Top 10 Highest-Paying States for Anesthesiologists in 2026

Key Takeaways

• Top-paying states offer anesthesiologist compensation of $400,000–$450,000+ annually
• North Carolina leads with reported compensation above $420,000
• Non-academic anesthesiologists earn a median of ~$500,000 total compensation
• Academic anesthesiologists earn ~$450,000 median total compensation
• Locum tenens anesthesiologists can earn $300–$450/hr in 2025–2026
• Job growth is a steady 3.2% projected (2024–2034) with approximately 45,300 employed nationwide

Anesthesiologists are among the highest-paid physicians in the United States — and your earning potential shifts significantly depending on where you practice. Whether you're finishing residency, considering a relocation, or evaluating locum tenens opportunities, understanding the anesthesiologist salary by state landscape is essential for strategic career planning.

In this 2026 guide, we rank the highest-paying states for anesthesiologists using the latest compensation data from CompHealth, BLS, and leading physician compensation surveys. We'll break down not just raw salary, but the factors that determine real-world take-home pay — from practice setting and subspecialty to cost of living and tax considerations.

Anesthesiology remains a rewarding and lucrative specialty. The BLS reports a mean base salary of $336,640 (May 2024), but this significantly understates total compensation. Verified physician surveys show median total comp of $535,000 (SalaryDr, 2026), with job listings averaging $393,215 (ZipRecruiter, 2026) and starting salaries of ~$377,000 (AMN Healthcare, 2025). The question isn't whether anesthesiologists are well-compensated — it's where they're compensated the most.

At-a-Glance: Top 10 Highest-Paying States for Anesthesiologists

📊 Salary Data Sources & Freshness This guide cites data from multiple sources: the U.S. Bureau of Labor Statistics (BLS, May 2024 — latest government data), ZipRecruiter (2026 advertised salaries), Glassdoor, AMN Healthcare, SalaryDr, and other industry reports. Government salary surveys have a 12–18 month reporting lag. Current advertised salaries on job boards typically reflect real-time market conditions and may be higher. Anesthesia provider compensation has risen steadily over the past five years.

(Sources: CompHealth 2025 Compensation Data, BLS May 2024, industry surveys)

Important note: Many anesthesiologist salaries exceed the BLS wage reporting cap, meaning official government data significantly underrepresents true compensation. The figures above reflect total compensation data from multiple industry sources.

Cost-of-Living Adjusted Perspective

Note: COL Index based on composite state-level data. 100 = national average.

When cost of living is factored in, Alabama, Tennessee, Texas, and North Carolina emerge as the true value leaders. Hawaii's impressive raw salary is significantly diminished by its extraordinary cost of living.

Detailed State-by-State Breakdown

#10: Tennessee — $370,000+

Tennessee combines strong anesthesiologist compensation with one of the nation's most favorable financial environments. With no state income tax and a cost of living 11% below the national average, every dollar goes further here.

Why Tennessee stands out:

• No state income tax
• Cost of living 11% below national average
• 2,950 CRNAs employed (indicating a large anesthesia care team market)
• Major healthcare hub in Nashville
• Growing surgical centers across the state

Nashville's status as a healthcare industry capital means anesthesiologists have access to major hospital systems, academic positions at Vanderbilt, and a thriving private practice environment. Memphis and Knoxville offer additional market opportunities.

👉 Browse anesthesiologist jobs in Tennessee

#9: Florida — $375,000+

Florida's massive and growing population creates relentless demand for surgical services — and anesthesiologists to staff them. With no state income tax, Florida effectively gives you a built-in raise compared to high-tax states.

Why Florida stands out:

• No state income tax
• Booming population driving surgical demand
• Diverse practice settings from academic to private
• Year-round pleasant climate
• Strong market for both permanent and locum tenens work

Florida's healthcare market is one of the nation's largest, with opportunities ranging from Miami's academic medical centers to rural facilities seeking anesthesiologists willing to serve underserved communities.

👉 Browse anesthesiologist jobs in Florida

#8: Georgia — $380,000+

Georgia's anesthesiologist market is driven by Atlanta's massive healthcare infrastructure and growing suburban and rural demand. The state offers a strong blend of compensation, cost of living, and professional opportunity.

Why Georgia stands out:

• Atlanta is a major healthcare hub with multiple Level I trauma centers
• Cost of living ~7% below national average
• Expanding surgical volumes in suburban areas
• Strong CAA employment market (physician-led teams)
• Emory University system offers academic excellence

Georgia is also a key state for Certified Anesthesiologist Assistants (CAAs), making it an excellent environment for anesthesiologists who prefer the anesthesia care team model.

