Nursing Assistant Salary in 2026: National, by State, City, Specialty & Real Value

A nursing assistant in the United States earns a median of $42,260 a year, about $20.32 an hour, according to the U.S. Bureau of Labor Statistics (2025). Pay runs from roughly $33,940 at the 10th percentile to $51,980 at the 90th, and it swings further once you account for state, metro, setting, specialty, cost of living, and tax. About 1,448,910 nursing assistants work nationwide. This guide is the complete picture: national and percentile pay, all 50 states ranked by real (cost-adjusted) value, top metros, settings, specialties, take-home after tax, the path in, the return on the degree, and answers to the questions people ask most.

National pay overview

The national median for nursing assistants is $42,260 a year ($20.32 an hour), with a mean of $42,700. The full wage curve, from entry to senior:

Percentile	Annual	Hourly
10th (entry)	$33,940	$16.32
25th	$37,260	$17.91
50th (median)	$42,260	$20.32
75th	$47,220	$22.70
90th (senior)	$51,980	$24.99

The gap from the 10th to the 90th percentile is about $18,040. A single national number hides that range, which is why the rest of this guide breaks pay down by every factor that moves it, and then translates the headline into cost-adjusted, after-tax dollars.

The mean of $42,700 sits above the median, which tells you the top of the field pulls the average up: a meaningful share of nursing assistants earn well into the upper percentiles through specialty, setting, geography, and seniority. The practical question is what you can earn given where you work, what you specialize in, and how you structure your hours, which matters far more than the field-wide average. Each section below answers one piece of that.

Pay by experience

BLS does not publish pay by years of experience, but the percentiles map closely to a career arc:

Stage	Typical percentile	Annual
New graduate	10th to 25th	$33,940 to $37,260
Mid-career	~50th	around $42,260
Experienced	~75th	around $47,220
Senior / specialized / lead	90th+	$51,980 and up

The climb from new graduate to senior is roughly $18,040. Early raises tend to come fastest as you move off new-grad pay; by mid-career the curve flattens, and the people who keep climbing usually do so by specializing, switching to a higher-paying setting or state, taking on lead and management duties, or adding hours through overtime and extra work. Geography and setting can outweigh experience entirely: an experienced certified nursing assistant in a low-paying state can earn less than a new graduate in a top-paying one.

Salary by state: all 50 states ranked by real value

This is the table most nursing assistant salary pages leave out. Below are every state and Washington, D.C., ranked by real value (the median adjusted for that state’s cost of living (BEA Regional Price Parities, 2024)) rather than by sticker pay. A high-paying state with high costs can leave you worse off than a moderate-paying, low-cost one. Tap a linked state for the full local breakdown.

