The median CNA salary in the United States is $39,530 per year ($19.01 per hour), according to the Bureau of Labor Statistics May 2024 Occupational Employment and Wage Statistics survey (SOC 31-1131). That figure covers 1.3 million nursing assistants working across hospitals, skilled nursing facilities, home health agencies, and assisted living communities — and it varies significantly depending on where you work, what setting you’re in, and how long you’ve been in the field.
This guide breaks down CNA pay by state and work setting, explains what drives the variation, and maps the path from CNA wages to LPN and RN earnings for those planning to advance.
CNA salary at a glance
The BLS percentile data for nursing assistants (SOC 31-1131, May 2024) shows a wide spread between entry-level and experienced pay:
| Percentile | Annual wage | Hourly wage |
|---|---|---|
| 10th (entry-level) | $31,390 | $15.09 |
| 25th | $36,260 | $17.43 |
| 50th (median) | $39,530 | $19.01 |
| 75th | $46,070 | $22.15 |
| 90th (top earners) | $50,140 | $24.11 |
The gap between the 10th and 90th percentile is nearly $19,000 per year — about 60% more earnings at the top of the range than at the bottom. That gap reflects the combined effect of geography, work setting, experience, and specialization.
CNA salary by state
State-level pay varies by roughly $18,000 per year between the highest- and lowest-paying states. Oregon ($48,390), New York ($47,390), and the District of Columbia ($46,860) lead the rankings. Louisiana ($30,240), Mississippi ($30,460), and Arkansas ($31,990) sit at the bottom.
The top five states by median CNA salary are Oregon, New York, DC, California, and New Hampshire. The bottom five are Louisiana, Mississippi, Arkansas, Alabama, and South Carolina. These differences track closely with cost of living, state minimum wage floors, and regional labor market conditions — CNAs in high-cost metro areas often need higher wages to attract workers, even if the purchasing power difference narrows when adjusted for local costs.
| State | Median annual | Median hourly |
|---|---|---|
| Oregon | $48,390 | $23.26 |
| New York | $47,390 | $22.78 |
| District of Columbia | $46,860 | $22.53 |
| California | $46,420 | $22.32 |
| New Hampshire | $46,050 | $22.14 |
| Alaska | $45,840 | $22.04 |
| Maine | $45,640 | $21.94 |
| Minnesota | $45,580 | $21.91 |
| Massachusetts | $45,410 | $21.83 |
| Nevada | $45,060 | $21.66 |
| Colorado | $44,950 | $21.61 |
| New Jersey | $44,910 | $21.59 |
| Hawaii | $44,830 | $21.55 |
| Illinois | $44,750 | $21.51 |
| Connecticut | $44,500 | $21.39 |
| North Dakota | $44,190 | $21.24 |
| Rhode Island | $44,160 | $21.23 |
| Vermont | $43,610 | $20.97 |
| Wisconsin | $43,250 | $20.79 |
| Arizona | $41,980 | $20.18 |
| Pennsylvania | $41,110 | $19.77 |
| Maryland | $40,000 | $19.23 |
| Montana | $39,300 | $18.99 (est.) |
| Delaware | $39,240 | $18.87 |
| Michigan | $38,900 | $18.70 |
| Iowa | $38,630 | $18.57 |
| Nebraska | $38,620 | $18.57 |
| Ohio | $38,570 | $18.54 |
| Utah | $38,500 | $18.51 |
| South Dakota | $38,070 | $18.30 |
| Wyoming | $38,360 | $18.44 |
| Virginia | $38,790 | $18.65 |
| Idaho | $37,530 | $18.04 |
| North Carolina | $37,670 | $18.11 |
| Indiana | $37,330 | $17.95 |
| Kentucky | $37,330 | $17.95 |
| Missouri | $37,170 | $17.87 |
| New Mexico | $37,030 | $17.80 |
| Kansas | $36,910 | $17.75 |
| Florida | $36,850 | $17.71 |
| Georgia | $36,570 | $17.58 |
| South Carolina | $36,370 | $17.49 |
| West Virginia | $36,340 | $17.47 |
| Texas | $36,390 | $17.49 |
| Tennessee | $36,750 | $17.67 |
| Oklahoma | $35,040 | $16.85 |
| Alabama | $32,470 | $15.61 |
| Arkansas | $31,990 | $15.38 |
| Mississippi | $30,460 | $14.64 |
| Louisiana | $30,240 | $14.54 |
Source: BLS OES May 2024, SOC 31-1131 (Nursing Assistants)
CNA salary by work setting
Where you work matters as much as where you live. Hospitals pay the most — the general medical and surgical hospital mean for CNAs is $40,840 per year. Skilled nursing facilities (SNFs), which employ the largest share of CNAs, pay a mean of $38,730. Home health care services pay the least of the major settings at $35,640.
