Median salary: $82K (Registered Nurse) vs $120K (Physician Assistant). Salary ranges overlap between 55K–110K and 90K–160K. The take-home difference depends on state taxes, cost of living, and where in the salary range you fall.
At the national median, Registered Nurses earn $82K and Physician Assistants earn $120K. After federal taxes and FICA (calculated without state tax to isolate the salary effect), Registered Nurses take home $66,462 vs $93,195 for Physician Assistants.
The $38K salary advantage for Physician Assistants doesn’t translate dollar-for-dollar to take-home. Because of progressive federal tax brackets, the Physician Assistant’s higher salary is taxed at a higher marginal rate. Of the $38K gross difference, only $26,733 reaches the Physician Assistant’s pocket — the rest goes to taxes.
Registered Nurses face an effective tax rate of 18.9% at median, while Physician Assistants pay 22.3%. The higher rate for Physician Assistants reflects more income being pushed into higher federal brackets.
The best states differ for each profession because salary adjustments vary by state cost index and interact differently with tax brackets. A state that’s great for a $82K earner may not be optimal for a $120K earner.
All 50 states showing estimated salary and take-home for both professions. Sorted by which states give Registered Nurses the largest take-home advantage over Physician Assistants.
| State | Registered Nurse Salary | Registered Nurse Take-Home | Physician Assistant Salary | Physician Assistant Take-Home | Difference | Higher |
|---|---|---|---|---|---|---|
| West Virginia | $68K | $54,350 | $100K | $75,797 | $-21,447 | Physician Assistant |
| Mississippi | $68K | $54,403 | $100K | $75,875 | $-21,472 | Physician Assistant |
| Arkansas | $71K | $56,924 | $103K | $78,624 | $-21,701 | Physician Assistant |
| Michigan | $75K | $57,225 | $109K | $79,189 | $-21,964 | Physician Assistant |
| Oklahoma | $71K | $56,531 | $104K | $78,728 | $-22,197 | Physician Assistant |
| Kentucky | $74K | $57,134 | $108K | $79,353 | $-22,219 | Physician Assistant |
| Alabama | $72K | $56,007 | $106K | $78,311 | $-22,304 | Physician Assistant |
| Missouri | $73K | $56,758 | $107K | $79,106 | $-22,348 | Physician Assistant |
| Indiana | $74K | $57,541 | $108K | $79,947 | $-22,406 | Physician Assistant |
| Ohio | $74K | $57,689 | $108K | $80,163 | $-22,474 | Physician Assistant |
| New Mexico | $75K | $58,661 | $109K | $81,276 | $-22,615 | Physician Assistant |
| Iowa | $73K | $57,357 | $107K | $79,984 | $-22,627 | Physician Assistant |
| Kansas | $74K | $58,092 | $108K | $80,752 | $-22,659 | Physician Assistant |
| Nebraska | $75K | $59,319 | $109K | $82,233 | $-22,913 | Physician Assistant |
| Louisiana | $75K | $59,466 | $109K | $82,445 | $-22,980 | Physician Assistant |
| South Carolina | $75K | $58,418 | $110K | $81,584 | $-23,166 | Physician Assistant |
| Idaho | $78K | $59,514 | $114K | $82,932 | $-23,418 | Physician Assistant |
| Georgia | $76K | $58,297 | $112K | $81,754 | $-23,458 | Physician Assistant |
| Wisconsin | $76K | $58,462 | $112K | $81,998 | $-23,536 | Physician Assistant |
| Illinois | $76K | $58,479 | $112K | $82,023 | $-23,544 | Physician Assistant |
| North Carolina | $78K | $60,536 | $114K | $84,425 | $-23,890 | Physician Assistant |
| Tennessee | $74K | $60,834 | $108K | $84,753 | $-23,919 | Physician Assistant |
| Montana | $80K | $62,117 | $116K | $86,121 | $-24,004 | Physician Assistant |
