Best States for 1099 Physicians (2026)

The published 50-state ranking

Compare the state taxes, living costs and malpractice insurance costs that matter when you work as an independent physician.

Higher scores mean a stronger result on the factors this guide measures. They do not guarantee a better fit for your household or investment. Ties stay tied, and missing data is clearly marked.

Taxstra’s published 2026 ranking. One methodology, applied consistently to every state. 80% financial evidence and 20% WalletHub Quality of Life. See the factors and scoring rules.

Pick a state. See how it fits.

Explore grades out of 10, category ranks and the tradeoffs behind them. Each state uses the same published factors and weights.

The map loads when the page opens. All 50 states are available in the selector and table.

1 / 1010 / 10

Gray = unavailable or provisional; no comparable rank. Alaska and Hawaii shown as insets.

Choose a state

Boundaries: U.S. Census Bureau / US Atlas.

Why Illinois scores this way

Illinois ranks #41 of 50, with 5.0 / 10. 2 states share this rank.

A higher category score means a stronger result on that measure. Check the “Good fit for” and “Less suited to” notes against your own priorities.

Full state analysis Grading methodology

2026 state guide

1099 physicians

Illinois

Taxstra’s state comparison

5.0/ 10

Overall score#41 in the comparison

80% cost and financial score (3.9/10) · 20% quality of life (9.3/10)

How to read this score

Uses a separately supplied $500K state-taxable ordinary-business base, regional spending and CMS relative malpractice costs. Does not derive a return from $500K profit or assume a contractor pay premium. Entity charges, retirement contributions, federal payroll and assignment-state sourcing remain separate.

State tax on $500K of taxable business income

#28 of 50 · 24% weight

5.2/10

$24,750 in state income tax in our $500,000 taxable-business-income example; business fees, payroll and local taxes are separate.

Everyday living costs

#33 of 50 · 32% weight

5.1/10

$99,958. What a $100,000 national spending budget would cost here; lower costs score better.

Malpractice insurance costs

#50 of 50 · 24% weight

1.0/10

2.20 on the CMS cost index; a lower number means lower relative insurance costs, not a quote for your specialty.

Quality of life

#5 of 50 · WalletHub category · 20% weight

9.3/10

WalletHub: #5 for Quality of Life, #18 overall; this score uses the category.

Home prices compared with pay

#21 of 50 · Not in overall score

8.4/10

1.22 ×. Home price divided by annual family-physician pay; lower means housing is more affordable relative to pay.

Homeowner property taxes

#45 of 50 · Not in overall score

5.2/10

$5,399 typical annual homeowner tax bill; check the specific property before budgeting.

Good fit for

Physicians with a strong specific offer who value Illinois amenities and manageable purchase prices
Contractors whose paid hours and coverage terms are documented

Less suited to

Buyers treating an inexpensive listing as proof of low long-term carrying costs
Budgets treating gross collections or an hourly quote as spendable annual income

Illinois: full analysis and evidenceRead the state-specific explanation and supporting sources.

Illinois

Back to comparison ↑

Median home $280,700Monthly gross rent $1,322HO-3 premium, 2023 $1,480

Illinois’s general price index is almost exactly national average, while its homeowner tax observation is well above Indiana’s and Iowa’s. Contractors holding profit constant should compare total home-base costs before assuming the modest purchase value is the whole story. Malpractice renewal terms also merit explicit attention because the cited study identifies selected premium increases, not a complete annual coverage price.

The 2024 BEA index prices a controlled $100,000 basket at $99,958 (cost position 33). ACS median homeowner tax is $5,399 for 2024, and the historical NAIC HO-3 premium is $1,480 for 2023. These household observations do not include practice expenses or malpractice.

AMA 2024–2025: ≥10% increases, 9.7%; sample 93.

The CMS underlying malpractice-cost index aggregates to 2.201 for Illinois, using published malpractice RVUs across 101 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Illinois retirement-tax details

Cite the state. Include the method.

Use the state, guide title, published methodology and source years when citing a score. State selection changes the card, not the ranking methodology.

Media and interview inquiries · Source data · Taxstra methodology

Full ranking table · 50 of 50 statesCompare every state’s rank, housing costs, property taxes and tax treatment.

