Physician Salary by State: Pay and Cost of Living in 2026
By Blake Moser · Published September 1, 2026
As of September 1, 2026, the latest comparable state wage estimates are the May 2025 Bureau of Labor Statistics Occupational Employment and Wage Statistics figures for SOC 29-1229, “Physicians, All Other.” Among states with the highest reported mean wages in that occupation, North Dakota leads at $406,630; when paired with the Bureau of Economic Analysis 2024 regional price parity, that wage equals about $457,098 in 2024 national-price-level dollars. This is a useful cost-of-living comparison, not an all-physician, specialty, take-home-pay, or total-compensation ranking.
State salary headlines can answer a narrow question well: where did employers report the highest average annual wages for a defined occupation? They cannot, by themselves, answer where a particular physician will have the strongest offer, the lowest tax bill, or the best long-term practice opportunity. A sound comparison separates those questions. This guide combines the current state wage release with an all-items cost-of-living measure so candidates and employers can begin with a consistent public benchmark, then evaluate the role, specialty, market, and contract in front of them.
Key findings
- North Dakota is the reported leader in this comparison. Its May 2025 mean annual wage for SOC 29-1229 was $406,630, and its 2024 regional price parity (RPP) was 89.0. The resulting cost-adjusted figure is $457,098.
- Nominal pay and purchasing-power rankings differ. Montana’s $385,010 nominal mean becomes $406,794 after its 94.6 RPP is applied. Wisconsin’s $364,840 nominal mean becomes $387,736 at an RPP of 94.1.
- Lower statewide prices can materially change interpretation. Kentucky, Louisiana, Wyoming, Indiana, New Mexico, and Tennessee appear among the leading adjusted results supplied here even though several are not in the ten highest nominal-wage states.
- The occupation label matters. These estimates describe BLS SOC 29-1229, “Physicians, All Other,” exactly as published. They must not be described as pay for all physicians or as a comparison of individual specialties.
- The figures are wages, not a complete earnings picture. OEWS excludes self-employed physicians and owners, and it does not capture much of the total value of a physician employment arrangement.
- A state is not a metro. State averages can conceal major differences among urban, suburban, rural, and remote markets. A role-specific offer still requires local comparison.
What the state wage data does and does not measure
The BLS state table is the foundation for this article because it offers a common occupation-and-geography framework. For this analysis, the relevant row is SOC 29-1229, labeled “Physicians, All Other.” The annual mean wage is an employer-reported wage estimate for workers in that occupation. It is not a census of every physician practicing in a state, and the label should not be broadened to “all physicians.”
That distinction is especially important in medicine. Specialty mix varies from state to state. A statewide result may reflect the occupations BLS classifies in this residual physician category, the employers sampled, and the geographic distribution of employment. It does not reveal the compensation of a cardiologist, family physician, hospitalist, surgeon, psychiatrist, or any other specialty as a standalone group. For a specialty-oriented discussion, see the 2026 physician salary guide.
OEWS estimates generally cover wage and salary employment. The BLS technical documentation explains the program’s scope and estimation practices. Self-employed workers are excluded, which is consequential for physician labor markets because practice ownership and independent work arrangements can be meaningful. The wage measure also is not a contract’s full economic value: it may not represent productivity incentives, sign-on payments, relocation support, loan repayment, call coverage, equity, retirement contributions, malpractice arrangements, benefits, partnership economics, or owner income.
Suppressed or unavailable cells deserve equal care. A blank, a suppression symbol, or an unreported estimate is not zero pay and not evidence of no physicians. BLS suppresses some estimates to protect confidentiality or when publication standards are not met. This article does not convert suppressed cells into ranks or substitute a guessed amount. A ranking is therefore a ranking of the published, comparable figures included in the analysis, not a claim that every omitted state falls below every listed state.
