Imagine weighing two tempting job offers: one from a New Jersey company offering $165,690, and another from an Oklahoma firm at $136,550. The New Jersey role pays $29,140 more—sounds like a clear choice, right? But before you decide, consider what that difference really means once you’ve got to live on it!
Adjust both for what a dollar actually buys in each state, and the Oklahoma offer is worth $155,448 while the New Jersey offer is worth $152,282. The "smaller" offer is the bigger paycheck.
That inversion is the whole point of this page. Nominal salary tells you what a job pays. Cost-of-living-adjusted salary tells you what it pays you — after housing, groceries, gas, and everything else that quietly eats the difference. Below you'll find every state and 51 major metro areas ranked both ways, built from federal wage data and federal price data, updated automatically as new figures are released.
What PAs actually earn right now
Two credible sources publish PA compensation, and they disagree in a way that's worth understanding before you read a single ranking.
The Bureau of Labor Statistics (May 2025 Occupational Employment and Wage Statistics, the most recent release) puts the national median PA salary at $135,880 and the mean at $141,280, across 162,150 employed PAs. The spread is wide: the bottom 10% earn $99,380 or less, the top 10% earn $190,280 or more, and the middle half falls between $120,670 and $163,980. That median is up 2.0% from May 2024's $133,260.
The AAPA 2026 Salary Report puts median total compensation at $140,000 for calendar year 2025 — a 4.5% jump over the prior year's $134,000. Median bonus was $6,000, received by more than 58% of respondents, and notably that bonus figure is down from $7,500 the year before. Base pay is climbing; the variable piece is thinning.
Why the gap? BLS data is employer-reported, covers wages only, and lags by roughly a year. AAPA data is PA-reported, includes bonus and incentive pay, and is newer. Neither is wrong. Use BLS when you want a defensible, geography-specific benchmark — which is exactly what a salary negotiation needs. Use AAPA when you want the freshest national read on total compensation. Every state and metro number on this page comes from BLS, because AAPA doesn't publish at that granularity.
How the cost-of-living adjustment works
Every adjusted figure on this page uses one formula, and I want it visible rather than buried:
Adjusted median = (BLS median salary ÷ Regional Price Parity) × 100
Regional Price Parities (RPPs) come from the U.S. Bureau of Economic Analysis, 2024 series, where the national average equals 100. An RPP of 110.72 (California) means a basket of goods costs about 10.7% more than the U.S. average. An RPP of 87.84 (Oklahoma) means it costs about 12.2% less. Divide the salary by that index and you get a number you can compare honestly across state lines.
This replaces the unsourced "cost of living index." Cost-of-living indexes float around the internet with no methodology attached, and they can be wildly off — using an unsourced model, Hawaii's cost of living is 79% above the national average, which would have made a Hawaii PA salary worth about $73,000. BEA's actual measured figure for Hawaii is $109.951, which puts the same salary at $149,203. That is not a rounding difference. It's the difference between "don't move there" and "that's a strong offer." If a number is going to influence where you take a job, it should be backed by a federal agency.
PA salary by state, adjusted for cost of living
The table below is a "living table." It pulls from our salary database and refreshes when BLS and BEA publish new figures — so it will not go stale between visits. Sort by adjusted median to see real buying power, or flip the toggle to compare against nominal pay. There's a metro-level table, a percentile calculator, and a two-city buying-power comparison further down inside the tool.
Live snapshot (Jul 27, 2026): U.S. median PA pay is $135,880 (May 2025 OEWS, employer-reported). Highest-paying state: New Jersey at $165,690. Adjusted for cost of living, Oklahoma leads — its median is worth $155,448 in national buying power.
