Average Emergency Room Nurse Practitioner Salary by State
Emergency Room Nurse Practitioners (ENPs) serve on the front lines of America's healthcare system—from snowmobile crashes in Alaska to heat‑stroke cases in Arizona. Salaries can swing by more than $60,000 depending on where you practice, local cost‑of‑living pressures, and state scope‑of‑practice laws. This guide aggregates the latest 2025 data from the U.S. Bureau of Labor Statistics (BLS), state labor departments, and high‑authority compensation sites so you can benchmark offers, pursue high‑pay locales, or negotiate raises with confidence.
How Geography Shapes ENP Pay
Before diving into state‑by‑state numbers, it's helpful to understand why location has such a dramatic impact. Urban trauma centers in California command higher pay due to sky-high housing costs, union contracts, and the 24/7 nature of patient care. Conversely, rural hospitals in states like Mississippi offer lower base salaries but may offset pay gaps with loan‑repayment or housing stipends. Keep these variables in mind as you compare figures across regions.
National Salary Snapshot
The paragraph below sets context for the upcoming table, clarifying how the national median provides a reference point against which each state's salary will be compared.
| Metric | Value | Source (2025) |
|---|---|---|
| U.S. Median NP Salary (all specialties) | $132,050 | BLS Occupational Employment Statistics |
| Estimated National ENP Premium | +7 % | Based on trauma skills & shift differentials |
| Projected ENP Job Growth 2022–2032 | 45 % | BLS Fastest‑Growing Occupations |
Using the 7 % premium, the estimated national median for ER NPs lands around $141,300. States above that line are outpacing the national benchmark, while those below may compensate with lower living costs or attractive perks.
Average ER Nurse Practitioner Salary by State
The following table presents average annual salaries for Emergency Room Nurse Practitioners in all 50 states plus Washington, DC. Data blends BLS state wage files, Salary.com metro‑specific emergency NP listings, and Indeed user‑reported figures. Where multiple sources disagree by more than 5 %, we calculate the midpoint to provide a realistic reference range.
| State | Average ENP Salary | Cost‑of‑Living Index† | Notes |
|---|---|---|---|
| Alabama | $123,600 | 88 | Lower base; strong rural loan‑repayment programs |
| Alaska | $154,900 | 125 | Includes remote‑site stipends & housing allowances |
| Arizona | $136,200 | 97 | Rapid growth in Phoenix‑area freestanding EDs |
| Arkansas | $121,500 | 87 | Critical‑access hospitals offer autonomy bonuses |
| California | $171,500 | 150 | Highest baseline; high housing costs |
| Colorado | $142,300 | 111 | Denver trauma centers pay best |
| Connecticut | $146,800 | 118 | Unionized systems; high income‑tax burden |
| Delaware | $138,400 | 103 | No sales tax offsets moderate salary |
| District of Columbia | $155,600 | 141 | Federal benefits at VA Medical Center |
| Florida | $133,200 | 100 | Night‑shift premiums common in hurricane zones |
| Georgia | $129,900 | 92 | ATL Level I trauma centers pay $135k+ |
| Hawaii | $150,500 | 165 | Highest COL; relocation bonuses up to $15k |
| Idaho | $128,400 | 94 | Rural EDs cover inpatient & clinic shifts |
| Illinois | $138,700 | 97 | Chicago trauma hubs drive state average up |
| Indiana | $126,800 | 90 | Cost‑effective for midwestern ENPs |
| Iowa | $124,100 | 89 | Loan‑forgiveness in critical‑access sites |
| Kansas | $123,800 | 88 | Signing bonuses in Wichita & Topeka |
| Kentucky | $125,600 | 89 | New prescriptive authority laws boosting demand |
| Louisiana | $126,200 | 91 | Overtime pay for hurricane season surge guards |
| Maine | $129,100 | 109 | Seasonal tourism spikes ED visits |
| Maryland | $144,300 | 120 | Baltimore trauma centers & federal facilities |
| Massachusetts | $150,900 | 134 | Academic centers, strong union presence |
| Michigan | $132,700 | 93 | Detroit Level I trauma premiums |
| Minnesota | $139,400 | 101 | Mayo Clinic raises statewide average |
| Mississippi | $118,600 | 86 | Among lowest base; robust rural stipends |
| Missouri | $126,900 | 91 | St. Louis trauma centers paying > $135k |
| Montana | $129,500 | 97 | Frontier sites offer housing and travel pay |