Highest reported nominal mean wages
The table below lists the ten highest nominal annual mean wages provided for the May 2025 state estimates of SOC 29-1229. “Nominal” means the wage is shown in current dollar terms from the wage release; it has not been adjusted for geographic price differences. The RPP column is included to show why a nominal leader may not remain in the same position after an all-items price adjustment.
| State |
May 2025 nominal mean wage |
2024 RPP, U.S. = 100 |
2025 wage expressed in 2024 national-price-level dollars |
| North Dakota | $406,630 | 89.0 | $457,098 |
| Montana | $385,010 | 94.6 | $406,794 |
| Maine | $367,590 | 97.0 | $378,764 |
| Wisconsin | $364,840 | 94.1 | $387,736 |
| Alaska | $353,510 | 102.4 | $345,363 |
| Kentucky | $331,860 | 90.2 | $368,083 |
| Vermont | $331,300 | 98.0 | $338,206 |
| Hawaii | $326,890 | 110.0 | $297,305 |
| Minnesota | $325,680 | 98.6 | $330,234 |
| Indiana | $323,600 | 93.3 | $346,730 |
The comparison illustrates the basic trade-off rather than a universal rule. Hawaii has a high reported nominal mean in this group, but its RPP of 110.0 is above the national price level, producing an adjusted value of $297,305. North Dakota’s RPP of 89.0 is below the national price level, so dividing by that lower price index increases the national-price-level expression. Alaska is another reminder that a high nominal wage does not automatically mean an above-national purchasing-power result.
Leading results after the all-items price adjustment
Cost adjustment changes the unit of comparison, not the underlying BLS occupation. The following leading adjusted results include states that rise because their statewide RPP is below 100. They are presented as 2025 wage expressed in 2024 national-price-level dollars. This wording matters: the wage remains a May 2025 estimate, while the price index is a 2024 BEA measure. It is not an inflation forecast or a 2026 salary estimate.
| State |
May 2025 nominal mean wage |
2024 RPP |
Adjusted wage |
| North Dakota | $406,630 | 89.0 | $457,098 |
| Montana | $385,010 | 94.6 | $406,794 |
| Wisconsin | $364,840 | 94.1 | $387,736 |
| Maine | $367,590 | 97.0 | $378,764 |
| Kentucky | $331,860 | 90.2 | $368,083 |
| Louisiana | $312,630 | 88.2 | $354,428 |
| Wyoming | $321,630 | 92.7 | $346,992 |
| Indiana | $323,600 | 93.3 | $346,730 |
| Alaska | $353,510 | 102.4 | $345,363 |
| New Mexico | $318,330 | 92.2 | $345,215 |
| Tennessee | $312,220 | 91.9 | $339,850 |
| Vermont | $331,300 | 98.0 | $338,206 |
These adjusted amounts support a limited direct answer: within this occupation and data pairing, a given reported wage buys the equivalent of the displayed amount at the 2024 national average price level. They do not establish that the state is “best” for every physician. Housing choices, commuting, availability of desired services, family needs, and the cost of a particular community can diverge sharply from an all-items statewide average.
Methodology and data vintage
This analysis uses the latest available state wage data as of September 1, 2026: May 2025 BLS OEWS state estimates. The wage input is the annual mean wage in SOC 29-1229, exactly labeled “Physicians, All Other,” from the BLS state release. The cost input is the BEA’s 2024 all-items regional price parity for each state, where the United States equals 100.
- Take the published May 2025 annual mean wage for SOC 29-1229 in each reported state.
- Match that state to its 2024 all-items RPP.
- Calculate adjusted wage as nominal mean wage divided by (RPP divided by 100).
- Round the displayed calculation to the nearest dollar and label it as a 2025 wage expressed in 2024 national-price-level dollars.
- Do not rank suppressed or unavailable BLS wage cells, and do not infer a state’s result from another occupation or from a specialty survey.