PA salary by state — nominal and cost-of-living adjusted (May 2025 OEWS)
| Rank | State | Median salary | Hourly | Adjusted for cost of living (RPP 2024) | Adjusted rank |
|---|---|---|---|---|---|
| 1 | New Jersey | $165,690 | $79.66 | $152,282 | 5 |
| 2 | California | $165,650 | $79.64 | $149,612 | 10 |
| 3 | Washington | $164,360 | $79.02 | $153,589 | 3 |
| 4 | Hawaii | $164,050 | $78.87 | $149,203 | 12 |
| 5 | New York | $160,880 | $77.35 | $149,072 | 13 |
| 6 | Oregon | $155,780 | $74.89 | $150,714 | 7 |
| 7 | New Hampshire | $150,960 | $72.58 | $144,924 | 19 |
| 8 | Alaska | $150,700 | $72.45 | $147,227 | 16 |
| 9 | Vermont | $150,490 | $72.35 | $153,627 | 2 |
| 10 | Massachusetts | $142,410 | $68.47 | $134,658 | 37 |
| 11 | Montana | $141,470 | $68.01 | $149,474 | 11 |
| 12 | Minnesota | $141,190 | $67.88 | $143,164 | 21 |
| 13 | Rhode Island | $139,930 | $67.27 | $136,811 | 30 |
| 14 | New Mexico | $139,920 | $67.27 | $151,737 | 6 |
| 15 | Connecticut | $139,860 | $67.24 | $134,987 | 35 |
| 16 | Delaware | $139,350 | $67.00 | $139,618 | 26 |
| 17 | Maryland | $137,560 | $66.13 | $131,061 | 42 |
| 18 | Oklahoma | $136,550 | $65.65 | $155,448 | 1 |
| 19 | Wyoming | $136,080 | $65.42 | $146,810 | 17 |
| 20 | Virginia | $135,940 | $65.36 | $134,456 | 38 |
| 21 | District of Columbia | $135,140 | $64.97 | $122,965 | 48 |
| 22 | Missouri | $135,130 | $64.97 | $148,794 | 14 |
| 23 | Iowa | $134,770 | $64.79 | $153,563 | 4 |
| 24 | Utah | $134,740 | $64.78 | $136,288 | 32 |
| 25 | Nevada | $134,660 | $64.74 | $134,688 | 36 |
| 26 | Arizona | $134,650 | $64.74 | $133,745 | 40 |
| 27 | Texas | $134,550 | $64.69 | $138,630 | 28 |
| 28 | Colorado | $134,540 | $64.68 | $130,555 | 44 |
| 29 | Wisconsin | $133,950 | $64.40 | $142,356 | 23 |
| 30 | Idaho | $133,790 | $64.32 | $140,103 | 25 |
| 31 | North Dakota | $133,450 | $64.16 | $150,013 | 9 |
| 32 | South Dakota | $133,200 | $64.04 | $150,362 | 8 |
| 33 | Nebraska | $133,040 | $63.96 | $147,653 | 15 |
| 34 | Ohio | $132,090 | $63.50 | $142,378 | 22 |
| 35 | Indiana | $132,050 | $63.49 | $141,489 | 24 |
| 36 | Illinois | $131,950 | $63.44 | $132,005 | 41 |
| 37 | Michigan | $131,510 | $63.23 | $136,681 | 31 |
| 38 | Maine | $131,170 | $63.06 | $135,157 | 34 |
| 39 | Florida | $129,620 | $62.32 | $125,341 | 47 |
| 40 | North Carolina | $129,360 | $62.19 | $137,141 | 29 |
| 41 | Louisiana | $128,870 | $61.96 | $146,100 | 18 |
| 42 | West Virginia | $128,610 | $61.83 | $143,703 | 20 |
| 43 | Pennsylvania | $127,070 | $61.09 | $130,232 | 45 |
| 44 | Kansas | $125,640 | $60.40 | $139,495 | 27 |
| 45 | South Carolina | $122,490 | $58.89 | $130,657 | 43 |
| 46 | Kentucky | $120,760 | $58.06 | $133,941 | 39 |
| 47 | Arkansas | $118,430 | $56.94 | $136,225 | 33 |
| 48 | Tennessee | $118,240 | $56.85 | $128,704 | 46 |
| 49 | Georgia | $115,390 | $55.48 | $119,832 | 50 |
| 50 | Mississippi | $105,920 | $50.92 | $121,813 | 49 |
| 51 | Alabama | $104,960 | $50.46 | $118,168 | 51 |
Highest-paying metros for PAs
| Metro | Median salary | Adjusted for cost of living |
|---|---|---|
| San Jose-Sunnyvale-Santa Clara, CA | $223,640 | $202,530 |
| San Francisco-Oakland-Fremont, CA | $184,380 | $159,480 |
| New York-Newark-Jersey City, NY-NJ | $167,650 | $148,939 |
| Seattle-Tacoma-Bellevue, WA | $167,290 | $150,531 |
| Riverside-San Bernardino-Ontario, CA | $165,490 | $155,474 |
| San Diego-Chula Vista-Carlsbad, CA | $165,160 | $147,613 |
