GeraJobs / US Real Pay Index / Medical and Health Services Managers
Best States to Be a Medical and Health Services Managers
After 2025 state income tax and 2024 cost of living, a medical and health services managers salary goes furthest in New York — a $164,120 BLS median worth $143,921 in real terms (Gera US Real Pay Index 121.1).
Which US states are best for a medical and health services managers after cost of living and tax?
For a medical and health services managers, the Gera US Real Pay Index ranks New York #1: a $164,120 BLS median becomes $143,921 in cost-of-living-and-tax-adjusted terms (index 121.1). Pennsylvania ranks last ($102,988, index 86.7). Real BLS OEWS May 2025 across 51 states; re-dated annually.
Gera US Real Pay Index
New York ranks #1 of 51 states for a medical and health services managers. Index 100 = the average state; 121.1 means pay goes 21.1% further after tax and cost of living.
How this is calculatedMedical and Health Services Managers — real pay by state (best first)
| # | State | BLS median | State tax | Cost (RPP) | Real pay | Index |
|---|---|---|---|---|---|---|
| 1 | New York | $164,120 | $8,799 | 107.9 | $143,921 | 121.1 |
| 2 | South Dakota | $122,050 | — | 88.6 | $137,776 | 115.9 |
| 3 | Washington | $145,290 | — | 107.0 | $135,769 | 114.3 |
| 4 | District of Columbia | $155,140 | $10,312 | 109.9 | $131,781 | 110.9 |
| 5 | Wisconsin | $128,320 | $5,649 | 94.1 | $130,370 | 109.7 |
| 6 | Georgia | $131,910 | $6,463 | 96.3 | $130,276 | 109.6 |
| 7 | New Mexico | $124,300 | $4,814 | 92.2 | $129,578 | 109.0 |
| 8 | Alaska | $132,240 | — | 102.4 | $129,192 | 108.7 |
| 9 | Delaware | $134,820 | $7,557 | 99.8 | $127,508 | 107.3 |
| 10 | New Jersey | $145,650 | $7,088 | 108.8 | $127,349 | 107.2 |
| 11 | Colorado | $134,910 | $5,276 | 103.1 | $125,795 | 105.9 |
| 12 | Oregon | $141,690 | $11,754 | 103.4 | $125,711 | 105.8 |
| 13 | Hawaii | $147,630 | $9,741 | 110.0 | $125,410 | 105.5 |
| 14 | Arizona | $128,850 | $2,746 | 100.7 | $125,256 | 105.4 |
| 15 | New Hampshire | $130,410 | — | 104.2 | $125,196 | 105.4 |
| 16 | Vermont | $128,690 | $6,114 | 98.0 | $125,131 | 105.3 |
| 17 | Virginia | $129,270 | $6,633 | 101.1 | $121,298 | 102.1 |
| 18 | Massachusetts | $134,360 | $6,498 | 105.8 | $120,902 | 101.7 |
| 19 | Connecticut | $130,790 | $5,697 | 103.6 | $120,734 | 101.6 |
| 20 | West Virginia | $112,010 | $4,464 | 89.5 | $120,167 | 101.1 |
| 21 | Nevada | $119,990 | — | 100.0 | $120,015 | 101.0 |
| 22 | Maryland | $131,810 | $5,995 | 105.0 | $119,870 | 100.9 |
| 23 | California | $141,480 | $9,036 | 110.7 | $119,621 | 100.7 |
| 24 | Texas | $114,150 | — | 97.1 | $117,611 | 99.0 |
| 25 | Idaho | $117,770 | $5,587 | 95.5 | $117,477 | 98.9 |
| 26 | Minnesota | $122,700 | $6,863 | 98.6 | $117,457 | 98.8 |
| 27 | North Dakota | $105,170 | $813 | 89.0 | $117,309 | 98.7 |
| 28 | Kansas | $111,030 | $5,396 | 90.1 | $117,283 | 98.7 |
| 29 | Maine | $120,320 | $6,654 | 97.0 | $117,121 | 98.6 |
| 30 | North Carolina | $114,410 | $4,321 | 94.3 | $116,712 | 98.2 |
| 31 | Tennessee | $107,120 | — | 91.9 | $116,600 | 98.1 |
| 32 | Wyoming | $108,030 | — | 92.7 | $116,549 | 98.1 |
| 33 | Florida | $120,360 | — | 103.4 | $116,387 | 97.9 |
| 34 | Louisiana | $104,550 | $2,762 | 88.2 | $115,397 | 97.1 |
| 35 | Nebraska | $107,700 | $4,504 | 90.1 | $114,531 | 96.4 |
| 36 | Rhode Island | $119,260 | $4,106 | 102.3 | $112,587 | 94.7 |
| 37 | Illinois | $117,850 | $5,693 | 100.0 | $112,205 | 94.4 |
| 38 | Ohio | $106,140 | $2,165 | 92.8 | $112,074 | 94.3 |
| 39 | Iowa | $101,940 | $3,834 | 87.8 | $111,787 | 94.1 |
| 40 | Utah | $114,980 | $5,232 | 98.9 | $111,009 | 93.4 |
| 41 | Missouri | $104,370 | $4,024 | 90.8 | $110,492 | 93.0 |
| 42 | Oklahoma | $101,270 | $4,273 | 87.8 | $110,421 | 92.9 |
| 43 | Kentucky | $103,450 | $4,007 | 90.2 | $110,297 | 92.8 |
| 44 | Mississippi | $98,160 | $3,514 | 87.0 | $108,847 | 91.6 |
| 45 | Indiana | $104,140 | $3,094 | 93.3 | $108,268 | 91.1 |
| 46 | South Carolina | $105,620 | $4,941 | 93.7 | $107,392 | 90.4 |
| 47 | Michigan | $107,570 | $4,325 | 96.2 | $107,304 | 90.3 |
| 48 | Montana | $105,840 | $5,106 | 94.6 | $106,433 | 89.6 |
| 49 | Alabama | $97,790 | $4,625 | 88.8 | $104,889 | 88.3 |
| 50 | Arkansas | $94,340 | $3,471 | 86.9 | $104,523 | 88.0 |
| 51 | Pennsylvania | $103,670 | $3,183 | 97.6 | $102,988 | 86.7 |
"Real pay" = BLS median − 2025 state income tax, divided by the state's 2024 BEA cost of living (US = 100). Only the 51 states for which BLS publishes a median for this occupation are ranked; suppressed cells are excluded, never set to zero.