| Work setting | Mean annual | Mean hourly | Notes |
|---|---|---|---|
| General medical and surgical hospitals | $40,840 | $19.63 | Highest base pay; often includes better benefits |
| Government facilities (VA, state hospitals) | ~$42,000+ | ~$20.19+ | Federal pay scales; strong benefits; competitive |
| Skilled nursing facilities (SNFs) | $38,730 | $18.62 | Largest employer of CNAs; often highest overtime opportunity |
| Continuing care / assisted living | $36,770 | $17.68 | Lower acuity than SNFs; more predictable environment |
| Home health care services | $35,640 | $17.13 | Flexibility; lower base; mileage reimbursement varies |
Sources: BLS OES May 2023–2024 industry-specific data, SOC 31-1131
Hospitals pay more because they carry higher acuity patients, require broader clinical skills, and compete with other hospital roles for staff. Government facilities — particularly VA medical centers and state-run long-term care facilities — often match or exceed hospital pay, and come with federal or state benefits packages that significantly raise total compensation.
SNFs employ the most CNAs nationally (roughly 471,000 workers), so they set the floor for the labor market in most regions. The tradeoff is that SNF shifts are often physically demanding, and overtime is widely available — a CNA working consistent overtime in an SNF can meaningfully close the gap with hospital pay.
Home health offers flexibility and independence that appeals to many CNAs, but base pay tends to be lower. Mileage reimbursement and scheduling autonomy partially offset the wage difference.
What affects CNA pay
Several factors push individual CNA wages above or below the state median.
Experience and seniority. New CNAs typically start at or near the 10th percentile ($15.09/hr). After two to three years, movement to the 25th–50th percentile is common, particularly in facilities with defined tenure raises. CNAs at the 90th percentile tend to have five or more years of experience, specialty certifications, or supervisory duties.
Geography — urban versus rural. Metropolitan areas consistently pay more. CNAs in San Jose, San Francisco, Seattle, and New York City earn well above their state medians. Rural CNAs often earn less in absolute dollars but may face lower housing costs. Before accepting a rural position at a lower wage, it’s worth running a cost-of-living comparison rather than relying on the gross number alone.
Shift differentials. Most facilities pay a differential for evening shifts (typically $1–$2/hr above base), night shifts ($2–$3/hr), and weekend shifts ($1–$3/hr). A CNA working permanent nights on weekends can add $4,000–$6,000 per year in differentials without any promotion. Overtime pay (1.5× the regular rate for hours beyond 40 per week) compounds further.
Certifications and specialty skills. CNAs who hold additional certifications beyond the basic state credential can command higher pay. Common certifications that increase earning potential include CNA Level II (in states that have a two-tier system), Certified Medication Aide (CMA), wound care assistant certification, dementia care specialist credentials, and IV therapy aide certification (state-dependent). Facilities often pay a flat rate differential or higher base for certified CNAs with specialty skills.
Union membership. In unionized settings — more common in hospitals, government facilities, and some SNFs in the Northeast and West — CNAs may earn wages set by collective bargaining agreements that exceed non-union rates. Union CNAs also typically receive defined benefit structures around shift differentials and seniority progression.
Setting choice. The setting decision may be the single largest lever available to a working CNA. A CNA moving from a home health role to a hospital role in the same city could add $4,000–$5,000 per year in base pay without any change in credentials or experience.
How to increase your CNA salary
The most reliable paths to higher CNA earnings fall into four categories: earn more credentials, target better-paying settings, use scheduling strategically, and plan the longer-term career move.
Earn a specialty certification. Specialty certifications make you more valuable to facilities that deal with specific patient populations. A dementia care specialist certification is in high demand at memory care units. A wound care assistant credential opens doors in both SNFs and home health. Certified Medication Aide programs, offered in most states, typically come with a pay bump of $1–$3/hr above standard CNA rates. Research what’s available in your state, since CNA scope of practice varies significantly.
Target hospital or government employment. If you’re currently in an SNF or home health role and want to raise your income without additional credentials, a hospital or VA facility application is the most direct move. Hospitals often prefer CNAs with at least one year of experience, so time in an SNF builds the resume that makes the transition possible.
Relocate to a higher-paying state — or metro. For CNAs open to relocating, the difference between Louisiana ($30,240 median) and Oregon ($48,390 median) is $18,150 per year. Even moving from a lower-paying state to a neighboring higher-paying one can add $5,000–$8,000 annually. Within any state, larger metro areas consistently pay above the state median.
