How much does a CRNA make in 2026?

In the Bureau of Labor Statistics May 2025 wage data, state medians for nurse anesthetists run from $126,600 in Utah to $341,210 in Alaska, and the median across the 44 states with published figures is $247,240. Those are W-2 salaries; locum CRNAs paid as 1099 contractors are not counted.

Is it better for a CRNA to be 1099 or W-2?

It depends on how steadily you can book work and what you value. A 1099 locum rate is usually higher by the hour, but you pay both halves of Social Security and Medicare, fund your own insurance and retirement, and are unpaid between assignments. A W-2 role trades some of the hourly rate for benefits, paid time off, a retirement match, and a predictable schedule. Compare the locum gross you can realistically book with the permanent offer’s total value, not its base salary.

Which states pay CRNAs the most?

In the May 2025 federal data, the highest state medians for nurse anesthetists were Alaska ($341,210), New York ($321,030), Massachusetts ($295,550), California ($292,410), and New Jersey ($291,350).

Do CRNAs earn more in opt-out states?

In the May 2025 federal data, the typical state that has fully opted out of physician supervision had a CRNA median of $263,930, against $236,960 in states where the federal rule applies. That is a correlation, not a cause: the opt-out list includes high-cost markets and rural states that depend on CRNA-only anesthesia.

How is locum CRNA pay taxed?

As self-employment income when you work as a 1099 contractor. Nothing is withheld, so you make quarterly estimated payments and pay self-employment tax, both halves of Social Security and Medicare, on your net earnings. Licensing, certification, CME, and qualifying travel are deductible business expenses. An accountant who works with locum clinicians is worth the fee in your first year.

CRNA Pay in 2026: Locum vs Permanent, 1099 vs W-2, and Pay by State

A permanent salary and a locum hourly rate do not compare directly. Here is what nurse anesthetists earn in every state that publishes it, what locum assignments pay and what the rate leaves out, and how to put a 1099 rate and a W-2 offer on the same page.

Every CRNA weighing a move ends up comparing two numbers that do not compare: a permanent salary and a locum hourly rate. The salary arrives with health insurance, a retirement match, paid time off, and an employer paying half of your Social Security and Medicare. The hourly rate arrives with none of that and is still, very often, the bigger number. This guide puts both on the same page: what the federal wage data says CRNAs earn in each state, what locum assignments advertise, how to turn a 1099 rate into something you can hold against an offer, and how the supervision rules in your state shape the job you would be paid for.

What CRNAs earn by state

The Bureau of Labor Statistics publishes annual wages for nurse anesthetists in 44 states in its May 2025 Occupational Employment and Wage Statistics. The median across those states is $247,240. The highest state median is Alaska at $341,210, followed by New York at $321,030, Massachusetts at $295,550, California at $292,410, and New Jersey at $291,350. The lowest is Utah at $126,600.

Two cautions before you lean on a state figure. The survey counts employees, so it reflects W-2 salaries and leaves out self-employed and 1099 CRNAs, which means most locum income is not in it. And a state median blends every setting, from academic centers to rural hospitals, so the posting in front of you can sit well above or below it.

