Based on the May 2025 BLS release
Most salary advice gives you one number. “A registered nurse earns about $97,550.” That number is real — it is the national median — and it is close to useless if you are deciding whether to take a job in a specific city.
The federal wage survey publishes the same figure for every metropolitan area separately. When you put those side by side, the national median stops looking like a fact about the job and starts looking like an average of wildly different local markets.
These are the roles we track where the gap between the best-paying and worst-paying metro is widest. The last column is simply the top divided by the bottom.
| Occupation | Lowest metro | Highest metro | Spread |
|---|---|---|---|
| Physician | $58,700 | $517,900 | 8.82× |
| EKG Technician | $32,630 | $224,280 | 6.87× |
| Firefighter | $22,800 | $152,100 | 6.67× |
| Psychiatrist | $65,270 | $413,890 | 6.34× |
| Massage Therapist | $21,730 | $135,630 | 6.24× |
| Respiratory Therapist | $25,780 | $149,680 | 5.81× |
| Registered Nurse | $37,460 | $216,740 | 5.79× |
| Marketing Specialist | $25,620 | $141,960 | 5.54× |
| Police Officer | $24,690 | $136,140 | 5.51× |
| Server / Waiter | $15,080 | $82,550 | 5.47× |
| Financial Services Sales | $31,340 | $167,890 | 5.36× |
| Radiologic Technologist | $30,850 | $160,380 | 5.2× |
Take the top row. A physician in Burlington-South Burlington has a median wage of $517,900. The same role in South Arkansas nonmetropolitan area has a median of $58,700. Same job title, same survey, same year — 8.82 times the pay.
Three things, roughly in order of size.
Cost of living. The obvious one, and the one people over-apply. It explains a lot of the California and New York numbers. It does not explain why two metros with similar housing costs can differ by 30% for the same role.
Local demand density. Where an industry clusters, employers compete for the same small pool and pay up. This is measurable — it is what the location quotient captures.
Who the employers are. A metro where the dominant employer of a role is a hospital system pays differently from one where it is a staffing agency. The survey does not break this out, but it is often the residual once you account for the first two.
Before you accept or negotiate, look up the median for your role in that metro, not nationally, and look at the percentile band around it. A national figure will mislead you in both directions: it will make a good offer in a cheap market look poor, and a poor offer in an expensive market look generous.
Every salary guide on this site lists the figure for all 513-odd metropolitan areas for exactly this reason.