| Portland-Vancouver-Hillsboro, OR-WA | $163,810 | $155,386 |
| Los Angeles-Long Beach-Anaheim, CA | $161,890 | $142,551 |
| Sacramento-Roseville-Folsom, CA | $161,470 | $151,373 |
| Santa Cruz-Watsonville, CA | $159,030 | $144,710 |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | $148,200 | $136,108 |
| Minneapolis-St. Paul-Bloomington, MN-WI | $145,030 | $138,358 |
| Boston-Cambridge-Newton, MA-NH | $142,410 | $131,537 |
| San Antonio-New Braunfels, TX | $140,160 | $147,979 |
| Providence-Warwick, RI-MA | $139,930 | $137,492 |
| Oklahoma City, OK | $138,920 | $153,659 |
| Baltimore-Columbia-Towson, MD | $138,790 | $132,830 |
| Hartford-West Hartford-East Hartford, CT | $138,680 | $134,974 |
| Columbus, OH | $137,550 | $144,078 |
| Houston-Pasadena-The Woodlands, TX | $137,240 | $139,148 |
| St. Louis, MO-IL | $136,120 | $143,152 |
| Cleveland, OH | $135,860 | $144,650 |
| Philadelphia-Camden-Wilmington, PA-NJ-DE-MD | $135,640 | $132,262 |
| Milwaukee-Waukesha, WI | $135,040 | $139,307 |
| Dallas-Fort Worth-Arlington, TX | $134,900 | $130,857 |
Sources: U.S. Bureau of Labor Statistics OEWS (occupation 29-1071, employer-reported), cost-of-living adjustment via U.S. Bureau of Economic Analysis Regional Price Parities. Adjusted value = median ÷ RPP × 100. Updated automatically.
Where a PA paycheck goes furthest
These are the ten states where the median PA salary buys the most, after adjusting for local prices:
- Oklahoma — $155,448 adjusted (from a $136,550 median, RPP 87.8)
- Vermont — $153,627 adjusted (from $150,490, RPP 98.0)
- Washington — $153,589 adjusted (from $164,360, RPP 107.0)
- Iowa — $153,563 adjusted (from $134,770, RPP 87.8)
- New Jersey — $152,282 adjusted (from $165,690, RPP 108.8)
- New Mexico — $151,737 adjusted (from $139,920, RPP 92.2)
- Oregon — $150,714 adjusted (from $155,780, RPP 103.4)
- South Dakota — $150,362 adjusted (from $133,200, RPP 88.6)
- North Dakota — $150,013 adjusted (from $133,450, RPP 89.0)
- California — $149,612 adjusted (from $165,650, RPP 110.7)
Notice what happened to that list. Oklahoma has the 18th-highest nominal PA salary in the country and the first-highest adjusted salary. Iowa climbs from 23rd to 4th. South Dakota goes 32nd to 8th, North Dakota 31st to 9th. Nobody puts these states on a "highest paying" listicle, and that is precisely why the jobs there are often easier to get and easier to negotiate.
Where a big number shrinks
The other direction is more painful, and more useful. These states drop hardest once you account for what living there costs:
- Washington, D.C. — 21st nominally, 48th adjusted. A $135,140 median becomes $122,965. A 27-place fall, the steepest in the country.
- Massachusetts — 10th nominally, 37th adjusted. $142,410 becomes $134,658.
- Maryland — 17th nominally, 42nd adjusted.
- Colorado — 28th nominally, 44th adjusted. $134,540 becomes $130,555.
- Connecticut — 15th nominally, 35th adjusted.
- Virginia — 20th nominally, 38th adjusted.
- Rhode Island — 13th nominally, 30th adjusted.
The bottom of the adjusted list belongs to Alabama ($118,168), Georgia ($119,832), Mississippi ($121,813), and D.C. ($122,965) — an unusual pairing, because Alabama and Mississippi get there through low pay while D.C. gets there through high prices. Same outcome for your budget, entirely different problem to solve. If you're in Alabama, you negotiate. If you're in D.C., you consider commuting from further out or you leave.
