BLS May 2025 data, real employer ranges, and the number that flips Iowa's low-pay narrative on its head: Iowa CRNAs out-earn the national average despite Iowa RNs sitting 20% below it.
Iowa registered nurses average $80,540 per year ($38.72/hr) according to BLS OEWS May 2025 — the federal government's most current compensation data. That puts Iowa about 20.6% below the national RN mean of $101,420, which is a meaningful gap. Iowa consistently ranks in the lower tier nationally, alongside Alabama, South Dakota, and Mississippi.
But raw salary comparisons without cost-of-living context are misleading. Iowa's cost of living runs roughly 8–12% below the national average, particularly in housing. Des Moines, which is by far the largest healthcare market in the state, remains one of the most affordable mid-size metros in the country. Your $80K in Des Moines doesn't stretch the same way it would in Houston, but it goes considerably further than it would in Boston or Seattle.
The practical wage range for Iowa RNs in 2026: entry-level new grads at major systems typically start $28–$32/hr. Experienced Med-Surg nurses with 3–5 years are landing $34–$40/hr. Night shift differentials add $3–$6/hr at most facilities, and specialty premiums — ICU, ER, L&D — push experienced nurses into the $42–$48/hr range.
Iowa mean RN: $80,540 vs. national mean $101,420 — a $20,880 gap. Iowa income tax is a flat 3.8% in 2026. Pair that with below-national COL and the effective purchasing power difference narrows to roughly 10–13%. Not nothing, but not the salary catastrophe the raw number implies.
Travel nurses in Iowa see posted base rates averaging $94,990/year (ZipRecruiter 2026), which is notably higher than the staff RN mean — the typical 18% premium you'd expect from a market where most hospitals run lean. Total package including tax-free housing and M&IE stipends runs approximately $116,000–$118,000 annually depending on location and assignment type.
Iowa's travel markets break down by city: Des Moines (UnityPoint Iowa Methodist, Iowa Lutheran, Blank Children's Hospital), Cedar Rapids (UnityPoint St. Luke's, Mercy Medical Center), Iowa City (University of Iowa Health Care), Davenport (Genesis Health System, UnityPoint Trinity), and Waterloo (UnityPoint Allen Hospital). University of Iowa Health Care, as the state's only Level I trauma center and a major academic referral center, typically posts the most consistent travel demand in the state, particularly in ICU and perioperative specialties.
Iowa's flat 3.8% income tax in 2026 is one of the simpler tax calculations in the Midwest — no bracket management required. If you're comparing Iowa to neighboring Illinois (4.95% flat) or Minnesota (graduated up to 9.85%), Iowa's tax position is genuinely favorable for high earners.
Iowa travel demand runs at a lower volume than coastal markets. You won't find the density of contracts you'd see in California or New York, but Iowa facilities tend to have longer contracts (16–26 weeks) and lower turnover in the traveler pool. For nurses who want stability over high velocity, that can be a feature, not a bug. The UIHC ICU is a legitimate training ground — it's an academic Level I that runs complex cases at high volume, and the nurses there know it.
Iowa CRNAs earn approximately $252,191 per year (TheCRNA.com 2026 blended dataset) — which actually exceeds the national CRNA mean of $248,320. That inversion is the most interesting data point in Iowa's nursing economy.
The explanation is straightforward if you know Iowa's geography. The state has 99 counties, and many of them are rural. Rural critical access hospitals (CAHs) are the only anesthesia providers within 40–70 miles for significant portions of the state's population. Recruiting and retaining CRNAs in that environment requires paying above-market, because the alternative is no anesthesia coverage at all. Iowa's 99-county critical access network is essentially a permanent CRNA shortage incubator.
Iowa also has NP full practice authority (FPA), which means NPs can serve as primary care providers in rural settings without physician collaborative agreements. That FPA structure has historically reduced some reliance on physician assistants and enabled nurse-led rural clinics, which in turn increases the clinical infrastructure CRNAs serve. The combination of rural demand and NP integration makes Iowa's CRNA premium durable — it's not a data anomaly, it's structural.
Iowa nurse practitioners average $133,020 per year per BLS OEWS May 2025, putting Iowa NPs near the national mean of $137,300. Given Iowa's lower baseline RN wages, the NP convergence with the national average tells you that NP practice in Iowa is a genuine market — particularly in primary care and rural health.
Iowa has maintained full practice authority for nurse practitioners for well over a decade. Iowa NPs can diagnose, treat, and prescribe including controlled substances with no collaborative agreement and no transition period required. The Board of Nursing exclusively handles NP licensure. This FPA structure created an NP ecosystem in Iowa that's more mature than states that shifted to FPA recently — employers here have built their rural clinic models around independent NPs, and compensation reflects that operational dependency.
For NPs considering Iowa: rural primary care and psychiatric NP positions consistently pay more than urban settings due to shortage premiums. NP salary negotiation in Iowa tends to be more productive than in restricted-practice states because employers can't easily swap you for a PA with supervisory requirements attached — they need an independently-practicing provider, and you're it.
Iowa ICU nurses average approximately $106,921/year based on 2026 aggregator data — a 33% premium over the general RN mean. That spread reflects real market dynamics: Iowa's ICU nurse workforce is smaller than the national proportion (fewer Level II and III trauma centers per capita than most states), and University of Iowa Health Care's ICU runs at high acuity, pulling experienced nurses into a competitive segment of the market.
