The cities that pay nurse practitioners the most are not where NPs keep the most. Once you add housing and taxes, the picture changes a lot.
I used pay data from the Bureau of Labor Statistics, home and rent prices from Zillow and crime data. Then I worked out what NPs keep after taxes and housing in each city.
These rates are from November 2024, when this was first written. Pay changes every year, so check current rates in Map My Pay.
A high salary can fool you
We know nurses make great money in Northern California. What surprised me is what these numbers mean for daily life.
Making $210,970 in San Jose sounds great. Then you see that a typical house there costs $1.4 million, with a mortgage over $10,500 a month.
In San Francisco, NPs make $192,720. After housing costs, NPs who own a home there go into debt each year.
The top five highest-paying cities for NPs
Here’s what NPs keep each year after taxes and either a mortgage or rent. A lower crime score means a safer city.
| City | NP salary | Left if you own | Left if you rent | Crime score |
|---|---|---|---|---|
| San Jose area, CA | $210,970 | $28,997 | $118,217 | 25.0 |
| Napa, CA | $206,130 | $72,476 | $113,192 | 25.2 |
| San Francisco area, CA | $192,720 | minus $40,246 | $31,718 | 26.6 |
| Vallejo-Fairfield, CA | $172,840 | $72,588 | $97,644 | 40.2 |
| El Centro, CA | $159,220 | $85,607 | $96,095 | 49.2 |
San Jose, Napa and San Francisco are fairly safe. Vallejo-Fairfield is a bit less safe. El Centro is medium risk.
If you own in San Francisco, you’d lose $40,246 a year. That means you’d go into debt just to live there.
New York City ranks 31st
NYC comes in at number 31, paying NPs $146,020.
If you own a home in NYC, you’d have $8,466 left a year. If you rent, you’d have $30,330 left. The crime score is 42.0, which is medium risk.
The big lesson
San Jose pays the most at $210,970. But look at what renters keep.
A renter in San Jose has $118,217 left. A renter in El Centro has $96,095 left. That’s only about $22,000 more, even though San Jose pays $51,750 more.
Where NPs keep the most after a mortgage
1. El Centro, CA
NPs keep $85,607 a year after the mortgage and taxes. The median salary is $159,220. Homes are cheap at $359,731, and the mortgage is only $2,762 a month.
The crime score is moderate at 49.2. It’s a growing town with a fair mix of pros and cons.
2. Corcoran, CA
NPs keep $84,681 a year. The salary is lower at $143,890. Homes are very cheap at $258,871, with a $1,966 mortgage.
Housing is cheap for a reason, though. Corcoran is known for one of California’s largest prisons. The high crime rate makes it less appealing, even with good numbers.
3. Wichita Falls, TX
This is the first city outside California on the list. NPs keep $82,710 a year on a salary of $133,440.
Homes are very cheap at $168,224, with a $1,535 mortgage. The crime score is moderate at 42.8. It has a good balance of cost and quality of life.
4. Madera, CA
NPs keep $81,020 a year on a salary of $158,110. Homes are fairly priced at $403,522.
Madera has the lowest crime score on this list at 12.4. It’s great for families. When you weigh everything, it’s the most well-rounded choice.
5. Flint, MI
NPs keep $80,389 a year. The salary is lower at $110,960. Homes are very cheap at $60,596, with a $448 mortgage.
Flint has a very high crime score of 85.6. It’s known for serious problems with its infrastructure, and home prices reflect that. The math looks good, but quality of life is a big worry.
Look past the numbers
Corcoran and Flint show high take-home pay. Their low housing costs come with serious downsides, though. Madera stands out as the most balanced choice, with good take-home pay and a safe place to live.
In real estate, people say “location, location, location.” Sometimes a bigger mortgage in a safer, nicer area is worth it.
The same idea works for RNs. See the top cities for nurse pay in 2024 and why nurses should rethink buying a home.
Why this matters
Monica and I used this same kind of data when we moved to Sacramento. It’s one reason we now work fewer than 20 hours a week and still earn around $300k a year.
The spreadsheet covers nursing assistants, LPNs, nursing instructors, RNs, nurse midwives, NPs and CRNAs. It comes with the Nurses to Riches Accelerator, along with our other spreadsheets.
Your next move
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Written by Jason, RN. I went from $37 an hour in New York to $143 an hour in California and paid off $128K of debt in under a year. I share our numbers in the Nurses to Riches newsletter and on YouTube.