GeraJobs / US Real Pay Index / Medical Secretaries and Administrative Assistants
Best States to Be a Medical Secretaries and Administrative Assistants
After 2025 state income tax and 2024 cost of living, a medical secretaries and administrative assistants salary goes furthest in Washington — a $58,100 BLS median worth $54,292 in real terms (Gera US Real Pay Index 120.5).
Which US states are best for a medical secretaries and administrative assistants after cost of living and tax?
For a medical secretaries and administrative assistants, the Gera US Real Pay Index ranks Washington #1: a $58,100 BLS median becomes $54,292 in cost-of-living-and-tax-adjusted terms (index 120.5). Alabama ranks last ($39,797, index 88.4). Real BLS OEWS May 2025 across 51 states; re-dated annually.
Gera US Real Pay Index
Washington ranks #1 of 51 states for a medical secretaries and administrative assistants. Index 100 = the average state; 120.5 means pay goes 20.5% further after tax and cost of living.
How this is calculatedMedical Secretaries and Administrative Assistants — real pay by state (best first)
| # | State | BLS median | State tax | Cost (RPP) | Real pay | Index |
|---|---|---|---|---|---|---|
| 1 | Washington | $58,100 | — | 107.0 | $54,292 | 120.5 |
| 2 | South Dakota | $45,810 | — | 88.6 | $51,712 | 114.8 |
| 3 | North Dakota | $45,390 | — | 89.0 | $51,024 | 113.3 |
| 4 | Wisconsin | $48,380 | $1,412 | 94.1 | $49,916 | 110.8 |
| 5 | Nebraska | $46,100 | $1,304 | 90.1 | $49,717 | 110.4 |
| 6 | Minnesota | $50,030 | $1,913 | 98.6 | $48,790 | 108.3 |
| 7 | Vermont | $48,200 | $1,196 | 98.0 | $47,984 | 106.5 |
| 8 | California | $54,490 | $1,366 | 110.7 | $47,981 | 106.5 |
| 9 | Wyoming | $44,430 | — | 92.7 | $47,933 | 106.4 |
| 10 | Ohio | $44,280 | $435 | 92.8 | $47,260 | 104.9 |
| 11 | Missouri | $43,980 | $1,186 | 90.8 | $47,121 | 104.6 |
| 12 | Nevada | $46,990 | — | 100.0 | $47,000 | 104.4 |
| 13 | New Mexico | $44,230 | $982 | 92.2 | $46,901 | 104.1 |
| 14 | Maine | $46,990 | $1,557 | 97.0 | $46,814 | 103.9 |
| 15 | Alaska | $47,870 | — | 102.4 | $46,767 | 103.8 |
| 16 | New Hampshire | $48,410 | — | 104.2 | $46,474 | 103.2 |
| 17 | Kansas | $43,020 | $1,601 | 90.1 | $45,987 | 102.1 |
| 18 | Indiana | $44,060 | $1,292 | 93.3 | $45,825 | 101.7 |
| 19 | Connecticut | $48,500 | $1,258 | 103.6 | $45,596 | 101.2 |
| 20 | Idaho | $44,920 | $1,438 | 95.5 | $45,534 | 101.1 |
| 21 | North Carolina | $44,190 | $1,336 | 94.3 | $45,432 | 100.9 |
| 22 | Massachusetts | $50,290 | $2,295 | 105.8 | $45,383 | 100.8 |
| 23 | Oregon | $50,130 | $3,582 | 103.4 | $45,034 | 100.0 |
| 24 | Iowa | $40,980 | $1,517 | 87.8 | $44,966 | 99.8 |
| 25 | Arizona | $45,820 | $671 | 100.7 | $44,846 | 99.6 |
| 26 | Montana | $43,740 | $1,442 | 94.6 | $44,691 | 99.2 |
| 27 | Rhode Island | $46,860 | $1,157 | 102.3 | $44,684 | 99.2 |
| 28 | Pennsylvania | $44,930 | $1,379 | 97.6 | $44,634 | 99.1 |
| 29 | Illinois | $46,670 | $2,169 | 100.0 | $44,520 | 98.9 |
| 30 | Texas | $42,910 | — | 97.1 | $44,211 | 98.2 |
| 31 | Colorado | $46,920 | $1,404 | 103.1 | $44,168 | 98.1 |
| 32 | Virginia | $46,180 | $1,856 | 101.1 | $43,840 | 97.3 |
| 33 | Maryland | $47,850 | $1,940 | 105.0 | $43,741 | 97.1 |
| 34 | New Jersey | $48,660 | $1,141 | 108.8 | $43,674 | 97.0 |
| 35 | Tennessee | $39,940 | — | 91.9 | $43,474 | 96.5 |
| 36 | Hawaii | $49,920 | $2,278 | 110.0 | $43,330 | 96.2 |
| 37 | Georgia | $43,160 | $1,680 | 96.3 | $43,077 | 95.6 |
