Nursing Assistant (CNA) Salary in North Carolina: Pay by Experience, City & Take-Home

A nursing assistant (CNA) in North Carolina earns a median of $38,460 a year, or about $18.49 an hour, according to the U.S. Bureau of Labor Statistics (2025). Most CNAs in the state land between $30,260 at the 10th percentile and $47,080 at the 90th. That state median runs $3,800 below the national CNA median of $42,260, so where you work inside North Carolina, and in which setting, moves your pay more than almost anything else.

How North Carolina CNA pay compares to the national figure

The national median for nursing assistants is $42,260 a year, per BLS OEWS 2025. North Carolina sits at $38,460. That’s a gap of $3,800, or roughly 9 percent below the national midpoint. In hourly terms, the state median of $18.49 trails the national pace by close to two dollars an hour, which works out to about $76 a week for a full-time schedule before tax.

The state mean (average) annual wage is $39,280, a bit above the median. When the mean sits above the median, it usually means a thinner band of higher-paid CNAs, often in hospitals or specialized units, pulls the average up while most workers cluster lower. The middle 50 percent of North Carolina CNAs earn between $35,950 (25th percentile) and $43,850 (75th percentile). That’s a tighter spread than you see in high-cost states, which is the trade-off: lower ceilings, but lower living costs to match.

Here’s the plain read. North Carolina is a below-national-median state for CNAs in raw dollars. But raw dollars aren’t the whole story. The state’s lower housing and everyday costs claw back a chunk of that gap, and the flat state tax keeps the math simple. We get into take-home in section four, which is where the comparison actually lands for your budget.

It helps to know what the percentile spread means in practice. The 10th percentile figure of $30,260 is roughly the floor: new CNAs in lower-paying settings like some assisted-living and long-term-care facilities. The 90th percentile of $47,080 is the ceiling for the role itself, the number a senior hospital CNA with years of differential-heavy shifts can reach. The distance between those two is $16,820. That single fact tells you the CNA title in North Carolina is a band, not a fixed wage, and your placement inside it is something you can move with the choices in section five.

One more way to frame the national gap: $3,800 a year is about $317 a month of gross pay. That sounds like a lot, and in a high-cost state it would sting. In North Carolina, where a CNA can find a one-bedroom outside the priciest neighborhoods of Charlotte or the Triangle for meaningfully less than the national average, that gap narrows fast once you measure it in real spending power rather than headline dollars.

North Carolina CNA salary by experience level

Pay climbs steadily with experience, shift differentials, and the setting you work in. The BLS percentile points are the cleanest way to map a CNA career in North Carolina, since they show where real workers actually fall rather than a recruiter’s wishful range. Entry-level pay tracks the 10th percentile, and a seasoned CNA with strong hours and a specialty unit tracks the 90th.

The jump from entry to senior is $16,820 a year, or about $8 an hour. Most of that climb comes in the first few years, plus the lift from working nights, weekends, and overtime. A new CNA starting at $30,260 who moves into the median band over two to three years is looking at an $8,200 annual raise just by clearing probation, picking up steady hours, and adding a setting like a hospital or a long-term acute care facility. The senior tier at $47,080 is reachable, but it usually takes a hospital staff role, a charge-CNA or CNA II credential, and consistent differential-heavy shifts.

The middle of the table is where most North Carolina CNAs actually live. The 25th-to-75th percentile band runs from $35,950 to $43,850, a $7,900 spread. If you’re negotiating an offer, that band is your reality check: an offer near $36,000 is entry-to-early money, an offer at $40,000 puts you above the state median, and anything past $43,850 means you’ve cleared three-quarters of CNAs in the state. Recruiters sometimes quote the top of the range to make an offer look generous, so anchor on these percentiles instead.

Worth noting how the hourly math works for a CNA who picks up extra shifts. At the median of $18.49 an hour, a standard 2,080-hour year produces $38,460. Add even four hours of overtime a week at time-and-a-half and you’re adding close to $5,800 a year in gross pay, which alone pushes a median earner into the experienced band. Many North Carolina CNAs reach the upper percentiles less through base-rate raises and more through hours, which is why two CNAs with the same title can have very different W-2s.

