Registered Nurse Salaries in America’s Major Cities: How Much RNs Really Take Home After Cost of Living (2025)
Registered nurse salaries vary widely across major U.S. cities. This comparison reveals where RNs earn the most—and where their income stretches furthest after cost of living.
Registered nurses are in high demand across the United States, but the value of an RN’s paycheck varies dramatically depending on where they work. Two nurses earning similar salaries on paper can experience completely different lifestyles depending on their city’s housing costs, taxes, and everyday expenses.
This analysis compares RN median annual salaries across major U.S. cities and adjusts them for local cost of living, resulting in a “real value” or purchasing-power equivalent salary. While this isn’t a literal after-tax take-home number, it reflects how far a typical nurse’s income goes after accounting for the cost differences between cities.
The result: a clearer picture of which cities offer the strongest financial comfort—and which make even high salaries feel tight.
California pays the highest—but also costs the most
Salaries in San Jose, Oakland, Sacramento, and other California cities top the national charts. However, sky-high housing and living expenses shrink the real value of these paychecks. A $130K salary can feel closer to $90K once adjusted for local costs.
Texas and Arizona offer some of the best “real value.”
Dallas, Houston, and Phoenix combine solid RN pay with affordable living. In some cases, a nurse earning $78K in Dallas has more purchasing power than someone earning $110K in Los Angeles.
Midwest cities deliver strong lifestyle-per-dollar
Minneapolis, St. Louis, and Kansas City don’t offer the highest nominal pay, but their low living expenses allow nurses to stretch their dollars much further each month.
Anchorage salaries lose value due to high import costs
Even with respectable wages, Alaska’s remote cost structure reduces real purchasing power compared to mainland cities.
Why Cost-of-Living Adjustments Matter for Nurses
Healthcare is one of the few professions where large salary swings appear between cities—even within the same state. But pay alone doesn’t tell the full story. Cost-of-living adjusted salaries reveal:
- Where nurses can afford housing more easily
- Which cities provide a comfortable lifestyle
- Where pay looks high but daily expenses erase the advantage
- How relocation decisions may impact long-term finances
For travel nurses, new grads, and mid-career RNs considering moves, these comparisons help determine where a salary goes the furthest.