RPP is a relative price-level index, not a physician household budget. It summarizes all-items price differences across states and metros in the BEA framework. It is valuable because it applies a common denominator to nominal wages, but it cannot capture every difference in a physician’s actual expenses. Nor does this calculation include federal, state, or local taxes. Tax treatment depends on income, filing status, deductions, residence, work location, and other circumstances; it should be modeled separately with qualified advice rather than implied by an RPP ranking.
The one-year vintage gap is transparent by design. At the stated publication cutoff, 2025 is the newest state wage year and 2024 is the cited RPP year. Calling the result a “2026 salary” would overstate what the source provides. This is a 2026 decision guide using the newest available underlying government releases, not a forecast of offers made in 2026.
How candidates should use the comparison
Use the tables as a screening tool, then replace the statewide average with the facts of the offer. Start by identifying whether your specialty and employment model resemble the BLS occupation at all. Next, compare base compensation, expected productivity, call, schedule, clinical support, malpractice coverage, benefits, and restrictive-covenant terms. A lower nominal base may be attractive if the local price environment, workload, partnership path, and personal fit are favorable; a higher figure may be insufficient if it carries unusually high call or production risk.
Ask an employer for the compensation plan in writing, including the measurement period, thresholds, conversion factors, quality requirements, and treatment of leave. Build a personal budget for the specific metro or community rather than relying solely on the state RPP. Include housing, childcare, transportation, loan obligations, licensing, and travel. Verify credentials and licensing requirements early through physician license verification, especially when a move or multi-state practice is involved.
Candidates comparing several markets can use the salary comparison resource to organize offer-level information. The RPP-adjusted result is one lens, not a substitute for a contract review or a local due-diligence visit.
How employers should use the comparison
For employers, a state wage average is a market signal, not a defensible standalone offer strategy. It can help explain why candidates assess purchasing power as well as nominal base salary, particularly in markets with below-national statewide prices. It should not be used to declare that a specialty should accept a particular rate. Specialty supply, incumbent coverage, payer environment, service-line economics, rurality, academic expectations, call burden, and local competing systems can all produce a valid market premium or discount.
Recruiting teams should benchmark the precise specialty and local labor market, then describe the full value proposition candidly. If an offer emphasizes affordability, show candidates the actual location and support the claim with local context rather than a statewide statistic alone. If a market requires a premium, explain the schedule, scope, practice resources, and retention plan that accompany it. Organizations building a location strategy can also review best states for physician recruiting and work with physician recruiters on role-specific outreach.
Frequently asked questions
Which state has the highest physician salary in this analysis?
North Dakota has the highest reported nominal mean wage among the listed May 2025 SOC 29-1229 results: $406,630. It also has the highest adjusted result shown, $457,098 in 2024 national-price-level dollars. This answer applies only to BLS “Physicians, All Other,” not to all physicians or every specialty.
What is the best state for physician purchasing power?
There is no universal best state. On this narrow wage-and-RPP calculation, North Dakota has the highest adjusted figure shown. A physician’s best choice can differ based on specialty, exact city, taxes, household needs, workload, and contract terms. Taxes are excluded from this analysis.
Why are self-employed physicians missing from OEWS?
OEWS is a wage and salary employment survey framework, and the BLS technical notes describe exclusions that include self-employed workers. Physician owners and independent clinicians can have earnings patterns that are not represented by these wage estimates. That is why this article does not treat OEWS as a complete measure of physician income.
Does a higher adjusted wage mean an offer is better?
No. The calculation adjusts a statewide mean wage for an all-items statewide price index. It does not price an individual neighborhood, account for taxes, or value call, benefits, equity, productivity risk, and quality of life. Compare the actual position before making a decision.
Why are some states absent from the tables?
The tables focus on the supplied leading published results. More generally, BLS suppression or nonpublication must not be read as zero pay or zero employment. A suppressed cell should remain unavailable rather than being estimated for a ranking.
Sources
Need help interpreting a physician offer or planning a search? Contact MedicalRecruiting.com for a conversation about your market and priorities.