North Carolina CNA salary by metro area

This is where the state number stops being useful and the local number takes over. Across the five largest North Carolina metros, median CNA pay swings by about $2,300 a year. The Triangle pays best, the Triad lags, and Charlotte sits in the middle despite being the largest single employer of CNAs in the state.

Durham-Chapel Hill leads at $40,560, which is $2,100 above the state median and the only metro on this list to clear $40,000. That’s the Duke and UNC academic-medical-center effect: large teaching hospitals concentrate demand and push pay up. Raleigh-Cary follows at $39,710, with Charlotte close behind at $39,430. Charlotte’s headline figure is the number of jobs, not the wage, with 13,580 CNAs employed, the deepest market in the state by a wide margin and the easiest place to find an open req.

At the other end, Greensboro-High Point ($38,260) and Winston-Salem ($38,660) sit slightly below the state median. If you’re mobile, the read is simple: the Triangle (Durham, Raleigh) pays the most per hour, Charlotte gives you the most openings and shift variety, and the Triad metros trade a little pay for a lower cost of living. A move from Greensboro to Durham is worth roughly $2,300 a year at the median, before you factor in any difference in rent.

Put the five metros together and they account for 34,560 of the state’s 64,010 CNA jobs, a little over half. That tells you the other half of North Carolina’s CNA workforce sits in smaller cities and rural counties, places like Fayetteville, Asheville, Wilmington, and the eastern and mountain regions. Those areas don’t show on this five-metro table, but the pattern holds: hospital systems and academic centers anchor the higher pay, while rural skilled-nursing and home-care work tends to track closer to the state floor. If you live outside a major metro, expect your local median to sit at or just under the statewide $38,460 unless a regional hospital is hiring.

The other lever inside a metro is the employer type. Within Charlotte’s 13,580 CNA jobs, an Atrium or Novant hospital role generally pays more than a standalone nursing home, and a hospital float-pool or travel-style assignment can pay more still. The metro median blends all of those together, so use the table as your baseline and then sort by setting once you’re searching real listings.

North Carolina CNA take-home pay after taxes

Gross salary isn’t what hits your account. North Carolina levies a flat state income tax, and every paycheck also loses federal income tax plus FICA (Social Security and Medicare). Here’s the breakdown at each percentile point for a single filer taking the standard deduction, using 2026 tax-year figures.

At the median, a North Carolina CNA keeps $31,848 of a $38,460 salary, an effective all-in rate of about 17.2 percent. That’s roughly $2,654 a month, or $1,225 every two weeks. The state tax bite at the median is $1,093, which is small relative to FICA’s $2,942 and federal’s $2,577. North Carolina’s flat rate keeps the state slice predictable across every income tier on this table.

Notice how the effective rate climbs across the table: 15.4 percent at entry, 17.2 percent at the median, 18.0 percent at the experienced tier, and 18.4 percent at the senior level. That’s federal tax doing the work, since the federal system is progressive and FICA stays flat at 7.65 percent of gross. The practical takeaway: a senior CNA at $47,080 takes home $38,408, which is $12,800 more in net pay than an entry CNA, even after the higher rate. Earning more always nets you more here; the tax code never eats a raise.

The cross-state comparison that matters. Take that same $38,460 median and run it in Texas, a state with no income tax. A Texas CNA on identical gross pay keeps $32,941 in net annual pay, versus $31,848 in North Carolina. That’s a gap of exactly $1,093, the full amount of North Carolina’s state income tax, in Texas’s favor. So on the same salary, you take home about $91 more a month in Texas purely from the tax structure. Whether that gap survives contact with reality depends on rent: if North Carolina housing runs more than $91 a month cheaper than the Texas metro you’d compare against, the tax advantage flips back in North Carolina’s favor.

