night pay, overtime, retention incentives.
4. Consider cost of living: A $100k salary in a low-COL state works out better than $120k in very high-COL area.
5. Advance your credentials: BSN or higher, certifications (e.g., CCRN) boost marketability and pay.
6. Stay open to relocation: Some states offer large pay premiums for RNs willing to relocate or work in underserved areas.
7. Track net monthly take-home: For example, an RN earning $100k might net ~$6,250/month after ~25% tax — plan accordingly.
8. Factor total compensation, not just base salary: Total comp = base + overtime + bonuses + benefits.

Statistics on RN Salaries & Projections

• Median annual wage for RNs was $93,600 in May 2024.  
• National mean annual wage was $89,010 in May 2022.  
• Across states, the top paying states for RNs (mean wage) included California ($133,340), Hawaii, Oregon etc.  
• Salary growth projections: Healthcare practitioners (which includes RNs) projected ~5%+ growth through 2034.  
• Adjusted for cost-of-living, some states with very high nominal wages still offer less purchasing power.  

For RNs aiming to break the $90k annual salary threshold in 2026 and beyond, location matters — as do specialization, shift flexibility, overtime willingness, and bonus-seeking. The ten states listed above illustrate where pay is already near or above the $90k mark for many RNs. However, remember that nominal salary is only one piece — cost of living, tax burden, total compensation, and workload are equally important.

If you like, I can expand the list beyond the top 10 states, showing all states where RNs cross the $90k mark (or are projected to by 2026), including hourly equivalents, and highlight travel-nurse or contract-nurse premiums as well.