The states that win on both lenses
A few states pay well in absolute terms and hold up after adjustment — the rare case where you don't have to trade one for the other. Washington ($164,360 nominal, $153,589 adjusted, 3rd on both lists), New Jersey ($165,690 / $152,282, 1st nominal and 5th adjusted), and Oregon ($155,780 / $150,714, 6th and 7th) are the standouts. Vermont is the quiet one: 9th nominal, 2nd adjusted, on a genuinely modest cost base.
Metro areas tell an even sharper story
State averages hide a lot. Within a single state, a metro can pay 30% above or below the statewide median, and prices swing just as hard. Some of the widest gaps in the country:
- San Jose–Sunnyvale–Santa Clara, CA pays a median of $223,640 — the highest PA salary of any metro in the United States by a wide margin. Even after a 110.4 price index it's worth $202,530 adjusted, still first in the country. This is the one place where the enormous number survives contact with reality.
- Oklahoma City pays $138,920 — unremarkable on paper. At an RPP of 90.4 it's worth $153,659, which lands it fifth nationally among metros, ahead of Seattle and New York.
- Riverside–San Bernardino–Ontario, CA ($165,490 → $155,474) and Portland–Vancouver–Hillsboro, OR–WA ($163,810 → $155,386) both outrank San Francisco on adjusted pay, because San Francisco's 115.6 price index takes $184,380 down to $159,480.
- Miami–Fort Lauderdale–West Palm Beach, FL is the worst trade in the dataset: a respectable $132,360 median against a 114.2 price index leaves $115,948 in real terms.
- Atlanta–Sandy Springs–Roswell, GA pays $111,810 at almost exactly the national price level, landing at $111,745 — the lowest adjusted metro figure on the list.
For what it's worth, my own market — Santa Cruz–Watsonville, CA — pays a $159,030 median against a 109.9 price index, or $144,710 adjusted. A good salary that a housing market does its level best to reclaim.
What this adjustment does not capture
I'd rather you trust these numbers for the right reasons, so here is what they leave out.
State income tax. BEA's price parities measure the cost of goods and services, not what your state takes off the top. Nine states levy no individual income tax on wages in 2026 — Alaska, Florida, Nevada, New Hampshire, South Dakota, Tennessee, Texas, Washington, and Wyoming — and several of them (Washington, South Dakota, Alaska) already sit high on the adjusted list. Their real advantage is larger than shown here. New Hampshire's interest-and-dividends tax ended with tax year 2025, and Washington does tax capital gains for high earners, so check the specifics before you build a plan around it.
Student loan burden. A $155,000 adjusted salary in a state with a strong loan repayment program for underserved areas is worth considerably more than the same figure somewhere without one. If you're carrying six figures of PA school debt, federal and state repayment programs can outweigh every ranking on this page.
Everything else that varies by state. Malpractice premiums, licensure fees and renewal cycles, scope-of-practice law, and — the big one — how many PA jobs actually exist near you. A state with the best adjusted salary in the country and three open positions is not a plan.
Timing. BLS wage data reflects May 2025 and is published with a lag. BEA price parities are the 2024 series. Both are the most recent available, and both describe a market that has already moved a little since. Treat them as a well-grounded starting point, not a live quote.
Turning this into a better offer
Rankings are interesting. What changes your life is walking into a negotiation knowing exactly where your specific offer falls. If you have an offer in hand, you can run it through PA Contract Check and get a free 0–100 score plus your percentile against BLS wage data for your own state in about thirty seconds — no signup. It'll also tell you which terms in the contract are worth pushing on, which is usually where the real money hides. And if you are paid by the hour without benefits — per diem, extra help, locums, or 1099 — cost of living is only half the story: our PA hourly rate calculator works out the break-even rate that actually matches a benefited PA in your market.
For the full picture — national percentiles, specialty and experience breakdowns, and the same metro data without the cost-of-living lens — see the PA Salary Report, which is the parent page for everything you see here.
Sources
Wage figures: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025, occupation 29-1071 (Physician Assistants). Price adjustment: U.S. Bureau of Economic Analysis, Regional Price Parities by State and Metropolitan Area, 2024 series, U.S. = 100. Total compensation and bonus figures: AAPA 2026 Salary Report. Additional context: NCCPA 2025 Statistical Profile of Board Certified PAs.