Where does your salary go furthest?
Enter a salary and a state. We adjust for 2025 state income tax and the 2024 BEA cost of living to show your real, purchasing-power-equivalent pay — then rank every state.
In New York, a $164,120 salary is worth about $135,498 in cost-of-living-and-tax-adjusted terms.
State income tax $17,889 (≈ top marginal 10.90% (upper bound)) · take-home $146,231 · BEA cost of living 107.9 (US = 100).
The same salary goes furthest in South Dakota — worth $185,266, a $49,768 gain over New York.
| # | State | Real value | Cost (RPP) |
|---|---|---|---|
| 1 | South Dakota | $185,266 | 88.6 |
| 2 | Arkansas | $181,418 | 86.9 |
| 3 | Louisiana | $180,480 | 88.2 |
| 4 | Mississippi | $180,441 | 87.0 |
| 5 | Iowa | $179,900 | 87.8 |
| 6 | North Dakota | $179,877 | 89.0 |
| 7 | Tennessee | $178,644 | 91.9 |
| 8 | Oklahoma | $177,959 | 87.8 |
| 9 | Wyoming | $177,061 | 92.7 |
| 10 | Alabama | $175,533 | 88.8 |
| 11 | Kentucky | $174,753 | 90.2 |
| 12 | West Virginia | $174,542 | 89.5 |
Estimate only. State income tax is approximated from each state's 2025 flat rate (or top marginal rate as an upper bound for graduated states) and ignores federal tax, deductions and credits. The pre-published occupation and state pages use exact 2025 bracket math. Cost of living is the 2024 BEA Regional Price Parity (All Items).
Medical and Health Services Managers — real pay FAQ
- What is the best state to be a medical and health services managers?
- By the Gera US Real Pay Index, New York is the best state for a medical and health services managers: a BLS median of $164,120 is worth $143,921 after the 2025 state income tax ($8,799) and the 2024 BEA cost-of-living adjustment (RPP 107.9), an index of 121.1 where the average state is 100.
- Does the highest-paying state also leave you best off?
- Not necessarily. New York has the highest headline BLS median for a medical and health services managers at $164,120, but after state tax and cost of living it ranks #1 of 51 on real pay (index 121.1). That gap is exactly what the Gera US Real Pay Index reveals.
- Where does a medical and health services managers salary go least far?
- Pennsylvania ranks last of 51 states for a medical and health services managers: a $103,670 BLS median is worth only $102,988 after tax and cost of living (index 86.7). Higher local prices and/or income tax less far than the national average erode the headline pay.
Compare other occupations
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- Fast Food and Counter WorkersCalifornia
- General and Operations ManagersSouth Dakota
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- CashiersWashington
- Laborers and Freight, Stock, and Material Movers, HandNorth Dakota
- Stockers and Order FillersWyoming
- Customer Service RepresentativesIowa
- Office Clerks, GeneralNorth Dakota
- Waiters and WaitressesVermont
- Janitors and Cleaners, Except Maids and Housekeeping CleanersWashington
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Related on GeraJobs
- Gera US Real Pay Index — all states ranked — and how the index is calculated.
- Methodology — the exact BLS + BEA + tax computation.
- Browse US jobs with salary ranges — roles hiring now.
Sources: U.S. Bureau of Labor Statistics — Occupational Employment and Wage Statistics (OEWS) (May 2025 state estimates, US federal public domain); U.S. Bureau of Economic Analysis — Regional Price Parities (All Items), by state (2024 (US = 100)); Tax Foundation — 2025 State Individual Income Tax Rates and Brackets. The Gera US Real Pay Index for a medical and health services managers is computed by GeraJobs from these figures; no figure is modelled or interpolated.