Real-pay ranking

Best states for emergency medicine

Ranked by what's actually left: each state's wage, minus estimated federal, FICA and state income tax, then adjusted for local prices. The biggest headline salary is often not the best deal.

For emergency medicine, adjusted take-home is highest in North Dakota at $319,930 — about 154% further than Utah, the lowest of the 31 states BLS publishes.

#StateAnnual meanEst. take-homeAdjusted take-home
1North Dakota$424,750$284,738$319,930
2Iowa$401,640$262,950$299,487
3Missouri$400,590$259,607$285,911
4West Virginia$381,470$248,027$277,125
5South Dakota$335,490$236,769$267,234
6Indiana$360,570$241,665$259,019
7Rhode Island$411,330$263,348$257,427
8Michigan$377,660$247,138$256,900
9Nebraska$353,880$230,814$256,175
10New Mexico$360,410$234,644$254,495
11Ohio$344,190$231,639$249,611
12Vermont$379,960$237,530$242,378
13North Carolina$340,980$226,259$239,935
14Maryland$387,020$248,569$236,732
15Minnesota$375,630$231,958$235,252
16Alaska$341,520$240,547$234,909
17Mississippi$300,550$202,196$232,409
18Oklahoma$300,600$201,122$229,068
19Washington$348,790$245,101$229,066
20Massachusetts$370,880$240,397$227,218
21Connecticut$364,450$233,015$224,918
22Florida$301,220$215,299$208,220
23South Carolina$285,730$189,486$202,226
24Texas$262,170$190,733$196,429
25Georgia$259,490$175,634$182,382
26Idaho$242,480$164,852$172,620
27District of Columbia$292,750$187,776$170,861
28Kentucky$214,570$151,032$167,441
29New Jersey$262,080$176,106$161,862
30New York$257,790$173,146$160,469
31Utah$178,200$124,575$125,961

Method: annual mean wage from U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 (“Emergency Medicine Physicians”, May 2025); take-home estimated for a single filer taking the standard deduction (federal + FICA + state income tax, wages only — Tax Foundation for state brackets); adjusted using U.S. Bureau of Economic Analysis, Regional Price Parities (2024) price levels where US average = 100. Only states with both a published wage and a published price level can be ranked honestly, so 31 states appear. This is an estimate for comparison, not tax advice, and wages exclude many self-employed/partnership physicians. VitalPost shows sourced public data for context only.