CRNA Salary 2026: What Nurse Anesthetists Really Earn

National CRNA Salary — What the Data Actually Says

The current federal benchmark: CRNAs earn a mean annual salary of $248,320 ($119.38/hour) per BLS OEWS May 2025 — the most recent national occupational wage survey. That's 2.4× the registered nurse mean of $101,420 and within $11,340 of the physician median for primary care. The 51,840 CRNAs currently employed represent a specialty with extraordinary pay leverage relative to training investment.

The mean-versus-median gap ($248,320 vs. $236,590) reflects a right-skewed distribution: a cluster of high-earning CRNAs at academic centers, in high-cost metro markets, and in locum tenens roles pulls the mean up. Most CRNAs sit somewhere between $200,000 and $260,000. That's still the top 1% of individual earners in the United States.

CRNA Salary by State — All 50 Ranked

The state range is dramatic: New Jersey ($287,792) pays CRNAs 64% more than Florida ($175,433). That gap isn't just cost of living — it's scope of practice law, hospital market competition, rural vs. urban concentration, and the local supply of anesthesiologists. Here's the full picture.

Top 10 Highest-Paying States

Full State Table — All 50 States

Sources: TheCRNA.com 2026 blended dataset; BLS OEWS May 2025 for states with sufficient sample sizes. "Medicare opt-out (confirmed)" marks states whose governor has notified CMS that the state opts out of the Medicare physician supervision requirement for nurse anesthetists. AANA counts 27 opt-out states as of September 2026; this column marks the 21 we could confirm from AANA's published lists (the 19 through 2020, plus Vermont and Ohio in July 2026), and shows a dash where we could not. Check the AANA state list for the rest. Opting out waives the federal rule only; each state's nurse practice act still sets CRNA scope.

What Drives the State Pay Gap

Four factors explain most of the variance between states:

• Scope of practice law — Opt-out states tend to pay more because CRNAs function as independent practitioners rather than clinical subordinates. The premium is real.
• Rural hospital density — States with high concentrations of Critical Access Hospitals (CAHs) often pay premiums because CRNAs are the only anesthesia option. North Dakota, New Mexico, and Alaska exemplify this.
• Urban market competition — NYC/Boston/Chicago academic centers bid against each other for a finite CRNA workforce. NJ's top rank is almost entirely explained by NYC market spillover.
• Physician anesthesiologist surplus — Florida and Georgia have large MD anesthesiology workforces, which suppresses CRNA leverage and pay. Florida ranks 50th despite a high cost of living.

CRNA Salary by Practice Setting

Where you work matters almost as much as where you live. Locum tenens CRNAs — filling short-term coverage gaps at hospitals and surgical centers — earn the highest hourly rates. Rural critical-access hospital staff CRNAs command a shortage premium. Academic medical centers often pay less than community hospitals because they offer academic prestige, research access, and teaching roles that compress wages.

CRNA Salary by Years of Experience

The CRNA career curve is compressed compared to most nursing roles. Entry-level CRNAs start above the national RN median. The largest jumps come in the first five years as new grads move from supervised to fully autonomous practice. After roughly 10 years, increases slow because the market cap is real — CRNAs at $260,000+ compete with physician anesthesiologists for the same slots.

New graduate CRNAs earn $172,400 on average — which is still $71,000 more than the national RN mean. That gap pays off the cost of a CRNA program in about 3–4 years assuming a $120,000 all-in program cost. The break-even is faster for RNs who were already earning at the top of the bedside scale.

Scope of Practice: The 29-State Opt-Out Map

Federal CMS regulations require physician supervision of CRNAs in Medicare-certified hospitals — unless a state's governor has formally opted out. As of September 2026, AANA counts 27 states that have submitted opt-out letters, most recently Vermont and Ohio in July 2026. That means CRNAs in those states practice independently under their own NBCRNA certification without requiring an anesthesiologist to supervise or direct their work.

Opt-out states (January 2026): Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky (partial), Louisiana (2025), Maine, Massachusetts, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina (2025), South Dakota, Vermont, Washington, West Virginia, Wisconsin.

Two states — Utah and Wyoming — have partial opt-outs that apply specifically to rural and critical-access hospitals. In all other facilities within those states, physician supervision requirements still apply.

For state-specific CRNA market deep-dives, see: New Jersey (#1) · Wisconsin (#2) · Massachusetts (#4) · Tennessee (HCA market dynamics) · West Virginia (Appalachian shortage)

Job Growth and Demand Outlook

BLS projects 38% job growth for nurse anesthetists from 2022 to 2032 — one of the highest growth rates in healthcare. The structural driver isn't population aging alone; it's the ongoing expansion of outpatient surgery and the retirement-wave hitting the current CRNA workforce.

By 2033, the U.S. faces a projected shortage of approximately 12,500 CRNAs — roughly 22% of the current workforce. This isn't a niche problem. About one-third of all hospitals and more than two-thirds of rural hospitals rely exclusively on CRNAs for anesthesia services. CRNAs provide more than 80% of all anesthesia in rural communities. When that supply tightens further, wages go up.

• 38% projected job growth (2022–2032, BLS)
• ~12,500 CRNA shortage projected by 2033
• 80%+ of rural anesthesia provided by CRNAs
• 2/3 of rural hospitals rely exclusively on CRNAs
• 51,840 CRNAs currently employed (BLS May 2025)

How to Become a CRNA

The credential is CRNA — Certified Registered Nurse Anesthetist. The pathway since 2022 requires a terminal doctoral degree (DNP or DNAP). You cannot enter a CRNA program with a diploma program or associate degree in nursing; most programs require a BSN with a minimum GPA, plus 1–2 years of ICU experience before you can apply.

• BSN or equivalent — Some programs accept direct-entry MSN graduates
• 1–2 years ICU experience — Most programs require CCRN or a minimum of 1,500–2,000 ICU hours in a high-acuity setting (SICU, MICU, CT-ICU, CVICU); CVICU experience preferred by competitive programs
• 36-month DNP/DNAP program — Accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA); 148 accredited programs as of 2026
• Pass the NBCRNA NCE — National Certification Exam; 87% first-attempt pass rate
• Recertify every 4 years — Continued Professional Certification (CPC) program requires 60 Class A CE credits

Program cost ranges from $70,000 to $150,000+ depending on public vs. private institution and in-state vs. out-of-state tuition. Average program cost runs approximately $120,000 all-in. The break-even on salary premium over a bedside RN is typically 3–4 years at the new-grad CRNA salary level.

Frequently Asked Questions