Radiologist Salaries in America’s 30 Largest Cities (After Tax & Cost of Living)

Radiologists earn some of the highest salaries in medicine — but taxes and cost of living can erase the advantage. Here’s where radiologists actually take home the most money.

Radiologists are among the highest-paid physicians in the United States, with many earning $500,000 to $600,000+ per year. But a big salary on paper doesn’t always translate into a high standard of living.

Taxes and cost of living can dramatically change how far that income actually goes. This article compares radiologist salaries in the 30 largest U.S. cities, focusing on:

• After-tax income
• Cost of living
• Real, cost-of-living–adjusted take-home pay

The results reveal some surprising winners — and some expensive cities where high salaries don’t stretch very far.

How This Comparison Was Calculated

To make the comparison meaningful, raw salaries alone weren’t enough. Here’s the approach used:

• Gross salary estimates are based on high-end physician compensation benchmarks from sources like Doximity, Medscape, and Salary.com, which consistently report average radiologist pay around $550,000 nationally, with variation by market.
• After-tax income accounts for federal taxes, payroll taxes, and state/local income taxes using realistic effective rates.
• Cost of living is adjusted using BLS Regional Price Parities (RPP), where the U.S. average equals 100.
• Real income reflects what a radiologist’s after-tax pay is actually worth in each city after adjusting for local prices.

In short: this shows where radiologists keep and spend the most, not just where they earn the most.

Radiologist Salaries After Tax and Cost of Living

The Cities Where Radiologists Take Home the Most

Some cities stand out for delivering exceptional real income once taxes and living costs are accounted for.

Top performers include:

• Oklahoma City
• Memphis
• Houston
• San Antonio
• Nashville

These cities benefit from a combination of:

• Lower housing costs
• Moderate cost of living
• Favorable or no state income taxes

In several cases, a radiologist earning a lower nominal salary here ends up with more real purchasing power than a peer earning $600,000+ in a coastal city.

High Salaries That Don’t Go Very Far

Not all high-paying cities are financial winners. Cities like San Francisco, San Jose, New York, Boston and San Diego offer some of the highest gross radiologist salaries in the country, but also impose: High state and local taxes, Extremely expensive housing and Above-average everyday costs. After adjusting for these factors, many of these cities fall near the bottom of the real income rankings.

A $620,000 salary in San Francisco, for example, can feel closer to $250,000–$260,000 in real purchasing power compared to the national average.

Why Texas Dominates the Rankings

Texas cities appear repeatedly near the top — and that’s no accident. Key reasons; No state income tax, Large hospital systems and strong demand for Radiologists, Cost of living still below many coastal metros

Cities like Houston, Dallas, Fort Worth, Austin, and San Antonio consistently outperform expectations once taxes and living costs are factored in.

For radiologists focused on wealth accumulation rather than prestige, Texas remains one of the strongest regions in the country.