ER nurses in Iowa average approximately $81,469/year, which closely tracks the general RN mean. Iowa's emergency nursing market is less stratified than ICU — most general community hospitals have EDs, and the skill premium in Iowa's ER market is narrower than in coastal markets where Level I trauma nursing commands significant premiums. Cedar Rapids and Des Moines metro EDs see the most volume and pay at the upper end of the range.
UnityPoint Health is Iowa's largest health system, operating 17+ hospitals and nearly 400 clinics across Iowa, western Illinois, and southern Wisconsin. Key Iowa campuses include Iowa Methodist Medical Center and Blank Children's Hospital (Des Moines), St. Luke's Hospital (Cedar Rapids), Allen Hospital (Waterloo), Finley Hospital (Dubuque), and Trinity facilities in the Quad Cities. In August 2025, nurses at four Des Moines UnityPoint hospitals filed for union recognition via Teamsters Local 90, representing approximately 2,000 nurses. That organizing drive is worth tracking — if successful, it would represent the largest union contract negotiation in Iowa nursing history.
University of Iowa Health Care (UIHC) in Iowa City operates an 811-bed academic medical center that is the state's only Level I trauma center. UIHC is the largest single-site nursing employer in Iowa. As an academic center, UIHC runs high-acuity specialty services — transplant, burn, pediatric oncology, and complex cardiac — that most Iowa nurses won't see at community hospitals. UIHC base RN wages are competitive for Iowa, and academic progression pathways and clinical ladder programs are established. Iowa City's cost of living is higher than the state average (university-town effect) but still well below most comparable academic medical centers.
Genesis Health System serves the Quad Cities market (Davenport/Bettendorf Iowa, Rock Island/Moline Illinois) with approximately 450 licensed beds across its flagship Genesis Medical Center campuses. Cross-border location means some nurses carry both Iowa and Illinois licenses — NLC compact portability is actively used in this corridor.
Iowa moved to a flat 3.8% income tax rate in 2026, down from its prior graduated bracket structure. This simplifies take-home pay calculations significantly. At $80,540 annual salary, Iowa state income tax is approximately $3,060 — a materially lower burden than neighboring states with higher rates.
Iowa's cost of living advantage is most pronounced in housing. Median home prices in Des Moines sit well below national medians, and Cedar Rapids and Waterloo/Cedar Falls are even more affordable. For nurses relocating from higher-COL states, the effective buying power of an Iowa salary is more competitive than the BLS figure alone would suggest.
Iowa is a Nurse Licensure Compact (NLC) member state. Nurses holding a valid multistate compact license with a primary state of residence in any other NLC member state can practice in Iowa without a separate Iowa license. Iowa's six-state border situation — Nebraska, South Dakota, Minnesota, Wisconsin, Illinois, and Missouri all share a boundary with Iowa or its metro areas — makes compact portability genuinely useful for cross-border telehealth, per diem work, and travel nursing in the border corridors.
If Iowa is your primary state of residence, you would obtain your license through the Iowa Board of Nursing, which issues a multistate compact license automatically (you don't need to separately request it). That Iowa compact license is then valid in all other NLC states without additional applications.
Iowa's 3.8% flat tax makes per-contract math simpler than most states. Run your full take-home estimate — base pay, stipend value, tax impact — in under 2 minutes.
Iowa Stipend Calculator →Iowa registered nurses average $80,540 per year ($38.72/hr) according to BLS OEWS May 2025 data — 20.6% below the national mean of $101,420. Employment is approximately 34,000 RNs statewide. UnityPoint Health and University of Iowa Health Care are the dominant employers. Iowa's cost of living runs 8–12% below the national average, which narrows the effective compensation gap considerably.
Travel nurses in Iowa average $94,990/year in posted base pay (ZipRecruiter 2026). Total package with tax-free housing and M&IE stipends runs approximately $116,000–$118,000 per year. Iowa's 3.8% flat income tax simplifies take-home calculations. University of Iowa Health Care (Iowa City), UnityPoint Des Moines, and Quad Cities facilities see the most consistent travel demand.
Iowa CRNAs earn approximately $252,191 per year (TheCRNA.com 2026 blended data) — slightly above the national mean of $248,320. That above-national premium reflects Iowa's dense rural critical access hospital network. Iowa has 99 counties, many relying on CRNAs as their sole anesthesia providers, creating structural shortage-driven demand that keeps CRNA pay elevated despite Iowa's lower baseline RN wages.
Yes. Iowa grants nurse practitioners full practice authority. Iowa NPs can diagnose, treat, and prescribe — including controlled substances — without any physician oversight requirement, collaboration agreement, or transition period. Iowa has maintained this regulatory framework for over a decade, making it one of the more established FPA ecosystems in the Midwest. Rural primary care and psychiatric NP positions in Iowa carry shortage premiums above the state average.
Yes. Iowa is a Nurse Licensure Compact (NLC) member state. Nurses with a multistate compact license whose primary state of residence is any NLC state can practice in Iowa without a separate Iowa license. Given Iowa's borders with Nebraska, South Dakota, Minnesota, Wisconsin, and Missouri — all NLC states — compact portability is actively useful for cross-border telehealth, per diem, and travel nursing in Iowa's border corridors.