Nurse anesthetist median and mean annual wages by state, Bureau of Labor Statistics, with supervision opt-out status
State	Median	Mean	Supervision
Alaska	$341,210	$311,110	Opted out
New York	$321,030	$285,020	Federal rule applies
Massachusetts	$295,550	$303,310	Opted out
California	$292,410	$283,780	Opted out
New Jersey	$291,350	$290,920	Federal rule applies
Illinois	$286,830	$251,600	Federal rule applies
Vermont	$283,060	$289,870	Opted out
West Virginia	$278,530	$275,100	Federal rule applies
Montana	$277,380	$270,330	Opted out
New Hampshire	$275,980	$277,740	Opted out
Washington	$274,390	$273,760	Opted out
Wisconsin	$273,170	$272,470	Opted out
Iowa	$273,070	$253,510	Opted out
Oregon	$272,330	$280,010	Opted out
Minnesota	$266,190	$259,210	Opted out
South Carolina	$265,480	$276,380	Federal rule applies
South Dakota	$263,930	$249,720	Opted out
Idaho	$263,130	$265,850	Opted out
Wyoming	$255,250	$260,650	Partial opt-out
Virginia	$252,110	$254,820	Federal rule applies
Arizona	$248,660	$256,610	Opted out
Maine	$247,470	$259,370	Federal rule applies
Michigan	$247,010	$253,760	Opted out
Nebraska	$246,730	$255,610	Opted out
Texas	$244,990	$255,820	Federal rule applies
North Dakota	$244,240	$248,580	Opted out
Missouri	$242,630	$271,780	Federal rule applies
Connecticut	$236,960	$225,810	Federal rule applies
Ohio	$231,810	$236,830	Opted out
Georgia	$224,630	$226,330	Federal rule applies
North Carolina	$224,610	$226,780	Federal rule applies
Arkansas	$224,280	$198,540	Opted out
Maryland	$223,140	$218,050	Federal rule applies
Kentucky	$222,520	$229,690	Opted out
Louisiana	$222,130	$243,240	Federal rule applies
Pennsylvania	$221,530	$233,320	Federal rule applies
Kansas	$212,090	$206,320	Opted out
Tennessee	$211,450	$218,870	Federal rule applies
Florida	$210,570	$239,830	Federal rule applies
Mississippi	$198,410	$217,470	Federal rule applies
Alabama	$190,300	$189,120	Federal rule applies
Oklahoma	$156,830	$190,820	Opted out
New Mexico	$129,370	$149,980	Opted out
Utah	$126,600	$139,750	Partial opt-out

Bureau of Labor Statistics Occupational Employment and Wage Statistics, May 2025, nurse anesthetists (SOC 29-1151), annual wages by state, highest median first. States without a published figure are omitted. Supervision status from the American Association of Nurse Anesthesiology's July 2026 opt-out fact sheet: “opted out” states have exempted themselves from Medicare's physician-supervision requirement for CRNAs; state law and facility bylaws still apply everywhere.

Do opt-out states pay more?

In this data, the typical state that has fully opted out of federal physician supervision had a CRNA median of $263,930, against $236,960 in states where the federal rule still applies. Treat that as context rather than cause. The opt-out list includes high-cost markets such as Alaska, Massachusetts, and California and rural states that depend on CRNA-only anesthesia, and both push pay up on their own.

What our open CRNA searches are paying

Across the 5 permanent CRNA searches MedStaff Nationwide has open today, posted base compensation runs $175k–$390k, with a median midpoint of $275k. Those are base salaries before call pay, sign-on bonuses, and benefits, and they update as searches open and close. The roles themselves are on our CRNA jobs page.

What locum CRNAs earn

Advertised locum CRNA rates on national job boards commonly run about $175 to $250 an hour in 2026, and some metro postings run higher. In a 2026 survey of 1099 CRNAs published by APEX Anesthesia, most reported earning $200 to $249 an hour and about a quarter reported more than $250. Five things move a locum rate:

Call, nights, and weekends. Call is usually paid at its own rate, and assignments heavy with it pay more by the hour.
Case mix. Cardiac, pediatric, trauma, and OB coverage command more than general and orthopedic rooms.
Notice. A facility that needs coverage next week pays for the urgency.
Location and travel. Remote rural hospitals pay a premium, and travel and lodging are arranged or reimbursed on top.
Practice model. Being the only anesthesia provider in the building is worth more than a medically directed room.

Guaranteed hours matter as much as the rate. A $250 rate with a 32-hour weekly guarantee pays less than $220 with a 40-hour guarantee if the schedule thins out, and call hours billed at the call rate should never count toward the guarantee. Read both lines of the assignment confirmation before you compare rates.