#	State	Median (nominal)	Cost level (US=100)	Real value	Employed
1	North Dakota	$45,820	89.0	$51,507	6,840
2	Maine	$47,070	97.0	$48,501	8,540
3	Oregon	$49,830	103.4	$48,210	14,800
4	Vermont	$47,130	98.0	$48,112	3,030
5	Wisconsin	$45,130	94.1	$47,962	28,370
6	Minnesota	$46,680	98.6	$47,333	29,120
7	Illinois	$45,960	100.0	$45,979	68,640
8	Colorado	$47,380	103.1	$45,977	22,240
9	Washington	$49,180	107.0	$45,957	30,270
10	New Hampshire	$47,870	104.2	$45,956	7,810
11	Pennsylvania	$44,590	97.6	$45,700	67,740
12	Nevada	$45,490	100.0	$45,500	8,100
13	Rhode Island	$46,440	102.3	$45,405	10,220
14	Alaska	$46,370	102.4	$45,301	2,060
15	New York	$48,590	107.9	$45,024	87,990
16	Iowa	$39,350	87.8	$44,837	22,670
17	Arizona	$44,780	100.7	$44,479	20,320
18	Nebraska	$40,000	90.1	$44,394	16,450
19	Massachusetts	$46,680	105.8	$44,139	38,130
20	South Dakota	$38,800	88.6	$43,799	6,860
21	District of Columbia	$47,700	109.9	$43,403	3,490
22	Connecticut	$44,790	103.6	$43,229	21,380
23	Montana	$40,900	94.6	$43,214	4,390
24	New Jersey	$46,830	108.8	$43,040	32,400
25	California	$47,630	110.7	$43,018	110,060
26	Virginia	$43,200	101.1	$42,728	40,580
27	New Mexico	$39,390	92.2	$42,717	4,750
28	Kentucky	$38,370	90.2	$42,558	23,410
29	Wyoming	$39,160	92.7	$42,248	2,830
30	Kansas	$38,010	90.1	$42,201	24,610
31	Delaware	$42,030	99.8	$42,111	5,530
32	Ohio	$39,010	92.8	$42,048	63,280
33	Missouri	$37,680	90.8	$41,490	34,050
34	Tennessee	$37,990	91.9	$41,352	27,040
35	Hawaii	$45,350	110.0	$41,246	5,050
36	Maryland	$43,240	105.0	$41,197	27,720
37	Michigan	$39,570	96.2	$41,126	43,290
38	Indiana	$38,330	93.3	$41,070	33,640
39	West Virginia	$36,720	89.5	$41,029	9,390
40	Oklahoma	$35,930	87.8	$40,903	19,410
41	North Carolina	$38,460	94.3	$40,773	64,010
42	Idaho	$38,650	95.5	$40,474	7,910
43	Utah	$39,840	98.9	$40,298	12,260
44	South Carolina	$37,220	93.7	$39,702	21,760
45	Arkansas	$34,430	86.9	$39,603	17,260
46	Georgia	$37,680	96.3	$39,131	43,440
47	Texas	$37,500	97.1	$38,637	88,680
48	Alabama	$34,140	88.8	$38,436	25,250
49	Florida	$37,510	103.4	$36,272	96,960
50	Mississippi	$31,520	87.0	$36,249	14,200
51	Louisiana	$30,510	88.2	$34,589	20,690

On real, cost-adjusted value, North Dakota leads at $51,507, while Louisiana trails at $34,589. By raw sticker pay the order is different: Oregon ($49,830), Washington ($49,180), and New York ($48,590) pay the most nominally, but several of them slide down the list once high housing and prices are counted. That reordering is the single most useful thing this page does, and it is why national averages and sticker rankings can steer you wrong.

Concrete example of the flip: California ranks #6 by sticker pay ($47,630) but only #25 once its cost level of 111 is applied, because high prices eat the higher salary. Meanwhile North Dakota looks middling on sticker (#16) yet climbs to #1 on real value, since a 45,820-dollar median goes much further at a cost level of 89. If you are willing to relocate, the real-value column, not the sticker column, is the one that should guide the decision.

The geographic pattern: the highest sticker pay clusters on the West Coast and in the Northeast, while the best real value often shows up in lower-cost states in the South, Midwest, and Mountain West where a strong salary meets cheap housing. There is no single best state, only the best fit for where you want to live and what your money will buy there.

Highest-paying metros

Within states, metros drive pay further. The largest certified nursing assistant job markets by employment, with median pay:

Metro	Median	Employed
New York-Newark-Jersey City, NY	$49,270	79,480
Chicago-Naperville-Elgin, IL	$46,940	45,850
Los Angeles-Long Beach-Anaheim, CA	$47,380	43,090
Philadelphia-Camden-Wilmington, PA	$46,220	30,680
Boston-Cambridge-Newton, MA	$47,590	26,130
Washington-Arlington-Alexandria, DC	$45,730	25,520
Miami-Fort Lauderdale-West Palm Beach, FL	$38,010	23,490
Dallas-Fort Worth-Arlington, TX	$38,530	23,420
Atlanta-Sandy Springs-Roswell, GA	$39,350	23,260
Houston-Pasadena-The Woodlands, TX	$37,970	19,230

The same cost-of-living rule applies inside a state: a higher-paying big metro can lose to a cheaper mid-size city once housing is counted. Big metros also hold the deepest job markets, so they pair the most pay with the most openings, while rural and smaller markets sometimes pay premiums to attract candidates. The state pages work the metro and cost math out city by city.

