Virginia nurse salary 2026: RN, NP & travel pay

Virginia RNs average $93,850/year — about 7.5% below the national mean of $101,420. If that's the first number you saw in a job ad comparison, it undersells the market significantly. ICU nurses in Virginia clear $107,414 — a 26% premium above the national ICU average of $85,205. CRNAs earn $243,259, putting them 2% below the national CRNA mean. The state doesn't pay badly. It pays unevenly.

Two variables drive the split: geography and practice environment. Northern Virginia's DC-metro corridor — anchored by INOVA Health System — commands salaries that rival Mid-Atlantic urban markets. Southwest Virginia and Appalachian communities run 15–25% lower and struggle with persistent vacancies. Meanwhile, Virginia's restricted NP scope of practice keeps advanced-practice earnings below FPA-state peers, while the state's NLC compact membership makes it a faster-entry market for travel nurses.

Virginia Nurse Salary at a Glance (2026)

Virginia RN Salary: The Geographic Divide That Changes Everything

The $93,850 state average is a blended number that flattens a wide spread. The real Virginia nurse salary market has three distinct zones:

Northern Virginia / DC Metro (highest tier): INOVA Health System — which operates Fairfax, Fair Oaks, Loudoun, Alexandria, and Reston hospitals — is the dominant employer and sets the pay ceiling for the region. Experienced RNs in INOVA ICU, ED, and OR units typically earn $85,000–$115,000. HCA Virginia (Henrico Doctors', Chippenham, Reston Hospital) competes with similar ranges. DC-proximity means NoVA nurses can also cross into Maryland for even higher-paying positions at MedStar Washington Hospital Center or Johns Hopkins — see the Maryland nurse salary guide for the full breakdown. Maryland eNLC compact status means the license switch is straightforward for most RNs.

Central Virginia / Richmond (mid-tier): VCU Health System and its flagship VCU Medical Center — Virginia's only Level I trauma center — anchor the Richmond market. Academic-medicine rates run $72,000–$95,000 for most RN roles, with ICU specialty units at the higher end. Bon Secours Virginia (part of the St. Francis Health System network) pays competitively for a faith-based system. The Richmond metro cost of living runs 10–15% lower than NoVA, making real-wage purchasing power roughly comparable to NoVA on similar base salaries.

Southwest Virginia / Appalachian Highlands (shortage tier): Carilion Clinic in Roanoke and Ballad Health in the Tri-Cities/Kingsport region pay $62,000–$80,000 for most staff RN roles — 8–15% below the state average. These communities face persistent RN vacancies driven by geographic isolation, limited new-grad pipeline, and competition from larger urban systems. Cost of living is the lowest in the state, which offsets some of the wage gap, but sign-on bonuses ($10,000–$25,000) are common to attract nurses willing to relocate.

Tidewater / Hampton Roads: Sentara Health System (Norfolk, Virginia Beach, Chesapeake) anchors this region. Pay runs $70,000–$92,000 for most RN roles, with military healthcare (Naval Medical Center Portsmouth, Langley/Eustis facilities) providing a stable parallel market that occasionally competes for civilian nurses.

Travel Nurse Salary in Virginia 2026

Virginia travel nurse posted wages average $100,264/year — nearly flat with the national travel average of $101,132. Total compensation including tax-free housing and meal stipends (based on GSA per diem rates for Virginia metros) typically runs $1,900–$2,800/week depending on specialty and location.

INOVA Fairfax and INOVA Loudoun in Northern Virginia run the highest-paying travel contracts in the state — ICU and OR travelers at INOVA Fairfax regularly pull $2,400–$2,900/week on 13-week contracts. VCU Medical Center Level I trauma travel contracts (ICU, Neuro, Burn) cluster in the $2,100–$2,600/week range. Sentara Norfolk General — a Level I trauma center in Hampton Roads — also runs competitive travel packages, particularly for ER and cardiac specialties.

Virginia's compact membership is the key logistical advantage here. If you hold a compact license, you can start a Virginia assignment within days of signing the contract. No waiting on board approvals. That makes Virginia one of the more traveler-accessible states on the East Coast — a genuine differentiator from non-compact neighbors like West Virginia and Pennsylvania (which joined compact but still has some timing friction).

Nurse Practitioner Salary in Virginia 2026

Virginia NPs earn $122,180/year — about $15,120 below the national NP mean of $137,300. That $15K gap isn't random. It's structural.

Virginia is a restricted practice authority state. NPs must maintain a practice agreement with a physician and cannot practice independently. Collaboration agreements add administrative overhead, create dependency on physician availability, and prevent NPs from opening solo practices or pursuing direct payer contracts without physician partnership. In full practice authority (FPA) states — 28+ states as of 2026 — NPs negotiate compensation based on patient panel productivity. In Virginia, that ceiling doesn't exist in the same way.

The practical impact: NPs in primary care or rural settings who can't find a collaborating physician face barriers that don't exist in neighboring West Virginia or Maryland. NPs in system-employed roles (INOVA Medical Group, VCU Health, UVA Physicians Group) typically earn $110,000–$140,000 depending on specialty — comparable to other restricted-state peers. Specialty NPs (oncology, cardiology, critical care at Level I centers) can clear $135,000–$155,000 in the NoVA market.

Virginia has had NP full practice authority legislation introduced multiple sessions and failed. There's no concrete path to FPA in 2026. If NP scope is a priority for your career, factor that into your state-of-residence decision.

CRNA Salary in Virginia 2026

Virginia CRNAs earn $243,259/year — 2% below the national CRNA mean of $248,320. That is close to national parity and well ahead of Virginia's RN gap, and it comes from two factors: the INOVA/NoVA market premium and Virginia's opt-out status under the CMS Medicare conditions of participation (CRNAs can practice without physician supervision).

INOVA Fairfax Hospital — a 900-bed Level I trauma center — runs one of the busiest OR suites on the East Coast. Cardiac, neurosurgical, and vascular anesthesia placements at INOVA carry top-tier CRNA compensation. VCU Medical Center's transplant and trauma surgery programs and UVA Health's cardiothoracic and pediatric surgical programs round out the academic CRNA market.

Travel CRNA rates in Virginia run $3,000–$4,500/week for specialty placements. Cardiac and transplant placements at Level I centers consistently reach the high end. CRNA programs in Virginia (Virginia Commonwealth, Virginia CRNA School) produce graduates who frequently stay in-state — but the physician-heavy academic programs also compete for CRNA talent in the same system, keeping demand tight.

ICU Nurse Salary in Virginia: The Real Outlier

Virginia ICU nurses averaging $107,414 deserve a closer look. A 26% premium over the national ICU average is not typical — it's one of the highest state-level ICU differentials in the country. The explanation is the concentration of Level I and Level II trauma centers and academic medical centers in a relatively small geographic area.

INOVA Fairfax (Level I), VCU Medical Center (Level I — Virginia's only dedicated Level I), UVA Medical Center (Level I), and Sentara Norfolk General (Level I) all operate full MICU, SICU, CVICU, and Neuro-ICU programs. These are high-acuity units that command CCRN premiums, charge-differential pay, and shift-differential structures that pull the average up significantly relative to the general RN baseline.

If you're an ICU-trained nurse considering Virginia, the math is different from the headline. $107,414 average for ICU in a state with a $93,850 RN baseline means specialty experience is being valued at a notable premium. Add NoVA cost-of-living supplemented by competitive travel contract rates and the picture gets better.

Virginia Nursing Employers: Who Pays What