Highest Paying States for CNAs / Nursing Assistants (2026): Where CNAs Earn the Most
The highest paying state for CNAs is Washington at $53,711 average median salary in 2026, based on BLS OEWS data across 52 states and 1686+ metro areas. CNA pay varies from Puerto Rico ($24,335) to Washington ($53,711) — driven by SNF reimbursement, hospital vs LTAC mix, and state minimum wage.
Best States for CNA / Nursing Assistant Salary: 2026 Rankings
CNA pay variance is driven by SNF Medicare reimbursement, hospital vs LTAC vs home health mix, state minimum wage floors, COL, and state income tax. Washington leads at $53,711, while Puerto Rico sits at $24,335.
Top-Tier States
- Alaska ($45,000-$55,000) — chronic shortage + no state income tax + IHS premium + rural housing assistance.
- California ($42,000-$52,000) — high state minimum wage ($16-$20/hr by metro). SF Bay Area / LA top.
- New York ($40,000-$50,000) — NYC + Long Island premium. SEIU 1199 union.
- Massachusetts ($40,000-$48,000) — Boston academic + strong LTAC.
- Washington ($40,000-$48,000) — Seattle + no state income tax.
- Hawaii ($40,000-$48,000) — shortage + high COL.
Mid-Tier Markets
- Oregon ($38,000-$46,000) — Portland + strong SNF.
- Nevada ($38,000-$45,000) — Las Vegas + no state income tax.
- Connecticut ($38,000-$45,000) — Fairfield + Hartford.
- New Jersey ($38,000-$45,000) — Bergen / Morris commuter premium.
- Minnesota ($36,000-$44,000) — Twin Cities + Mayo.
- Colorado ($35,000-$42,000) — Denver / Boulder.
- Arizona ($32,000-$40,000) — Phoenix retiree demand.
Setting Premium Markets
- Hospital CNA (acute care) — premium hospital benefits.
- SNF CNA (Medicare reimbursement) — premium hourly.
- Home Health Aide / CHHA — premium per-visit.
- LTAC CNA — premium specialty.
- PCT (Patient Care Tech) hospital — premium acute care.
- Travel CNA contracts — premium hourly + per-diem.
- Federal VA / DoD / IHS — pension + PSLF + premium federal.
- Correctional health CNA — premium contract.
2026 State Ranking Methodology
Rankings reflect 2026 projected median from BLS OEWS 2025. State minimum wage floors + SNF Medicare reimbursement materially affect pay. CNA-to-LPN-to-RN bridge accelerates earnings.
2019 BLS
$29,660
2025 BLS
$42,260
2026 Current Est.
$45,007
2019–2027 Growth
+61.6%
National Average for Context
2019–2025: BLS OEWS actual data. 2026+: CAGR 6.50% projection.
| Year | Median Annual Salary | Status |
|---|---|---|
| 2019 | $29,660 | Actual |
| 2020 | $30,850 | Actual |
| 2021 | $30,310 | Actual |
| 2022 | $35,760 | Actual |
| 2023 | $38,200 | Actual |
| 2024 | $39,530 | Actual |
| 2025 | $42,260 | Actual |
| 2026(current) | $45,007 | Estimated |
| 2027 | $47,932 | Projected |
Understanding the national salary trend helps contextualize state-level differences. The national median provides a baseline for comparing how each state's certified nursing assistant pay stacks up.
Note: BLS actual data is sourced from the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey. Estimated and projected values are calculated using a 6.50% historical CAGR. Actual compensation may vary based on employer, experience, certifications, and local market conditions.
Top 10 Highest Paying States for Certified Nursing Assistants
What Drives State-Level CNA Pay Differences
Five primary factors explain CNA state-level pay variance.
1. State Minimum Wage Floor (25-35%)
- State minimum wage — CA $16-$20/hr, WA $16.66, NY $15-$16, MA $15. Direct floor on CNA pay.
- Federal minimum $7.25 — applies in 20+ states with no state floor.
- Local city minimums (SF $18.67, NYC $16, Seattle $19) — additional floor.
- Medicaid SNF rate compression — limits how much SNFs can raise CNA pay.
2. Cost of Living (25-35%)
- HCOL markets command premium.
- RPP from BEA — CA 113, MS 86.
- Housing dominant.
- COL-adjusted real income — Texas / Tennessee often beat California net.