Use differentials and overtime strategically. If your facility offers shift differentials, consider whether a permanent evening or night shift assignment makes financial sense. The extra hourly rate compounds across a full schedule. Similarly, picking up overtime during periods when you need to maximize income (paying down debt, building a training fund) is more effective than waiting for base wage increases.
Bridge to LPN or RN. The most significant income increase available to a CNA is advancing to a licensed nursing role. The credential ladder goes CNA → LPN → ADN-RN → BSN-RN. CNAs who earned their credential as a stepping stone to nursing school are in a strong position — clinical experience, patient familiarity, and professional references all transfer. California CNAs have an accelerated route worth knowing about: the BVNPT experience-based pathway allows qualifying CNAs with 48 months of acute-care hours to complete LVN licensure in roughly 12 months rather than the standard 1,530-hour program. See the CNA to LVN California guide for the full eligibility requirements. For broader bridging options, see the how to become a CNA guide.
CNA salary vs LPN vs RN
The nursing career ladder produces meaningful income gains at each step. A CNA earning the median $39,530 who advances to LPN adds roughly $20,000 per year. An LPN who bridges to RN adds another $34,000 or more.
| Role | Median annual (BLS May 2024) | Median hourly | Typical education | SOC code |
|---|---|---|---|---|
| CNA (Nursing Assistant) | $39,530 | $19.01 | State-approved training program (4–12 weeks) | 31-1131 |
| LPN/LVN | $59,730 | $28.72 | Practical nursing program (12–18 months) | 29-2061 |
| RN (Registered Nurse) | $93,600 | $45.00 | ADN (2 years) or BSN (4 years) | 29-1141 |
Source: BLS Occupational Employment and Wage Statistics, May 2024
The steps require real time investment. An LPN program runs 12–18 months and costs $10,000–$20,000 at community colleges; employer tuition assistance is common for CNAs who are already employed. An ADN program adds two more years; a BSN four. But the compounding effect is significant — an RN earns $54,000 more per year than a CNA at the median. Over a 20-year career, that differential is considerable.
For more on those paths, see the how to become an LPN guide and the ADN degree and BSN degree pages.
Is becoming a CNA worth it?
For most people who want to work in healthcare, the CNA credential is one of the best entry points available. The program takes weeks, not years. Most state-approved programs cost under $2,000, and many SNFs and hospitals offer employer-paid training in exchange for a short work commitment afterward.
The CNA role provides direct patient care experience that’s genuinely difficult to get any other way before nursing school. You’ll learn how patients move, communicate, and respond to care at the bedside level — context that accelerates your development in nursing school and makes you a stronger candidate for clinical programs.
The wage picture is honest: entry-level CNA pay in most states is $15–$17/hr, which is livable in lower-cost regions and tight in expensive cities. With experience, specialty certifications, and strategic setting choices, a CNA can realistically reach $22–$24/hr without advancing to a licensed role. That’s a reasonable income for a credential that takes weeks to earn.
Where the CNA credential shows its full value is as a bridge. For nursing students who want clinical experience before applying to ADN or BSN programs, or for career changers who want to confirm that nursing is the right field before committing to a multi-year degree, the CNA credential is a low-cost, high-information decision. You work in hospitals and SNFs, you see what nursing work actually looks like, and you build the professional network that helps you get into programs and jobs later.
The calculation is different if long-term CNA work is the goal, rather than a stepping stone. The physical demands are real, the median wage is modest, and advancement within the CNA role is limited without moving into a licensed nursing credential. For those planning to stay in the role long-term, the best strategy is to maximize income through setting, differentials, and specialty certifications while building toward the best possible compensation floor.
Key takeaways
- The median CNA salary is $39,530 per year ($19.01/hr), based on BLS May 2024 OEWS data for SOC 31-1131
- State pay ranges from $30,240 (Louisiana) to $48,390 (Oregon) — an $18,000 gap
- Hospitals pay more than SNFs ($40,840 vs. $38,730 mean annual); home health pays least at $35,640
- Shift differentials (nights, weekends) and overtime can add $4,000–$6,000/yr without any credential change
- Specialty certifications — CMA, wound care, dementia care — typically add $1–$3/hr above base
- The career ladder to LPN adds ~$20,000/yr median; advancing to RN adds ~$54,000/yr vs. CNA median
- CNA is a strong entry credential: low cost, fast to earn, real clinical experience — and a clear bridge to licensed nursing
For a full walkthrough of the CNA credential process, see the companion guide: how to become a CNA.
To compare salaries across the nursing ladder, see the LPN salary guide and RN salary guide.