Salary by work setting

Where nursing assistants work changes pay as much as geography. National medians by employer type:

Setting	Employed (U.S.)	Median
Nursing Care Facilities (Skilled Nursing Facilities)	534,270	$43,000
General Medical and Surgical Hospitals	442,820	$41,650
Continuing Care Retirement Communities and Assisted Living Facilities for the Elderly	161,150	$39,490
Home Health Care Services	70,770	$38,040
Employment Services	48,300	$47,810
Individual and Family Services	32,110	$35,380
Specialty (except Psychiatric and Substance Abuse) Hospitals	28,810	$45,660

The gap between the highest- and lowest-paying settings is real money over a career, and it usually comes with trade-offs in pace, caseload, autonomy, and schedule rather than in difficulty alone. The largest employer is not always the best payer, so it is worth weighing where the volume of jobs is against where the pay is when you choose a setting.

How it compares to related careers

It helps to see a nursing assistant beside the roles people weigh against it, with pay set next to the education each requires:

Role	National median	Education
Home Health/Personal Care Aide	$35,800	HS / short training
Nursing Assistant (this role)	$42,260	CNA certificate
Licensed Practical Nurse	$64,400	Practical nursing certificate
Registered Nurse	$97,550	Bachelor’s (BSN)

Against home health/personal care aide at $35,800, this role pays about $6,460 more for the added schooling. The higher-paid licensed practical nurse ($64,400) sits $22,140 above, but on a longer or different training path. The right comparison is always pay set against the time, cost, and debt of the credential, not pay alone.

Certification, setting, and what they mean for pay

Becoming a CNA requires completing a state-approved training program and passing a competency exam; that certification, plus the setting and shift, gates pay. The biggest pay differences come from the setting, hospitals generally pay above nursing homes and home care, the state, and shift differentials for nights and weekends. Additional certifications, such as in geriatrics or as a patient-care technician, can modestly raise pay.

Licensing is not just a hurdle, it shapes pay. Where a role can practice more independently or bill for more services, it tends to command more, and license portability between states affects how easily you can chase a higher-paying market. Always confirm the current rules with the relevant state board, since scope and requirements change and vary widely.

Specialties and where the pay is

Pay rises with the setting and added skills: CNAs in hospitals and specialized units, and those who become patient-care technicians with phlebotomy or EKG skills, out-earn those in nursing homes and home care, and night and weekend shifts pay more. The most significant pay gains come from advancing up the nursing ladder, to LPN and then RN, which many CNAs use the role to begin.

The practical takeaway: within nursing assistants, specialty and setting usually move pay more than another year of general experience. The top earners are rarely just the most tenured, they are the ones in the higher-paying focus areas, settings, or leadership and ownership roles.

If you are early in the field, the decisions with the biggest long-run payoff are which specialty to pursue and which setting to enter, because both compound over a career and are easier to choose early than to switch later. A credential that takes a year to earn can pay for itself many times over through higher pay and more job options, which is the same logic the ROI section applies to the degree itself.

What moves the pay

• State and metro, and crucially the cost of living that goes with them, which the real-value table reorders.
• Experience, which lifts pay steadily and then plateaus without a specialty or a step up.
• Work setting and employer, since some settings and employers pay well above others, as the settings table shows.
• Specialty and board certification, a clear premium in most of these fields.
• Hours and structure, since overtime, extra shifts, and contract or travel work can push total pay well above base.

Salary, hourly, and total compensation

The $42,260 median is base pay, and real total compensation often runs higher. Most CNA roles are hourly, with extra pay from shift differentials, overtime, and weekend coverage rather than bonuses; equity is rare. The biggest levers are working in a hospital or specialized unit, adding patient-care-technician skills, and advancing up the nursing ladder to LPN and RN. When comparing offers, weigh the whole package, base, any bonus or equity, overtime or premiums where they apply, retirement match, and paid time off, since two offers with the same base can differ by thousands once the rest is counted.