3. Setting Mix: Hospital / SNF / Home Health (15-20%)
- Hospital CNA / PCT (acute care) — premium benefits.
- SNF CNA (Medicare-driven) — premium hourly.
- Home Health Aide / CHHA — premium per-visit.
- LTAC CNA — premium specialty.
- Hospice CNA — premium niche.
- Correctional health — premium contract.
4. State Income Tax (5-10% take-home)
- No state income tax — AK, WA, TX, FL, TN, NV, SD, WY, NH.
- High state income tax — CA, NY, OR, MN, HI.
- NYC + Philadelphia local — additional 3-4%.
- Property + sales tax — TX, NJ property tax tradeoff.
5. SEIU + Union Density (5-10%)
- SEIU 1199 (NY, NJ, CT) — premium union contracts.
- SEIU UHW (CA) — strong CA contracts.
- Non-union states — wider salary range.
- Hospital union vs non-union — 10-20% premium union.
- SNF union density (NY, IL) — premium.
Where Do Certified Nursing Assistants Get Paid the Most?
Complete ranking of all 52 states by average certified nursing assistant salary. Click any state to see city-level breakdowns and detailed data.
| Rank | State | Avg Salary |
|---|---|---|
| 1 | Washington | $53,711 |
| 2 | Oregon | $52,903 |
| 3 | California | $51,757 |
| 4 | Vermont | $51,077 |
| 5 | Maine | $51,049 |
| 6 | Colorado | $51,001 |
| 7 | New York | $50,490 |
| 8 | Massachusetts | $50,116 |
| 9 | Minnesota | $49,969 |
| 10 | New Hampshire | $49,317 |
| 11 | Rhode Island | $49,296 |
| 12 | New Jersey | $48,913 |
| 13 | Illinois | $48,821 |
| 14 | District of Columbia | $48,702 |
| 15 | Nevada | $48,609 |
| 16 | Hawaii | $48,596 |
| 17 | Alaska | $48,282 |
| 18 | Wisconsin | $47,735 |
| 19 | Pennsylvania | $47,576 |
| 20 | Connecticut | $47,476 |
| 21 | Arizona | $47,341 |
| 22 | North Dakota | $45,388 |
| 23 | Maryland | $45,379 |
| 24 | Wyoming | $44,930 |
| 25 | Iowa | $43,701 |
| 26 | Virginia | $43,417 |
| 27 | Kentucky | $43,401 |
| 28 | Montana | $43,106 |
| 29 | New Mexico | $42,991 |
| 30 | Ohio | $42,757 |
| 31 | Michigan | $42,654 |
| 32 | Delaware | $42,290 |
| 33 | Nebraska | $42,189 |
| 34 | Utah | $42,130 |
| 35 | North Carolina | $41,547 |
| 36 | Idaho | $41,525 |
| 37 | South Dakota | $41,491 |
| 38 | Missouri | $41,408 |
| 39 | Georgia | $41,028 |
| 40 | Tennessee | $40,880 |
| 41 | Indiana | $40,571 |
| 42 | Kansas | $40,070 |
| 43 | South Carolina | $40,060 |
| 44 | Florida | $40,031 |
| 45 | Texas | $39,680 |
| 46 | Oklahoma | $38,902 |
| 47 | West Virginia | $38,834 |
| 48 | Arkansas | $36,817 |
| 49 | Alabama | $36,227 |
| 50 | Louisiana | $34,134 |
| 51 | Mississippi | $33,757 |
| 52 | Puerto Rico | $24,335 |
Lowest Paying States for Certified Nursing Assistants
Even the lowest-paying states offer certified nursing assistant salaries well above the national average for all occupations. Here are the 5 lowest-paying states:
Top Earner Potential by State
The 90th percentile represents what experienced, highly-skilled certified nursing assistants earn in each state. These are the 10 states with the highest earning ceilings:
| # | State | Top Earner (P90) |
|---|---|---|
| 1 | Washington | $67,640 |
| 2 | California | $65,235 |
| 3 | Oregon | $64,980 |
| 4 | Vermont | $63,888 |
| 5 | Maine | $63,063 |
| 6 | Massachusetts | $62,080 |
| 7 | Arizona | $61,674 |
| 8 | New York | $61,516 |
| 9 | New Hampshire | $61,370 |
| 10 | Alaska | $60,952 |
How to Move to a Higher-Paying State for CNA Work
Relocating for CNA pay requires balancing nominal salary against state minimum wage, setting mix, COL, and state tax. Here is the playbook.