| Nebraska | $125,400 | 90 | Critical‑access autonomy; lower malpractice costs |
| Nevada | $148,700 | 112 | Las Vegas night‑shift differentials high |
| New Hampshire | $138,900 | 112 | No state income tax; moderate housing costs |
| New Jersey | $149,300 | 125 | High malpractice rates factored into salary |
| New Mexico | $128,700 | 94 | Rural hospitals pay extra for bilingual ENPs |
| New York | $154,400 | 134 | NYC trauma centers pay $160k+ but tax burden high |
| North Carolina | $131,800 | 95 | Fast‑growing Raleigh‑Durham ED market |
| North Dakota | $127,200 | 92 | Oilfield boom drives western ND premiums |
| Ohio | $129,300 | 90 | Metro bonuses in Cleveland & Columbus |
| Oklahoma | $122,900 | 88 | Cost‑competitive; procedure autonomy in rural EDs |
| Oregon | $148,200 | 116 | Portland unions elevate wages |
| Pennsylvania | $134,800 | 94 | Academic trauma centers in Philly & Pittsburgh |
| Rhode Island | $139,700 | 113 | Single‑metro state; strong hospital networks |
| South Carolina | $127,600 | 92 | Coastal hurricane zones add surge pay |
| South Dakota | $124,400 | 89 | Rural ED autonomy; lower malpractice costs |
| Tennessee | $128,100 | 91 | No state income tax; Nashville premiums |
| Texas | $134,400 | 93 | High volume, no state income tax |
| Utah | $133,900 | 101 | Salt Lake City trauma centers pay top dollar |
| Vermont | $131,400 | 110 | Rural critical‑access loan forgiveness |
| Virginia | $138,200 | 103 | Northern Virginia DC‑market influence |
| Washington | $149,800 | 118 | Level I trauma at Harborview sets bar |
| West Virginia | $122,000 | 87 | Federal HPSA loan‑repayment opportunities |
| Wisconsin | $131,900 | 94 | Academic centers in Madison & Milwaukee |
| Wyoming | $128,800 | 94 | Frontier hospitals offer housing + call pay |
†National average cost‑of‑living index = 100. Numbers above 100 indicate higher living costs.
Regional Patterns and Takeaways
Comparing the salary table reveals three clear trends:
- West Coast premium: California, Washington, and Oregon top the charts, reflecting union contracts and higher living costs.
- No‑income‑tax advantage: States like Texas, Florida, and Nevada pair solid salaries with lower tax burdens.
- Rural incentive packages: Lower‑pay states often offset base gaps with loan‑repayment, housing, or call‑pay perks.
Adjusting Salaries for Cost of Living
Raw salary figures can mislead. Earning $ 149,000 in Seattle may stretch to less than $ 134,000 in Houston when accounting for housing and tax differences. Use a cost‑of‑living calculator to compare net salaries. For example, a $ 140,000 ENP salary in Dallas equates to roughly $ 116,000 in San Francisco after taxes and expenses.
How to Use This Data for Negotiation
Knowing the state average is only your starting point. These tips help convert numbers into a stronger negotiating position:
- Benchmark against metro data: A Dallas ENP should cite Texas metropolitan averages, not the statewide mean.
- Quantify your value add: List trauma certifications, leadership roles, and productivity metrics to justify top‑quartile pay.
- Factor in shift differentials: Night and holiday premiums can add $10,000–$20,000 to the base.
- Request relocation or housing stipends, Especially in high‑cost states like California or Hawaii.
- Leverage competing offers: Even verbal interest from another facility can increase your leverage.
Additional Tools and Next Steps
Whether you're evaluating multiple offers or planning a cross‑country move, the resources below can help you translate salary data into a concrete career strategy.
- ENP Certification Exam Guide – Passing the specialty board can boost your earning power by $4k–$9k annually.
- Cost‑of‑Living Calculator – Compare take‑home purchasing power before relocating.
- Loan Repayment & Incentive Programs – Explore federal and state debt‑forgiveness options tied to underserved emergency departments.
Sources
- U.S. Bureau of Labor Statistics. Occupational Employment & Wage Statistics (May 2024).
- Salary.com. Emergency Room Nurse Practitioner Pay Benchmarks (2025).
- Indeed. Emergency Nurse Practitioner Salaries by State (2025 snapshot).
- Missouri Economic Research and Information Center. Cost of Living Index by State (Q1 2025).
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