Take-home pay after tax

Two nursing assistants on the same $42,260 salary keep very different amounts depending on the state. Worked examples on the national median, single filer, 2026 federal plus FICA plus state:

State	Gross	Est. take-home	Effective rate
Texas (no state income tax)	$42,260	$35,994	14.8%
New York	$42,260	$34,275	18.9%
California	$42,260	$35,143	16.8%

That is roughly $851 a year more in take-home in no-tax Texas than in California on an identical salary, before cost of living is even counted. Nine states levy no income tax.

Take-home also scales with where you sit on the pay curve. In Texas, an entry-level certified nursing assistant earning $37,260 nets about $31,977, while a senior one at $51,980 keeps about $43,804, since higher pay pushes more income into higher federal brackets. The effective rate climbs with income, so a raise is worth somewhat less on take-home than on the headline. Every state page includes a full breakdown and a paycheck calculator to run your own number.

How to maximize earnings

• Target a high-real-value state or metro using the table above, not the highest sticker.
• Move into the higher-paying setting and specialty for your field.
• Add board certification or a specialty credential, which pays a clear premium.
• Use overtime, contract, or travel work to lift total pay, and negotiate the full package.
• Consider leadership or ownership for the higher ceiling.

How pay is changing

Wages for nursing assistants have broadly risen with demand and inflation, but the real story is in the mix: pay grows fastest where labor is scarce and where the role takes on more responsibility. Watch three things if you are planning a career here, the spread between settings (which keeps widening as specialized and higher-skill roles pull ahead), the value of cost-of-living arbitrage (a strong salary in a cheap state has rarely been worth more relative to expensive coastal markets), and the premium on specialty credentials. The figures on this page are the May 2025 BLS estimates, the most recent national data, and the state pages carry the same detail locally.

Job outlook

Employment of nursing assistants and orderlies is projected to grow about 2% from 2024 to 2034, slower than the average for all occupations, but with a large roughly 211,800 openings a year, according to the U.S. Bureau of Labor Statistics, mostly from high turnover and retirements. An aging population drives the need to care for older people with chronic conditions, though financial pressures on nursing homes can constrain hiring.

For context, the average growth rate across all U.S. occupations through 2034 is about 3%. A large share of yearly openings also comes from replacing workers who retire or move on, so real hiring tends to run ahead of the net-growth figure, and shortage and rural areas often pay the most to attract candidates.

How to become a nursing assistant

CNA is a fast-to-enter, certified role and a common first step into nursing:

1. Complete a state-approved CNA program (often four to twelve weeks).
2. Pass the competency exam to earn certification and join your state registry.
3. Gain experience, ideally in a hospital or specialized unit, and add skills (EKG, phlebotomy) as a patient-care technician.
4. Advance up the nursing ladder to LPN and then RN, where pay rises substantially.

Is it worth it? The return on the degree

The return is strong on a small investment: a few weeks of training and an exam lead to a median near $42,260, with steady demand. The larger gains come from working in higher-paying settings like hospitals, adding patient-care-technician skills, and advancing up the nursing ladder to LPN and RN. Weigh program cost, your starting state and setting, and the specialties you can reach against the debt. The pay tables above, set next to the education column in the comparison section, are the honest way to run that math before committing.

Two levers change the answer most: the price of the program you choose, since cost varies enormously between public and private schools, and the state and setting you start in, since the same degree pays very differently across the by-state and settings tables above. A graduate who controls program cost and starts in a high-real-value state can clear the debt years faster than one who does neither, on the identical credential.

Frequently asked questions

State guides and tools

Sources: U.S. Bureau of Labor Statistics, OEWS May 2025 and Occupational Outlook Handbook (SOC 31-1131 and related codes); national, state, and metro estimates. U.S. Bureau of Economic Analysis, Regional Price Parities, 2024. Take-home figures are 2026 estimates (federal, FICA, and state) for a single filer and will vary with deductions and filing status. See our methodology.