The jobs where moving states changes your pay most
Figures from the May 2025 BLS release
We have already looked at how much metro areas differ. States are the coarser cut, and for some occupations the coarser cut is the one that matters — because licensing, public-sector pay scales and industry concentration are often set at state level rather than city level.
Widest state-level gaps
| Occupation | Lowest state | Median | Highest state | Median | Gap |
|---|---|---|---|---|---|
| Physician | District of Columbia | $77,430 | North Dakota | $454,550 | 5.87× |
| Psychiatrist | West Virginia | $63,320 | California | $353,500 | 5.58× |
| Financial Services Sales | Virgin Islands | $35,160 | New York | $168,340 | 4.79× |
| Massage Therapist | Puerto Rico | $29,000 | Alaska | $134,930 | 4.65× |
| Server / Waiter | Louisiana | $15,080 | Hawaii | $62,390 | 4.14× |
| Surgical Assistant | Puerto Rico | $30,160 | District of Columbia | $123,390 | 4.09× |
| Bartender | South Carolina | $19,370 | Hawaii | $76,490 | 3.95× |
| Heavy Equipment Operator | Puerto Rico | $29,810 | Hawaii | $115,860 | 3.89× |
| School Bus Driver | Alabama | $17,630 | Massachusetts | $65,170 | 3.7× |
| Sales Manager | Guam | $60,740 | New York | $217,640 | 3.58× |
| Registered Nurse | Puerto Rico | $39,880 | California | $140,270 | 3.52× |
| Paramedic | Puerto Rico | $29,960 | Washington | $104,310 | 3.48× |
| Radiologic Technologist | Puerto Rico | $35,280 | California | $121,260 | 3.44× |
| Purchasing Agent | Puerto Rico | $36,750 | District of Columbia | $124,090 | 3.38× |
The top row is stark. Physician in North Dakota has a median of $454,550; in District of Columbia the median is $77,430. Same occupation code, same survey, same year, 5.87 times the pay.
Three things drive this, and cost of living is only one
Licensing and scope of practice. Healthcare shows up repeatedly in this table because what a given credential is permitted to do varies by state. Where scope is broader, the role absorbs more responsibility and pays accordingly.
Public versus private employment mix. Occupations dominated by state or local government inherit that state's pay scales. Two states with similar living costs can differ by 30% on the same public-sector role.
Industry concentration. Where an industry clusters, employers compete for a small pool. This is measurable — see what each state is unusually good at employing.
A caution on the extremes
Territories and very small states appear at both ends of these rankings more often than their size warrants, because a smaller survey base produces a noisier median. Treat the ratio as a signal that geography matters for that occupation, not as a precise multiple you can plan a move around. The per-occupation guides give the metro-level detail, which is what an actual relocation decision needs.