Certified registered nurse anesthetists continue to rank among the nation’s highest-earning advanced practice providers — but their pay landscape is changing. As health systems recalibrate anesthesia models and demand steadies, compensation is evolving in ways that reflect both stability and subtle realignment.
Here are five trends to know:
1. Pay remains high but wage growth is slowing: CRNAs continue to report average annual salaries of $214,200, with a mean hourly wage of $102.98. After several years of 15% to 25% pandemic-era increases, wage growth is beginning to slow as demand cools and fewer anesthesia contracts change hands. Median pay now sits around $251,000, with 1099 rates averaging $200-$250 per hour, reflecting a more stable market.
2. Outpatient and ASC settings lead: CRNAs working in ASCs earn some of the highest salaries in the field, averaging $263,960 annually, compared to lower averages in hospitals and physician offices. This reflects a broader procedural migration — as orthopedic, spine and cardiovascular cases continue shifting to the ambulatory setting.
3. Total compensation is boosted by incentive pay: Base salary is only part of total CRNA earnings. .Performance-based pay is increasingly common in high-volume outpatient practices and competitive metro markets, and when factoring in bonuses and productivity incentives, average annual total compensation climbs to about $256,000..
4. Contract models are shifting as hospitals rethink anesthesia coverage: Independent and 1099 CRNAs — who saw double-digit pay increases and rapid six-month contract renewals during the pandemic — are now operating in a steadier environment. The American Association of Nurse Anesthesiology reported that this surge has leveled off as hospitals move away from frequent anesthesia group transitions.
Fewer contract turnovers — a slowdown in what the AANA calls “contract churn” — have prompted health systems to focus on retention and long-term coverage stability rather than repeated rate resets.
5. State-by-state volatility is widening: National averages mask significant regional disparities. The average annual CRNA salary rose to $231,700 in 2024, a $17,500 increase from 2023, though not all states followed that upward trend. Illinois’ average salary fell from $281,240 in 2023 to $254,350 in 2024, and California also saw declines. When adjusted for cost of living, West Virginia ranks among the highest, with an estimated $152.76 hourly equivalent.