1. Verify State CNA Certification + Registry
- State-approved CNA training (75-180 hours) — required. Varies by state.
- State CNA exam (written + skills) — required entry.
- State CNA registry listing — required to work.
- Reciprocity between states — most states accept out-of-state CNA with reciprocity.
- Federal Nurse Aide Registry (NAR) — universal.
- BLS / CPR certification — required.
- Background check + fingerprint — typical.
- Continuing education requirements — vary by state.
2. Calculate Real Take-Home, Not Nominal
- COL-adjusted income — Texas CNA at $35,000 may exceed California CNA at $48,000 net.
- State + local income tax — effective rate.
- Property + sales tax — TX tradeoff.
- Childcare cost spread — major variance.
- Health + benefits — hospital vs SNF vs LTAC.
- 401(k) match (hospital) vs pension (federal/state) — long-term.
- Commute cost — urban vs rural.
3. Target Hospital PCT or Travel CNA Premium
- Hospital PCT / acute care CNA — premium benefits.
- SNF CNA (Medicare-driven) — premium hourly.
- Home Health Aide / CHHA — premium per-visit.
- LTAC CNA — premium specialty.
- Hospice CNA — premium niche.
- Correctional health — premium contract.
- Travel CNA (15-30% premium hourly) — premium.
- Per-diem (PRN) supplemental — $22-$32/hour senior CNAs.
4. Negotiate Sign-On + CNA-to-LPN Path
- Sign-on bonus ($500-$3,000) — common at shortage.
- Relocation assistance ($500-$2,000) — standard.
- Tuition reimbursement (CNA-to-LPN-to-RN bridge) — premium at hospital systems.
- PSLF stack (501(c)(3) + government) — 10-year forgiveness on remaining loans.
- Shift differential (night, weekend) — 10-30% premium.
- SEIU union shop premium — 10-20% above non-union.
- Hazard / certification stipend — premium specialty.
- Federal employer (VA, DoD, IHS) — pension + PSLF + premium.
5. Choose Setting Based on Career Plan
- Hospital PCT (acute care benefits) — premium benefits + CNA-to-LPN path.
- SNF CNA (Medicare-driven income) — premium hourly.
- Home Health Aide / CHHA — premium per-visit.
- LTAC CNA — premium specialty.
- Hospice CNA — premium niche.
- Correctional health — premium contract.
- Federal VA / DoD / IHS — pension + PSLF.
- Travel CNA / per-diem — premium hourly.
- CNA-to-LPN-to-RN-to-BSN bridge — premier long-term wealth.
- SEIU union shop (NY, NJ, CA) — premium contract.
Additional Geographic + Lifestyle Considerations
- Climate fit + lifestyle preference — extreme heat (TX, FL, AZ) vs winter (MN, ME, AK) — major lifestyle differential beyond paycheck.
- School district quality (for families with children) — major hidden cost. Top suburban districts in NJ / NY / MA / CA add significant value.
- Healthcare access + cost-of-living index — verify metro-specific data on BLS / BEA.
- Spousal employment market — coordinate timing with partner career.
- Aging parent proximity — major life consideration.
- Network + alumni density (professional + social) — major.
- Recreation + outdoor access — varies dramatically by state.
- State + local political climate fit — major lifestyle differential.
More Salary Resources
Frequently Asked Questions
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Written by Emily Chen, BSN, RN
Career Analyst
Emily has over 10 years of experience in nursing. She focuses on workforce trends in nursing. Emily has worked in various healthcare settings, including hospitals and long-term care facilities.
Methodology & Data Source
State salary rankings on this page are 2026 projections based on the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey, May 2026 release. A 6.50% compound annual growth rate (CAGR), derived from 6-year national BLS wage trends, was applied to each state's average salary. Cost-of-living adjustments use BEA Regional Price Parity data. Individual pay varies by city, employer, certifications, and experience.
Data Sources & Methodology
Source: BLS, OEWS , released .
Compiled and verified by Emily Chen, BSN, RN, a licensed certified nursing assistant with 10+ years of clinical experience. · View source data at BLS.gov