👉 Browse anesthesiologist jobs in Georgia

#7: Texas — $385,000+

The Lone Star State is a titan in healthcare employment, offering anesthesiologists both high compensation and no state income tax. Texas employs the most CRNAs in the nation (5,390), reflecting an enormous and growing anesthesia services market.

Why Texas stands out:

• No state income tax — massive effective income boost
• Largest CRNA employment base signals huge anesthesia demand
• Diverse metros: Houston, Dallas, San Antonio, Austin
• Cost of living ~8.5% below national average
• Major medical centers (MD Anderson, UT Southwestern, Baylor)

Texas offers anesthesiologists a rare combination: top-tier compensation, low taxes, low cost of living, and a dynamic job market with everything from academic positions to high-volume surgical centers.

👉 Browse anesthesiologist jobs in Texas

#6: Alabama — $390,000+

Alabama delivers arguably the best financial value for anesthesiologists in the country. BLS data shows Alabama among the highest-paying states with available wage data ($323,940 mean per BLS), and total compensation packages from private practice and hospital-employed positions push well above $390,000.

Why Alabama stands out:

• Cost of living ~12% below national average — exceptional purchasing power
• Strong demand in both urban and rural settings
• UAB (Birmingham) offers academic excellence
• Relatively low provider competition
• BLS-reported mean of $323,940 (many positions exceed this)

When you combine Alabama's compensation with its remarkably low cost of living, the adjusted value exceeds $443,000 — the highest on this list. For anesthesiologists prioritizing wealth building, Alabama is hard to beat.

👉 Browse anesthesiologist jobs in Alabama

#5: Nevada — $400,000

Nevada's booming healthcare sector, driven by Las Vegas's explosive population growth, creates strong demand for anesthesiologists. The state's lack of state income tax adds another layer of financial advantage.

Why Nevada stands out:

• No state income tax
• $400,000 average compensation (CompHealth data)
• Las Vegas metro driving rapid healthcare expansion
• Growing need for anesthesiologists in new surgical centers
• Cost of living near the national average

Nevada is particularly attractive for anesthesiologists seeking high compensation without the cost-of-living penalties of California or the Northeast. The Las Vegas market continues to expand rapidly.

👉 Browse anesthesiologist jobs in Nevada

#4: Hawaii — $408,000

Hawaii offers one of the highest raw compensation figures for anesthesiologists in the nation. The island setting limits provider supply, creating premium compensation to attract mainland-trained physicians.

Why Hawaii stands out:

• $408,000 average compensation
• Severe provider shortages drive premium pay
• Unique lifestyle opportunity
• Strong sign-on bonuses and relocation packages
• Limited competition for positions

The important caveat: Hawaii's cost of living is approximately 70% above the national average. Housing costs are particularly extreme. However, for anesthesiologists who value the lifestyle, the premium compensation partially offsets these costs, and many employers offer housing assistance.

👉 Browse anesthesiologist jobs in Hawaii

#3: Colorado — $413,000

Colorado's rapidly growing population and healthcare infrastructure create robust demand for anesthesiologists. The Denver metro area leads much of this growth, but mountain communities and smaller cities also compete aggressively for anesthesia providers.

Why Colorado stands out:

• $413,000 average compensation (CompHealth)
• Rapidly growing healthcare market
• Exceptional quality of life — outdoor recreation, culture
• Strong academic center at University of Colorado
• Both urban and rural opportunities

Colorado's cost of living is about 5% above the national average, making it a solid value proposition when combined with its high compensation and unmatched quality of life.

👉 Browse anesthesiologist jobs in Colorado

#2: Oregon — $415,000

Oregon continues to invest heavily in healthcare infrastructure, and anesthesiologists benefit directly. With growing surgical volumes and a relatively limited provider supply, compensation packages here are among the nation's most competitive.

Why Oregon stands out:

• $415,000 average compensation
• No state sales tax — stretches your dollars further
• Growing healthcare systems in Portland and beyond
• Strong demand in rural and underserved areas
• Progressive practice environment

Oregon's income tax rates are notably high, which is an important consideration. However, the combination of high compensation, no sales tax, and excellent quality of life makes Oregon a popular destination for anesthesiologists exploring new opportunities.