That’s the framing to hold onto. Net pay minus local housing is the number that actually matters, not the gross on the offer letter and not the tax rate in isolation. A $38,460 CNA salary in Durham with $1,250 rent leaves more real money than the same salary in a metro where rent runs $1,600, even after the tax difference. Before you sign anything, run your exact number through the North Carolina paycheck calculator, then subtract your real rent. If you want help projecting your full tax picture for the year, tools like TurboTax can estimate your refund or balance due before filing.

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How to earn more as a CNA in North Carolina

The median is $38,460, but the experienced and senior tiers ($43,850 and $47,080) are real and reachable. Here’s how CNAs in North Carolina close that $8,000-plus gap, in rough order of payoff.

• Move to a hospital or academic medical center. The Durham-Chapel Hill median ($40,560) and Raleigh-Cary ($39,710) sit above the state figure largely because hospital systems pay more than nursing homes and assisted-living facilities. A setting change alone can be worth $2,000 or more a year.
• Earn the CNA II credential. North Carolina has a two-tier nurse aide system. Listing as a CNA II with the state board adds skills like sterile dressing changes and catheter care, which qualifies you for higher-paying acute-care roles and the upper percentile bands.
• Work the differential shifts. Nights, weekends, and holidays carry pay premiums. Stacking those shifts is the fastest way to push a median base toward the 75th percentile ($43,850) without changing employers.
• Specialize. Dialysis, the operating room, telemetry, and long-term acute care all command higher CNA pay than general medical-surgical floors. Pick a unit, get the on-the-job training, and your market value rises.
• Use the CNA role as a bridge to LPN or RN. The single biggest raise isn’t a better CNA job, it’s the next credential. North Carolina community colleges run LPN and ADN programs built around working aides. Structured prep and prerequisite courses through platforms like Coursera can keep you moving while you work.
• Relocate within the state. If you’re flexible, the Triangle pays the most per hour and Charlotte offers the most openings. A Greensboro-to-Durham move is worth about $2,300 a year at the median.

Job outlook for CNAs in North Carolina

North Carolina employs 64,010 nursing assistants, per BLS OEWS 2025, one of the larger CNA workforces in the country. Charlotte alone accounts for 13,580 of those jobs, with Raleigh (6,420), Greensboro (5,280), Durham (4,830), and Winston-Salem (4,450) rounding out the major markets. That’s a deep, steady employer base spread across hospitals, skilled nursing facilities, assisted living, and home-care agencies.

Demand for nursing assistants tracks an aging population, and North Carolina’s growth, especially in the Charlotte and Triangle regions, keeps openings flowing. CNAs rarely struggle to find work; the harder question is which setting pays best for the hours you can give. To see live openings and current pay ranges by metro, a job board like ZipRecruiter lets you filter by city, setting, and shift.

A few things shape day-to-day demand. Skilled nursing facilities and assisted living carry the most consistent, year-round openings, since turnover in those settings runs high and census stays full. Hospitals hire in waves tied to budget cycles and unit expansions, and they pay more, so the move from a nursing home to a hospital is the most common pay-raising switch a North Carolina CNA makes. Home-care agencies, the third big employer, offer flexible hours but tend to pay closer to the home-health-aide range covered in section seven. Knowing which of those three buckets an opening falls into tells you most of what you need about the pay before you read the listing.

Related and higher-paying healthcare roles in North Carolina

If you want a bigger jump than CNA percentile bands allow, the adjacent roles tell you where the money is. Here’s how two related North Carolina healthcare roles compare to the CNA state median of $38,460, using BLS OEWS 2025 figures.

A clinical laboratory technologist in North Carolina earns $60,650 at the median, which is $22,190 more than a nursing assistant in North Carolina. That role takes more schooling, usually an associate or bachelor’s degree, but it’s a clear target if you want to stay in healthcare and roughly double the pay over time. At the other end, a home health and personal care aide earns $31,240, which is $7,220 less than a nursing assistant in North Carolina, a useful reference point if you’re weighing a home-care role against a facility CNA job.

North Carolina CNA salary FAQ

Sources: U.S. Bureau of Labor Statistics, OEWS 2025 (occupation 31-1131, Nursing Assistants); 2026 federal and North Carolina tax-year figures for take-home estimates. Last updated 2026. See our methodology.