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How is a nurse’s salary determined and what are the highest-paid nursing specialties?

Published On: 
April 13, 2022
Written by:
Mary Flenner

If you are considering a future in nursing or contemplating a shift in your nursing career, you’re likely to compare different salary possibilities and options. As compensation transparency becomes the norm, more salary ranges are being listed on job postings. When you see a broad range on a nursing job description, you may be unsure where you’ll fall in the range or what you can expect a fair offer to be based on your personal background.

If you’re a current RN you may have also wondered what certifications you could earn to increase your salary or what the highest paying nursing specialties are. We’ll cover all of the above so you can go into your next job offer negotiation feeling confident. 

As a recruiting firm dedicated to helping nurse leaders, managers, and healthcare workers find opportunities, we are well versed in what makes up a fair, good, and great salary while assisting our candidates through salary negotiation.

The main factors that determine a nursing salary are: education, experience, certification, shift and location. 

It's important to keep this in mind because a lot of information can be packed into a "national average" number and it can be quite easy to forget about these details that get buried into aggregated figures.

What is the average RN Nurse Salary in 2021?

According to the BLS, Bureau of Labor Statistics, as of 2021, (data released bi-annually) the average national salary for Registered Nurses in 2021 was $75,338 per year.

The Factors Determining a Nurse's Salary and Wage 


In general, the more advanced your degree, the more high-paying nursing roles are available. A higher nursing degree is a great way to advance your career and secure new opportunities and an increased salary.

Nationally, the average salary for a nurse with a master’s degree (MSN) is about $131,000 or $52/hour. A Nurse with an MSN can make, on average, about $30,000 more than a nurse with a BSN, according to

Advance Practice Nurses (APRNs) have an average salary of $97,000, whereas the national average for those with a BSN, earn approximately $84,000 annually. An RN with an associate’s degree starts out earning an average of $49,000 per year, while a bachelor’s degree in nursing starts out earning an average annual salary of around $54,000 per year.


With more years of experience comes more knowledge and value. Your years of experience in nursing and your specialty area will impact your salary. 

Once you’ve had a few years of experience, typically between 4-5 yrs of bedside experience, you may seek options to become a Nurse Manager. If becoming an RN Nurse Manager is your goal, obtaining your MSN will give you a leg up on the competition and help you find a role within a top hospital. Many hospitals only hire nurse managers with advanced degrees and this is fast becoming a requirement in many healthcare systems. 

A Nurse Manager salary nationally ranges from $79,000 and $130,000, with an average of $88,000, according to

MSN Nurse Experience : Salary

(Source: Compiled using data from U.S. Bureau of Labor Statistics)

Starting (Entry-Level)


1-4 Years of Experience


5-9 Years of Experience


10-19 Years of Experience


20 Years or More Experience


Average (MSN) Salary



Gaining certifications is another way to earn nurse leadership roles and increase your salary.  

The CNML, Certified Nurse Manager and Leader is a smart option for leaders in a nurse manager or other supervisory role and is offered in collaboration with the American Association of Critical-Care Nurses (AACN). Certified in Executive Nursing Practice (CENP): This certification is geared toward nurse leaders working in nurse executive positions.

An immense amount of nursing experience can often be considered equivalent to a more advanced degree and these more experienced nurses may be able to find a role as a Nurse Manager without a master’s degree. Nurses with a decade or more of experience can also obtain these certifications (CNML, AACN, CENP) easier than nurses who are newer in their careers. 


Overall, nurses working the night shift make more than those who work the day shift. Working holidays and filling in can also increase your pay.


It may not come as a surprise but higher salaries don't always mean more money in your pocket. Why? If you’re relocating from the midwest to the east coast or California, you may get excited when you see the higher nursing salary ranges, but you must also take into account the increased cost of living. Many of the states offering the highest salaries have a corresponding more expensive cost of living. 

What are the highest paid states for nursing salaries in 2022?

Nurses working for hospitals tend to make more on average than RNs who work in private practice. In terms of geographic location, some of the highest paying states for nurse salaries in 2022 are:

  1. California
  2. District of Columbia
  3. Massachusetts
  4. Oregon
  5. Alaska
  6. Nevada
  7. New York
  8. Washington
  9. New Jersey
  10. Connecticut
  11. Rhode Island
  12. Arizona
  13. Maryland 

What are the National Average Salaries for Specific Nurse Specialities?

What area of patient care a nurse works in also has a large impact on their salary. These are some of the top-earning positions and specialties in nursing. 

Nurse Practitioner

Nurse practitioners remain a very in-demand role. Nurse practitioners may work in collaboration with primary care physicians or operate their own family care practices and prescribe controlled substances. Nurse Practitioners earn an average salary of $95,000. 


 A Certified Registered Nurse Anesthetist (CRNA) is a highly-skilled nurse who administers anesthesia to patients alongside surgeons, anesthesiologists, dentists, and other healthcare professionals. A CRNA earns an average annual salary of $133,000. 


A Certified Nurse Midwife (CNM) working in labor and delivery or prenatal care has an average annual salary of $102,000. 

Psychiatric Mental Health Nurse Practitioner

A psychiatric mental health nurse practitioner may work at a behavioral health hospital or within an acute care hospital dealing with mental, emotional, and physiological support to patients and their families. A PMHNP earns an average salary of $102,000 per year. 

Pain Management 

Nurses who specialize in pain management help patients suffering from chronic pain or who are recovering after surgery. Pain management nurses also help patients navigate their medication and treatment plans. Their average salary is $90,288. 

Pediatric Oncology Nurse

A pediatric oncology nurse helps children undergoing cancer treatments by providing comfort and support to them and their parents. Pediatric oncology nurses earn an average of $72,000 annually. 

Medical-Surgical Nurse 

A medical-surgical nurse or, as is often called in healthcare, a "med-surg" nurse, deals with a variety of circumstances and provides care to patients directly before and after medical procedures. The average salary for a med-surg nurse is around $77,000. 

Critical Care Nurse

A critical care nurse usually works in the ICU Intensive Care Unit within a hospital dealing with patients in serious life and death situations. A critical care nurse earns an average of $76,000.

If you want to talk over how to best negotiate a nursing offer or get tailored advice on what salary you can expect based on your personal nursing experience, please connect with us.

We believe in honest communication and transparency and can provide feedback on what salary that you can realistically ask for and what may be out of reach.  Send us an email at, we’d love to hear from you. 

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