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Mapped: The Highest-Paying Job in Every State
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Key Takeaways
- Healthcare occupations rank as the highest-paying job in 48 of 50 states.
- Missouri tops the nation, where orthopedic surgeons earn roughly $843,000 annually.
- California ranks just 45th, with eye surgeons earning about $400,000 a year.
The highest-paying jobs in America aren’t concentrated in Silicon Valley, Wall Street, or even the nation’s largest cities.
Using data from the U.S. Bureau of Labor Statistics, this graphic ranks the highest-paying occupation in every state by median salary as of May 2025. Healthcare professions dominate the list, but the biggest surprise is where the largest paychecks are found.
Missouri ranks first in the nation, with orthopedic surgeons earning roughly $843,000 annually. By comparison, California’s highest-paying occupation earns less than half that amount.
Healthcare Dominates America’s Top Pay Rankings
Healthcare occupations rank as the highest-paying job in 48 states, making medicine by far the most dominant profession on the map.
| State | Highest-Paying Occupation | Median Annual Wage 2025 |
|---|---|---|
| Alabama | Cardiologists | $519K |
| Connecticut | Cardiologists | $489K |
| Illinois | Cardiologists | $518K |
| Indiana | Cardiologists | $589K |
| Kentucky | Cardiologists | $558K |
| Nebraska | Cardiologists | $646K |
| New York | Cardiologists | $492K |
| Pennsylvania | Cardiologists | $579K |
| Tennessee | Cardiologists | $610K |
| Texas | Cardiologists | $410K |
| Washington | Cardiologists | $656K |
| Wisconsin | Cardiologists | $637K |
| Arizona | Orthopedic Surgeons | $559K |
| Florida | Orthopedic Surgeons | $474K |
| Mississippi | Orthopedic Surgeons | $544K |
| Missouri | Orthopedic Surgeons | $843K |
| Montana | Orthopedic Surgeons | $561K |
| New Hampshire | Orthopedic Surgeons | $556K |
| West Virginia | Orthopedic Surgeons | $598K |
| Maine | Radiologists | $556K |
| Maryland | Radiologists | $582K |
| Massachusetts | Radiologists | $427K |
| Michigan | Radiologists | $486K |
| Minnesota | Radiologists | $708K |
| New Jersey | Radiologists | $483K |
| South Dakota | Radiologists | $586K |
| North Carolina | Surgeons | $398K |
| North Dakota | Surgeons | $605K |
| Ohio | Surgeons | $554K |
| Oklahoma | Surgeons | $554K |
| Vermont | Surgeons | $439K |
| Wyoming | Surgeons | $388K |
| Alaska | ER Doctors | $453K |
| Iowa | ER Doctors | $429K |
| New Mexico | ER Doctors | $405K |
| Rhode Island | ER Doctors | $513K |
| Arkansas | Dermatologists | $422K |
| Delaware | Dermatologists | $442K |
| Nevada | Dermatologists | $419K |
| Kansas | Anesthesiologists | $437K |
| Virginia | Anesthesiologists | $488K |
| Oregon | Obstetricians & Gynecologists | $395K |
| Utah | Obstetricians & Gynecologists | $437K |
| Georgia | Pilots | $618K |
| Idaho | Pilots | $508K |
| California | Eye Surgeons | $400K |
| South Carolina | Internal Medicine | $360K |
| Washington D.C. | Neurologists | $332K |
| Colorado | Orthodontists | $416K |
| Louisiana | Pediatricians | $503K |
| Hawaii | Physicians | $339K |
Cardiologists lead in 10 states, while surgical specialties account for many of the highest-paying occupations elsewhere. The pattern reflects both the extensive training required to become a physician and the growing shortage of medical professionals nationwide.
By 2036, the U.S. could face a shortage of up to 86,000 physicians, increasing competition for talent as healthcare demand continues to rise with an aging population.
Missouri Tops the Nation
Healthcare dominates the rankings nationwide, but salaries vary enormously depending on specialty and location.
Missouri ranks first overall, with orthopedic surgeons earning a median annual wage of roughly $843,000, more than 10 times the national median of about $81,000.
The figure highlights how specialist compensation can vary based on regional labor shortages, healthcare demand, and physician supply. In some markets, hospitals and healthcare systems must offer significantly higher pay to attract and retain specialized talent.
The specialty itself also sits at the center of a powerful demographic trend. As Americans live longer, demand for procedures such as hip and knee replacements is expected to rise, increasing the need for orthopedic specialists in many regions.
The Pilot Exception
Georgia and Idaho are the only states where airline pilots rank as the highest-paying occupation.
Pilot compensation has risen sharply in recent years. Captains at major U.S. airlines have seen wages climb 46% since 2020, while regional airline pilots have received raises of 86% amid persistent labor shortages.
With North America projected to face a shortage of roughly 13,000 pilots by 2032, aviation remains one of the few professions capable of competing with top medical specialties on pay.
Why Healthcare Pays So Much
The concentration of healthcare occupations at the top of state pay rankings points to a broader trend reshaping the U.S. economy.
Healthcare accounts for nearly one-fifth of U.S. GDP, or over $5 trillion in spending annually. As Americans live longer and require more complex care, demand for physicians and specialists is expected to remain strong.
The map also highlights how valuable scarce expertise has become. Whether in medicine or aviation, the highest-paying jobs tend to be those that require years of training, specialized knowledge, and skills that are difficult to replace.
In that sense, the map is about more than salaries. It offers a snapshot of where demand for talent is strongest and which professions remain among the most valuable in America today.
Learn More on the Voronoi App
To learn more about this topic, check out this graphic on the income needed to buy a home in every state.