👉 Browse anesthesiologist jobs in Oregon

#1: North Carolina — $420,000+

North Carolina leads the nation in anesthesiologist compensation, with average total packages exceeding $420,000. The state's thriving healthcare sector — anchored by Duke, UNC, and Wake Forest systems — creates intense competition for anesthesia talent.

Why North Carolina stands out:

• Highest reported anesthesiologist compensation in the nation
• World-class academic medical systems
• Cost of living ~5% below national average
• Growing population driving demand for surgical services
• Strong mix of academic, community, and private practice options
• Emerging research triangle health innovation corridor

North Carolina offers the complete package: premier compensation, manageable cost of living, outstanding medical facilities, and a quality of life that's hard to match. Whether you're interested in academic medicine or private practice, North Carolina delivers.

👉 Browse anesthesiologist jobs in North Carolina

Academic vs. Non-Academic Compensation

One of the most significant factors affecting your anesthesiologist salary isn't geography — it's practice setting.

The roughly $50,000 gap between academic and non-academic compensation reflects the trade-off between research/teaching opportunities and pure earning power. Both paths are excellent — the right choice depends on your professional goals and priorities.

Factors That Influence Anesthesiologist Salary by State

Subspecialty Premiums

Anesthesiologists specializing in cardiac, pediatric, pain management, or obstetric anesthesiology often command higher compensation. Cardiac anesthesiologists, in particular, can earn 10–20% above general anesthesiology rates.

Supply and Demand Dynamics

With approximately 45,300 anesthesiologists employed nationwide and modest job growth of 3.2% projected through 2034, the market remains favorable for providers. States with growing populations and limited training programs offer the strongest leverage.

Partnership and Ownership

Private practice anesthesiologists with partnership or ownership stakes often earn substantially more than employed physicians. Equity in a successful practice can add $100,000+ in annual income through profit-sharing and distributions.

Benefits and Total Compensation

When evaluating offers, look beyond base salary to:

• Sign-on bonuses ($25,000–$75,000 is common)
• Loan repayment (up to $200,000 in underserved areas)
• Retirement contributions (employer match and deferred compensation)
• Malpractice coverage (worth $15,000–$50,000/year)
• CME allowance and time off

How Anesthesiologist Compensation Compares

Anesthesiologists are among the most highly compensated professionals in all of healthcare. For context:

• Anesthesiologist: $336,640 BLS mean base / $535,000 median total comp (SalaryDr, 2026)
• CRNA median: $223,210 (BLS, 2024) / $260,000 advertised avg (ZipRecruiter, 2026) — see full CRNA salary breakdown
• CAA average: $247,000–$253,000 (Becker's/Marit Health, 2026) — see full CAA salary guide

For a deeper dive into how these roles compare financially, read our CRNA vs Anesthesiologist Salary Comparison.

Related Reading

• How Much Do Anesthesiologists Make? 2026 Salary Breakdown
• CRNA vs Anesthesiologist Salary: Full Compensation Comparison
• Top 10 Highest-Paying States for CRNAs in 2026
• Exploring Anesthesia Careers

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Frequently Asked Questions

What is the highest-paying state for anesthesiologists in 2026?

North Carolina leads the nation with average anesthesiologist compensation exceeding $420,000, according to CompHealth 2025 data. Oregon ($415,000) and Colorado ($413,000) round out the top three.

How much do anesthesiologists make per year on average?

The BLS reports a mean anesthesiologist base salary of $336,640 (May 2024), but this substantially understates total compensation. Verified physician surveys show median total comp of $535,000 (SalaryDr, 2026, 176 reports), while current job postings average $393,215 (ZipRecruiter, May 2026). Non-academic median total compensation reaches approximately $500,000+, while academic positions average around $450,000.

Do anesthesiologists make more in private practice or academic settings?

Non-academic and private practice anesthesiologists typically earn about $50,000 more than their academic counterparts, with a median total compensation of approximately $500,000 vs. $450,000 for academic positions. However, academic settings offer research opportunities, teaching roles, and often stronger retirement benefits.

How much do locum tenens anesthesiologists earn?

Locum tenens anesthesiologists earn approximately $300–$450 per hour in 2025–2026, which can translate to $600,000–$900,000+ in gross annual income depending on hours worked. However, locum providers are responsible for their own benefits, malpractice coverage, and taxes.

Is anesthesiology still a good career financially?

Absolutely. Anesthesiology remains one of the highest-compensated medical specialties, with total compensation packages routinely exceeding $400,000. With approximately 45,300 positions nationwide and steady job growth of 3.2% projected through 2034, the financial outlook for anesthesiologists remains very strong.