| North Dakota | $75K | $60,587 | $110K | $84,766 | $-24,179 | Physician Assistant |
| Minnesota | $81K | $60,572 | $119K | $84,873 | $-24,300 | Physician Assistant |
| Arizona | $80K | $63,055 | $116K | $87,481 | $-24,426 | Physician Assistant |
| Delaware | $84K | $63,005 | $122K | $87,538 | $-24,533 | Physician Assistant |
| South Dakota | $75K | $61,538 | $110K | $86,160 | $-24,622 | Physician Assistant |
| Utah | $81K | $61,992 | $119K | $86,958 | $-24,966 | Physician Assistant |
| Maine | $80K | $61,337 | $118K | $86,304 | $-24,967 | Physician Assistant |
| Pennsylvania | $80K | $61,399 | $118K | $86,395 | $-24,996 | Physician Assistant |
| Texas | $76K | $62,241 | $112K | $87,567 | $-25,326 | Physician Assistant |
| Wyoming | $77K | $62,945 | $113K | $88,271 | $-25,326 | Physician Assistant |
| Vermont | $86K | $64,385 | $126K | $90,181 | $-25,796 | Physician Assistant |
| Oregon | $90K | $64,949 | $132K | $90,974 | $-26,025 | Physician Assistant |
| Colorado | $86K | $65,492 | $126K | $91,803 | $-26,311 | Physician Assistant |
| Rhode Island | $86K | $65,928 | $126K | $92,441 | $-26,514 | Physician Assistant |
| Virginia | $84K | $64,730 | $124K | $91,346 | $-26,616 | Physician Assistant |
| Florida | $82K | $66,462 | $120K | $93,195 | $-26,733 | Physician Assistant |
| Nevada | $83K | $67,166 | $121K | $93,899 | $-26,733 | Physician Assistant |
| Maryland | $92K | $68,679 | $134K | $95,797 | $-27,118 | Physician Assistant |
| Connecticut | $91K | $68,659 | $133K | $96,089 | $-27,430 | Physician Assistant |
| New Jersey | $94K | $68,336 | $138K | $95,906 | $-27,570 | Physician Assistant |
| New York | $103K | $72,393 | $150K | $100,874 | $-28,481 | Physician Assistant |
| New Hampshire | $89K | $71,387 | $130K | $100,081 | $-28,694 | Physician Assistant |
| Massachusetts | $97K | $72,165 | $142K | $101,183 | $-29,018 | Physician Assistant |
| Washington | $90K | $72,090 | $132K | $101,448 | $-29,358 | Physician Assistant |
| California | $116K | $80,353 | $170K | $112,725 | $-32,372 | Physician Assistant |
| Alaska | $104K | $81,939 | $152K | $115,118 | $-33,179 | Physician Assistant |
| Hawaii | $157K | $107,310 | $230K | $153,689 | $-46,379 | Physician Assistant |
Job Security & Demand: Healthcare careers offer exceptional job security, and both Registered Nurses and Physician Assistants are in consistent demand nationwide. Registered Nurse roles tend to be available in virtually every community, while Physician Assistant positions may be more concentrated in urban and suburban areas. Both professions are largely recession-proof — people need healthcare regardless of economic conditions.
Growth & Advancement: The aging US population drives growth for both careers. Registered Nurse demand is projected to grow steadily through 2030+, with particular shortages in rural areas. Physician Assistant roles are also expanding, especially as healthcare systems seek to provide more services at lower cost. Scope-of-practice expansion varies by state, which can affect earning potential.
Work-Life Balance & Lifestyle: Shift work is common for Registered Nurses, with nights, weekends, and holidays often required — though some specialties offer more predictable schedules. Physician Assistants may have more regular hours depending on the practice setting. Both careers involve significant emotional demands. Unlike tech roles, these careers require in-person presence, limiting your ability to choose a state purely for tax benefits.