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Best States to Be a Nursing Assistants

After 2025 state income tax and 2024 cost of living, a nursing assistants salary goes furthest in North Dakota — a $45,820 BLS median worth $51,507 in real terms (Gera US Real Pay Index 123.1).

Which US states are best for a nursing assistants after cost of living and tax?

For a nursing assistants, the Gera US Real Pay Index ranks North Dakota #1: a $45,820 BLS median becomes $51,507 in cost-of-living-and-tax-adjusted terms (index 123.1). Louisiana ranks last ($33,977, index 81.2). Real BLS OEWS May 2025 across 51 states; re-dated annually.

Source:U.S. Bureau of Labor Statistics — Occupational Employment and Wage Statistics (OEWS)·As of May 2025 state estimates · updated annually · last refreshed

Gera US Real Pay Index

North Dakota ranks #1 of 51 states for a nursing assistants. Index 100 = the average state; 123.1 means pay goes 23.1% further after tax and cost of living.

How this is calculated
123.1

Nursing Assistants — real pay by state (best first)

#StateBLS medianState taxCost (RPP)Real payIndex
1North Dakota$45,82089.0$51,507123.1
2Vermont$47,130$1,16098.0$46,928112.1
3Maine$47,070$1,56397.0$46,891112.1
4Wisconsin$45,130$1,24094.1$46,645111.5
5Washington$49,180107.0$45,957109.8
6New Hampshire$47,870104.2$45,956109.8
7Minnesota$46,680$1,69898.6$45,611109.0
8Nevada$45,490100.0$45,500108.7
9Alaska$46,370102.4$45,301108.3
10Oregon$49,830$3,556103.4$44,769107.0
11Colorado$47,380$1,425103.1$44,594106.6
12Pennsylvania$44,590$1,36997.6$44,297105.9
13Rhode Island$46,440$1,142102.3$44,289105.8
14Illinois$45,960$2,134100.0$43,844104.8
15Arizona$44,780$645100.7$43,839104.8
16South Dakota$38,80088.6$43,799104.7
17Nebraska$40,000$99890.1$43,286103.4
18Iowa$39,350$1,45587.8$43,179103.2
19New York$48,590$2,067107.9$43,108103.0
20Wyoming$39,16092.7$42,248101.0
21Connecticut$44,790$1,091103.6$42,177100.8
22California$47,630$954110.7$42,157100.7
23Massachusetts$46,680$2,114105.8$42,140100.7
24New Jersey$46,830$1,040108.8$42,085100.6
25New Mexico$39,390$77492.2$41,878100.1
26Montana$40,900$1,27594.6$41,867100.0
27District of Columbia$47,700$1,762109.9$41,79999.9
28Ohio$39,010$29092.8$41,73599.7
29Tennessee$37,99091.9$41,35298.8
30Virginia$43,200$1,684101.1$41,06298.1
31Kentucky$38,370$1,40490.2$41,00198.0
32Kansas$38,010$1,32190.1$40,73497.3
33Missouri$37,680$89090.8$40,51096.8
34Delaware$42,030$1,65699.8$40,45296.7
35West Virginia$36,720$99089.5$39,92395.4
36Indiana$38,330$1,12093.3$39,87095.3
37Michigan$39,570$1,43596.2$39,63494.7
38North Carolina$38,460$1,09394.3$39,61594.7
39Oklahoma$35,930$1,16987.8$39,57294.6
40Maryland$43,240$1,721105.0$39,55794.5
41Hawaii$45,350$1,949110.0$39,47394.3
42Idaho$38,650$1,08195.5$39,34294.0
43South Carolina$37,220$70093.7$38,95593.1
44Texas$37,50097.1$38,63792.3
45Utah$39,840$1,81398.9$38,46491.9
46Arkansas$34,430$1,13486.9$38,29991.5
47Georgia$37,680$1,38496.3$37,69390.1
48Alabama$34,140$1,44288.8$36,81388.0
49Florida$37,510103.4$36,27286.7
50Mississippi$31,520$58287.0$35,58185.0
51Louisiana$30,510$54088.2$33,97781.2

"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 North Dakota, a $45,820 salary is worth about $50,219 in cost-of-living-and-tax-adjusted terms.

State income tax $1,146 (≈ top marginal 2.50% (upper bound)) · take-home $44,675 · BEA cost of living 89.0 (US = 100).

The same salary goes furthest in South Dakota — worth $51,724, a $1,505 gain over North Dakota.

#StateReal valueCost (RPP)
1South Dakota$51,72488.6
2Arkansas$50,64986.9
3Louisiana$50,38888.2
4Mississippi$50,37787.0
5Iowa$50,22587.8
6North Dakota$50,21989.0
7Tennessee$49,87591.9
8Oklahoma$49,68487.8
9Wyoming$49,43392.7
10Alabama$49,00688.8
11Kentucky$48,78890.2
12West Virginia$48,73089.5

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).

Nursing Assistants — real pay FAQ

What is the best state to be a nursing assistants?
By the Gera US Real Pay Index, North Dakota is the best state for a nursing assistants: a BLS median of $45,820 is worth $51,507 after the 2025 state income tax ($0) and the 2024 BEA cost-of-living adjustment (RPP 89.0), an index of 123.1 where the average state is 100.
Does the highest-paying state also leave you best off?
Not necessarily. Oregon has the highest headline BLS median for a nursing assistants at $49,830, but after state tax and cost of living it ranks #10 of 51 on real pay (index 107.0). That gap is exactly what the Gera US Real Pay Index reveals.
Where does a nursing assistants salary go least far?
Louisiana ranks last of 51 states for a nursing assistants: a $30,510 BLS median is worth only $33,977 after tax and cost of living (index 81.2). Higher local prices and/or income tax less far than the national average erode the headline pay.

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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 nursing assistants is computed by GeraJobs from these figures; no figure is modelled or interpolated.

GeraJobs is a job-search and recruitment platform that connects candidates with independent employers and recruiters. Gera is not the employer, recruiter, or hiring agent of record and is not party to any employment relationship — hiring decisions, job offers, and employment terms are solely between candidates and employers.