| 38 | District of Columbia | $49,180 | $1,851 | 109.9 | $43,065 | 95.6 |
| 39 | Utah | $44,330 | $2,017 | 98.9 | $42,799 | 95.0 |
| 40 | Delaware | $44,500 | $1,793 | 99.8 | $42,789 | 95.0 |
| 41 | New York | $47,710 | $2,019 | 107.9 | $42,337 | 94.0 |
| 42 | Oklahoma | $38,330 | $1,283 | 87.8 | $42,174 | 93.6 |
| 43 | South Carolina | $40,170 | $883 | 93.7 | $41,906 | 93.0 |
| 44 | West Virginia | $38,430 | $1,047 | 89.5 | $41,771 | 92.7 |
| 45 | Kentucky | $38,750 | $1,419 | 90.2 | $41,406 | 91.9 |
| 46 | Michigan | $41,100 | $1,500 | 96.2 | $41,157 | 91.4 |
| 47 | Arkansas | $37,000 | $1,235 | 86.9 | $41,140 | 91.3 |
| 48 | Louisiana | $36,930 | $733 | 88.2 | $41,037 | 91.1 |
| 49 | Mississippi | $36,290 | $792 | 87.0 | $40,825 | 90.6 |
| 50 | Florida | $41,730 | — | 103.4 | $40,352 | 89.6 |
| 51 | Alabama | $36,930 | $1,582 | 88.8 | $39,797 | 88.4 |
"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 Washington, a $58,100 salary is worth about $54,292 in cost-of-living-and-tax-adjusted terms.
State income tax $0 (no state income tax) · take-home $58,100 · BEA cost of living 107.0 (US = 100).
The same salary goes furthest in South Dakota — worth $65,586, a $11,294 gain over Washington.
| # | State | Real value | Cost (RPP) |
|---|---|---|---|
| 1 | South Dakota | $65,586 | 88.6 |
| 2 | Arkansas | $64,224 | 86.9 |
| 3 | Louisiana | $63,892 | 88.2 |
| 4 | Mississippi | $63,878 | 87.0 |
| 5 | Iowa | $63,686 | 87.8 |
| 6 | North Dakota | $63,678 | 89.0 |
| 7 | Tennessee | $63,242 | 91.9 |
| 8 | Oklahoma | $62,999 | 87.8 |
| 9 | Wyoming | $62,681 | 92.7 |
| 10 | Alabama | $62,140 | 88.8 |
| 11 | Kentucky | $61,864 | 90.2 |
| 12 | West Virginia | $61,789 | 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 Secretaries and Administrative Assistants — real pay FAQ
- What is the best state to be a medical secretaries and administrative assistants?
- By the Gera US Real Pay Index, Washington is the best state for a medical secretaries and administrative assistants: a BLS median of $58,100 is worth $54,292 after the 2025 state income tax ($0) and the 2024 BEA cost-of-living adjustment (RPP 107.0), an index of 120.5 where the average state is 100.
- Does the highest-paying state also leave you best off?
- Not necessarily. Washington has the highest headline BLS median for a medical secretaries and administrative assistants at $58,100, but after state tax and cost of living it ranks #1 of 51 on real pay (index 120.5). That gap is exactly what the Gera US Real Pay Index reveals.
- Where does a medical secretaries and administrative assistants salary go least far?
- Alabama ranks last of 51 states for a medical secretaries and administrative assistants: a $36,930 BLS median is worth only $39,797 after tax and cost of living (index 88.4). Higher local prices and/or income tax less far than the national average erode the headline pay.
Compare other occupations
- Home Health and Personal Care AidesWashington
- Retail SalespersonsNorth Dakota
- Fast Food and Counter WorkersCalifornia
- General and Operations ManagersSouth Dakota
- Registered NursesCalifornia
- 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
Get the Gera US Real Pay Index when BLS refreshes OEWS
BLS OEWS updates roughly once a year. Save your email and we’ll send the refreshed real-pay rankings when new wage data lands.
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 secretaries and administrative assistants is computed by GeraJobs from these figures; no figure is modelled or interpolated.