1099 vs W-2: putting the two on the same page

Most locum CRNAs work as independent contractors on a 1099, including those placed by MedStaff Locum Tenens. Permanent CRNAs are employees on a W-2. Here is what each side actually includes:

	Locum on a 1099	Permanent on a W-2
Taxes withheld	None; you pay estimated tax quarterly	Withheld from every paycheck
Social Security and Medicare	Both halves, as self-employment tax: 15.3 percent up to the Social Security wage base, 2.9 percent above it	Half; the employer pays the other half
Health insurance	Yours to buy	Employer plan, usually subsidized
Retirement	Your own solo 401(k) or SEP-IRA, with no match	Employer 401(k) or 403(b), often with a match
Malpractice	Usually provided by the agency for each assignment	Provided by the employer; check who pays the tail
Paid time off	None; time off is unpaid	Vacation, sick time, and CME days
Weeks between assignments	Unpaid	Not a factor
Business expenses	Deductible: licenses, certification, CME, and qualifying travel	Generally not deductible for employees
Travel and lodging	Arranged or reimbursed per assignment	Usually none; relocation is sometimes paid

Now run the numbers at $200 an hour. Forty hours a week for forty-six weeks is $368,000 before anything comes out. From that, a 1099 CRNA pays the employer's half of Social Security and Medicare as well as their own, buys health insurance, funds retirement with no match, and is unpaid for any week without an assignment. A permanent offer at a lower base carries all of those for you. Whether locum work still comes out ahead depends mostly on how steadily you can book it, and on how much you value choosing where and when you work.

A practical way to compare: turn the permanent offer into its total value before you look at the locum rate. Add base salary, call pay, sign-on or retention bonus, the employer's half of payroll taxes, the health premium the employer pays, the retirement match, malpractice and tail coverage, CME, and paid time off. Then compare that figure with the locum gross you can realistically book in a year, not the one a full calendar would produce.

How supervision rules shape the job you would be paid for

Medicare's conditions of participation require a CRNA to be supervised by the operating practitioner, such as the surgeon, or by an anesthesiologist who is immediately available, unless the state's governor has opted out of that requirement. According to the American Association of Nurse Anesthesiology's July 2026 fact sheet, 27 states and Guam have opted out: Alaska, Arizona, Arkansas, California, Colorado, Delaware, Idaho, Iowa, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, South Dakota, Utah, Vermont, Washington, Wisconsin, and Wyoming. Utah and Wyoming opted out only for critical access and certain rural or small hospitals, Colorado moved from a partial to a full opt-out in 2023, and Vermont and Ohio joined in July 2026.

An opt-out does not by itself make a role independent. State law and each facility's medical staff bylaws still decide how CRNAs practice there. In practice, the job you would take falls into one of a few models: a medically directed care team, where an anesthesiologist directs up to four concurrent rooms; a CRNA-only department, common in rural hospitals, surgery centers, and offices; or a mix. The model affects pay, call, and how long people stay, so ask which one the role is before you compare offers.

Negotiating a permanent CRNA offer

Base salary starts the conversation. These are the lines where CRNA offers actually separate:

Call pay. Whether call is paid separately, at what rate, and how often you take it.
Schedule. Eights, tens, or twelves, weekends, and how the schedule is built and changed.
Sign-on and retention bonuses. The amount, and the repayment terms if you leave early: prorated or all at once, and whether repayment is gross or net of tax.
Loan repayment. Employer, state, or federal programs where the site qualifies, which can be worth more than a higher base.
Retirement match. The percentage and the vesting schedule.
Malpractice. Occurrence or claims-made, and who pays the tail if you leave.
CME, licenses, and certification. An annual allowance and paid days to use it.
Practice model in writing. Care team ratio or CRNA-only, so the job does not change after you start.

Questions to ask before a locum assignment

What is the hourly rate, and what are the guaranteed weekly hours?
How is call paid, and does it count toward the guarantee?
Is malpractice provided, is it occurrence or claims-made, and who carries the tail?
Are travel and lodging arranged, or reimbursed, and up to what amount?
What happens, and what am I paid, if the facility cancels or shortens the assignment?
Who handles credentialing and licensing, and how far ahead do I need to start?
When and how am I paid, and how are hours approved?

Many CRNAs do both over a career: a permanent role for stability, locum work to try a region or bridge a move. MedStaff Nationwide's CRNA recruiters run permanent searches, and our sister company places CRNAs on locum assignments, so one conversation can cover both.