Why After-Tax Pay Matters
A $250,000 salary in California doesn't equal $250,000 in Texas. State income taxes can cost CRNAs $10,000-25,000 annually—a significant factor in where to practice.
States with No Income Tax
The Tax-Free Nine
| State | Avg CRNA Salary | No Income Tax Savings |
|---|---|---|
| **Texas** | $225,000 | $10,000-15,000/year |
| **Florida** | $218,000 | $9,000-12,000/year |
| **Tennessee** | $208,000 | $8,000-11,000/year |
| **Nevada** | $220,000 | $9,000-13,000/year |
| **Washington** | $245,000 | $12,000-18,000/year |
| **Wyoming** | $255,000 | $12,000-16,000/year |
| **South Dakota** | $215,000 | $9,000-12,000/year |
| **Alaska** | $230,000 | $10,000-14,000/year |
| **New Hampshire** | $210,000* | Limited savings* |
*New Hampshire taxes only interest/dividends, not wages.
Top After-Tax States for CRNAs
When Combining Salary + Tax Benefits
| Rank | State | Gross Salary | Tax Rate | Est. Take-Home |
|---|---|---|---|---|
| 1 | **Wyoming** | $255,000 | 0% | ~$185,000 |
| 2 | **Texas (rural)** | $240,000 | 0% | ~$174,000 |
| 3 | **Washington** | $245,000 | 0% | ~$178,000 |
| 4 | **Florida** | $218,000 | 0% | ~$158,000 |
| 5 | **Texas (metro)** | $228,000 | 0% | ~$165,000 |
| 6 | **Nevada** | $220,000 | 0% | ~$160,000 |
| 7 | **Tennessee** | $208,000 | 0% | ~$151,000 |
| 8 | **South Dakota** | $215,000 | 0% | ~$156,000 |
Take-home estimates assume married filing jointly with standard deductions, federal taxes only variable.
High-Tax States: The Real Cost
States with Highest Income Tax Impact
| State | Avg Salary | State Tax Rate | Annual Tax |
|---|---|---|---|
| **California** | $245,000 | 9.3-12.3% | $20,000-28,000 |
| **New Jersey** | $235,000 | 8.97-10.75% | $18,000-24,000 |
| **New York** | $248,000 | 8.82-10.9% | $19,000-26,000 |
| **Oregon** | $238,000 | 9.0-9.9% | $18,000-22,000 |
| **Minnesota** | $218,000 | 7.85-9.85% | $14,000-18,000 |
| **Massachusetts** | $242,000 | 5.0%* | $11,000-12,000 |
Salary Comparison: Gross vs Net
| State | Gross | State Tax | Fed Tax | FICA | Net |
|---|---|---|---|---|---|
| Texas | $225K | $0 | $40K | $17K | $168K |
| California | $245K | $25K | $45K | $18K | $157K |
| **Difference** | -$20K | -$25K | +$5K | +$1K | **+$11K Texas** |
Despite California paying $20K more in salary, Texas CRNA takes home $11K more.
Cost of Living Adjustments
After-Tax AND After-COL
| State | After-Tax Income | COL Index | Purchasing Power |
|---|---|---|---|
| **Wyoming** | $185,000 | 92 | $201,000 |
| **Texas (rural)** | $174,000 | 88 | $198,000 |
| **Tennessee** | $151,000 | 89 | $170,000 |
| **Florida (non-coastal)** | $158,000 | 97 | $163,000 |
| **California (coastal)** | $145,000 | 151 | $96,000 |
| **New York City** | $155,000 | 187 | $83,000 |
Wyoming offers the highest purchasing power for CRNAs nationwide.
Best Value Markets
High Salary + No Tax + Low COL
| Market | Salary | No Tax | COL | Value Score |
|---|---|---|---|---|
| **Rural Texas** | ★★★★★ | ★★★★★ | ★★★★★ | Excellent |
| **Wyoming** | ★★★★★ | ★★★★★ | ★★★★☆ | Excellent |
| **Tennessee (non-Nashville)** | ★★★★☆ | ★★★★★ | ★★★★★ | Very Good |
| **Florida (non-coastal)** | ★★★★☆ | ★★★★★ | ★★★★☆ | Very Good |
| **South Dakota** | ★★★★☆ | ★★★★★ | ★★★★★ | Very Good |
Tax Planning Strategies
For High-Earners
| Strategy | Potential Savings |
|---|---|
| **401k maximum contribution** | $6,000-8,000 tax reduction |
| **403b if available** | Similar savings |
| **HSA contributions** | $1,500-2,500 tax reduction |
| **Mortgage interest** | Varies by amount |
| **Student loan interest** | Up to $2,500 deduction |
For 1099 CRNAs
| Strategy | Benefit |
|---|---|
| **SEP-IRA (25% of net)** | Major tax reduction |
| **Solo 401k** | Up to $66,000/year |
| **Business expense deductions** | License, CME, insurance |
| **Home office deduction** | If applicable |
| **QBI deduction** | 20% of qualified income |
State-Specific Considerations
Texas
Pros: No income tax, large job market, growing healthcare Cons: Property taxes higher, still requires income tax to federal Best for: CRNAs maximizing take-home pay
Florida
Pros: No income tax, beach lifestyle, aging population (jobs) Cons: Hurricane risk, rising insurance costs, traffic Best for: CRNAs wanting lifestyle + tax savings
Washington
Pros: No income tax, high salaries, full practice authority Cons: High property values, rainy climate (west) Best for: CRNAs wanting Pacific Northwest + tax benefits
Tennessee
Pros: No income tax, growing healthcare hub, low COL Cons: Supervision requirements, humid summers Best for: CRNAs near Nashville healthcare industry
When High-Tax States Make Sense
Reasons to Accept Lower Net Pay
- Partner's career requires specific location
- Family proximity matters more than money
- Lifestyle preferences outweigh financial
- Specific employer offers career advantages
- Short-term plan with exit strategy
Break-Even Analysis
Calculate when high-tax state makes sense:
| Factor | Calculate |
|---|---|
| Tax cost difference | Salary × tax rate difference |
| COL difference | Monthly expenses × 12 |
| Career value | Future earning impact |
| Quality of life | Subjective but important |
Conclusion
For CRNAs purely optimizing take-home pay, Texas, Florida, Tennessee, Washington, and Wyoming offer the best combination of salaries and zero state income tax. When combined with cost of living analysis, rural Texas and Wyoming provide the highest actual purchasing power. However, financial optimization should be balanced with career goals, family needs, and lifestyle preferences.
Tax information is general. Consult a CPA for personal tax planning.