Physician Salary by State (2026)

In the Bureau of Labor Statistics' May 2025 wage survey, family medicine physicians had the highest average pay in Rhode Island ($365,960), Montana ($337,850) and Oklahoma ($329,940), and general internal medicine physicians had the highest in Georgia ($388,060) and Minnesota ($387,730). Doximity's 2026 Physician Compensation Report, which ranks 60 metro areas rather than states, found the highest average pay across all specialties in Oklahoma City ($495,617), followed by Sacramento ($484,817) and Rochester, Minnesota ($478,861).

No public source ranks every state by pay for all physicians combined. BLS publishes state figures one occupation at a time and leaves out self-employed physicians, and Doximity reports metro areas only. This guide uses the BLS figures for the two largest primary care occupations, adjusts them for state price levels with the Bureau of Economic Analysis's regional price parities, and adds each state's 2026 top income tax rate from the Tax Foundation.

Physician Pay by State: The BLS Data

The table shows the mean annual wage that the Bureau of Labor Statistics reported for May 2025 for family medicine physicians and general internal medicine physicians in each state and the District of Columbia, sorted by the family medicine figure. BLS does not publish a combined state figure for all physicians. Its Occupational Employment and Wage Statistics survey covers wage and salary workers and leaves out the self-employed, so many practice owners are not counted.

BLS withholds some estimates. For internal medicine in Hawaii it reports only that the mean is at least $239,200 a year ($115.00 an hour), its top-coded value, and it released no internal medicine estimate for Delaware, Kansas, Montana, New Mexico, Virginia or Wyoming. The table marks those cells rather than filling them in.

Which States Pay the Most After Cost of Living

The Bureau of Economic Analysis measures how price levels differ by state, including rents. Its 2024 regional price parities were highest in California (110.7), Hawaii (110.0), the District of Columbia (109.9) and New Jersey (108.8), and lowest in Arkansas (86.9), Mississippi (87.0), Iowa (87.8) and Oklahoma (87.8).

Dividing each state's BLS family medicine mean by its price level gives a rough measure of purchasing power. On that basis Oklahoma ranks first at about $375,600 in U.S.-average prices, followed by Rhode Island ($357,800), Montana ($357,000), Idaho ($321,900) and Iowa ($318,000). The five lowest are Alabama ($191,100), Connecticut ($193,800), New York ($196,000), Hawaii ($202,400) and Florida ($215,000).

Price parities cover consumer goods, services and rent. They do not include taxes, so the tax column in the table is a separate adjustment. They are also statewide averages, and prices in a large metro area can differ from the state figure.

Doximity's Metro Rankings

Doximity's 2026 Physician Compensation Report draws on nearly 23,000 compensation surveys that full-time U.S. physicians completed in 2025. It reports average pay across all specialties for 60 metro areas and does not rank states. Average physician pay rose 2% from 2024 to 2025.

• •Highest average pay: Oklahoma City ($495,617), Sacramento ($484,817), Rochester, Minnesota ($478,861), Los Angeles ($469,047) and Louisville, Kentucky ($465,924).
• •Lowest average pay: Durham-Chapel Hill, North Carolina ($381,424), San Antonio ($384,329), Ann Arbor, Michigan ($385,135), Birmingham, Alabama ($390,472) and Providence, Rhode Island ($390,998).
• •Highest after Doximity's cost-of-living adjustment: Oklahoma City, Rochester, Minnesota, Little Rock, Arkansas, Omaha, Nebraska and Louisville, Kentucky.
• •Lowest after the adjustment: Boston, Washington, D.C., Baltimore, Denver and Providence.

The sources disagree on Rhode Island. Its BLS family medicine mean is the highest of any state, while Doximity puts Providence among its five lowest-paid metros for all specialties. The BLS Rhode Island figure is based on about 210 employed family physicians and has a 14.0% relative standard error, so treat it with caution.

Self-Reported Salaries by State

SalaryDr publishes a median physician salary for every state from 3,350 approved salaries that physicians submitted themselves, across all specialties. Sample sizes vary widely. Its top state, Wyoming ($760,000), is based on 2 submissions, and North Dakota's figure on 1.

Among the 12 states with at least 100 submissions, the highest medians were Texas ($550,000 from 144 submissions), California ($530,000 from 424) and New York ($500,000 from 149). The lowest were Iowa ($370,000 from 130) and Alabama ($360,000 from 144). Each state's submissions mix different specialties, so these medians reflect who submitted as much as what jobs in that state pay. We did not use them in the table.

State Income Taxes in 2026

According to the Tax Foundation, eight states have no individual income tax in 2026: Alaska, Florida, Nevada, New Hampshire, South Dakota, Tennessee, Texas and Wyoming. Washington taxes capital gains but not wages. The lowest flat rates are in Arizona (2.5%), Ohio (2.75%), Indiana (2.95%) and Pennsylvania (3.07%).

Top rates in the high-tax states apply only at high incomes, so a state's top rate can overstate what a physician pays. For a single filer in 2026, California's rate is 9.3% on taxable income from $72,724 to $371,479 and reaches 13.3% over $1 million. New York's rate is 6.85% from $215,400 to $1,077,550, and its 10.9% top rate starts at $25 million. Minnesota's 9.85% rate starts at $203,150 and Oregon's 9.9% rate at $125,000, so those top rates do apply at typical physician incomes.

California and New York also have low BLS family medicine means for their price levels: $252,930 in California (price level 110.7) and $211,570 in New York (107.9). To see what a state's brackets mean for your salary, use our Tax Withholding Calculator or read How Much Do Doctors Take Home After Taxes.

Rural and Shortage-Area Jobs

None of the sources above publishes a state-by-state pay premium for rural or shortage-area jobs, so this guide does not give one. What you can check for a specific job is whether it qualifies for loan repayment. The National Health Service Corps Loan Repayment Program repays loans for clinicians who work at approved sites in Health Professional Shortage Areas. Our FQHC Physician Playbook covers the award amounts and how the program works alongside PSLF, and our PSLF Calculator models forgiveness for your loans.

How to Use This Data

• •Step 1: Compare offers within your specialty. The BLS columns cover family medicine and general internal medicine only. For other fields, start with our Physician Salary by Specialty guide.
• •Step 2: Estimate after-tax pay. Apply the state's brackets to your expected salary instead of its top rate. Our Tax Withholding Calculator does this for your filing status and deductions.
• •Step 3: Adjust for prices. Divide after-tax pay by the state's price level over 100 (for example, 0.878 for Oklahoma) to compare purchasing power across states.
• •Step 4: Add terms that salary surveys miss. Ask about signing bonuses, loan repayment, malpractice coverage and tail, and call pay. Our Student Loan Payoff Calculator shows what a loan repayment award is worth against your balance.