50 of 50 states

1099 physicians: economic observations and tax context
Rank	State	Physician contractor tax, cost and lifestyle grade	Home value ACS 2024	Property-tax bill ACS 2024 median	Price index BEA 2024	Individual bonus treatment
1	Iowa	8.4 / 10	$227,300	$2,937	87.8	Iowa follows current federal depreciation, including §168(k) and §168(n), for 2026 to 2027.
2	South Dakota	8.4 / 10	$289,600	$2,940	88.6	South Dakota does not impose a broad individual income tax.
3	North Dakota	7.9 / 10	$266,100	$2,550	89.0	North Dakota follows the federal deductions through its current federal income starting point.
4	Tennessee	7.9 / 10	$332,600	$1,488	91.9	Tennessee does not impose a broad individual income tax.
5	Texas	7.8 / 10	$313,200	$4,108	97.1	Texas does not impose a broad individual income tax.
6	Ohio	7.6 / 10	$239,800	$2,937	92.8	For §168(k), generally add back five-sixths and deduct one-fifth of that addback in each of the next five years. Payroll-growth and NOL exceptions can change the result; §168(n) generally follows federal law.
7	Indiana	7.5 / 10	$243,500	$1,798	93.3	Add back federal bonus depreciation and maintain Indiana basis for later depreciation or disposition.
8	Kansas	7.5 / 10	$238,700	$2,983	90.1	Current Kansas statutes recognize federal §168(k); a direct current official statement on §168(n) was not located.
9	Wyoming	7.5 / 10	$339,500	$1,947	92.7	Wyoming does not impose a broad individual income tax.
10	Nebraska	7.4 / 10	$263,100	$3,739	90.1	Nebraska follows the current federal depreciation deduction for 2026 to 2027.
11	Wisconsin	7.4 / 10	$294,700	$3,680	94.1	Wisconsin does not adopt federal §168(k) or §168(n); compute Wisconsin depreciation separately.
12	North Carolina	7.2 / 10	$333,000	$2,044	94.3	Add back 85% of the federal accelerated-depreciation amount, then deduct 20% of that addition in each of the next five years.
13	Arkansas	7.2 / 10	$215,600	$1,113	86.9	Federal bonus depreciation is not adopted; use the Arkansas depreciation computation.
13	Oklahoma	7.2 / 10	$222,100	$1,672	87.8	Oklahoma permits a state 100% expensing election for qualifying property; it is not simple federal bonus conformity.
15	Nevada	7.1 / 10	$455,500	$2,143	100.0	Nevada does not impose a broad individual income tax.
16	Louisiana	7.0 / 10	$223,200	$1,187	88.2	Louisiana offers an optional state 100% expensing deduction for qualifying property; later federal depreciation on the same basis is added back.
17	Pennsylvania	7.0 / 10	$277,600	$3,214	97.6	Pennsylvania personal income tax uses its own depreciation rules rather than the federal bonus amount.
18	Mississippi	6.8 / 10	$186,500	$1,221	87.0	Mississippi permits a state 100% first-year deduction for qualifying depreciable property; it is not simple federal bonus conformity.
19	Alabama	6.8 / 10	$233,300	$890	88.8	Follows the federal §168(k) and §168(n) deductions for 2026 to 2027.
20	Washington	6.7 / 10	$602,200	$4,729	107.0	Washington does not impose a broad individual income tax.
21	Missouri	6.7 / 10	$254,400	$2,021	90.8	Missouri follows current federal depreciation and does not require a bonus addback for current property.
22	Kentucky	6.5 / 10	$226,000	$1,611	90.2	Kentucky does not adopt the current federal bonus provisions; use Kentucky depreciation.
23	Idaho	6.4 / 10	$446,400	$1,912	95.5	Add back the federal bonus difference in the first year; deduct later Idaho-versus-federal depreciation differences.
24	Arizona	6.4 / 10	$426,000	$1,828	100.7	Individuals retain the full federal §168(k) bonus amount for eligible new property in 2026; §168(n) is separately added back.
25	Florida	6.3 / 10	$396,900	$2,993	103.4	Florida does not impose a broad individual income tax.
26	Minnesota	6.3 / 10	$344,600	$3,501	98.6	For §168(k), add back 80% and deduct one-fifth of that addition in each of the next five years. Qualified production property under §168(n) is not added back.
27	Colorado	6.2 / 10	$574,600	$2,828	103.1	Colorado follows the federal deductions for §168(k) bonus and §168(n) qualified production property.
28	Michigan	6.2 / 10	$254,200	$2,988	96.2	For individuals and flow-through entities, Michigan retains the pre-OBBBA phaseout: 20% federal bonus in 2026 and 0% in 2027; §168(n) is disallowed.
29	South Carolina	6.1 / 10	$299,500	$1,337	93.7	Use South Carolina depreciation without federal §168(k) or §168(n).
30	New Mexico	6.1 / 10	$279,900	$1,776	92.2	Ordinary §168(k) bonus flows into individual income in 2026. The enacted 2027 depreciation reversal changes the corporate base, not the individual base.
31	Alaska	6.1 / 10	$376,500	$3,976	102.4	Alaska does not impose a broad individual income tax.
32	New Hampshire	6.0 / 10	$458,800	$6,707	104.2	New Hampshire does not impose a broad individual income tax.
33	Maine	5.9 / 10	$341,900	$3,103	97.1	Add back the federal bonus amount and claim depreciation under Maine’s pro-forma computation.
34	Georgia	5.9 / 10	$343,300	$2,554	96.3	Use Georgia depreciation without federal §168(k) or §168(n).
34	Montana	5.9 / 10	$425,400	$2,939	94.6	Montana begins with the current federal income base and has no current bonus-depreciation addback.
36	Utah	5.8 / 10	$545,200	$2,648	98.9	Utah starts with current federal adjusted gross income and does not enumerate a §168(k) or §168(n) reversal.
37	Massachusetts	5.7 / 10	$607,400	$6,080	105.8	§168(k) remains disallowed. §168(n) is disallowed for 2026 and follows federal law beginning in 2027.
38	Virginia	5.7 / 10	$403,500	$2,872	101.1	Recompute Virginia depreciation as though the federal bonus provisions did not apply.
39	West Virginia	5.6 / 10	$170,800	$881	89.5	West Virginia adopted the 2025 federal changes, so §168(k) and §168(n) flow through for 2026 to 2027.
40	Vermont	5.2 / 10	$352,800	$5,026	98.0	Vermont disallows §168(k) and §168(n), then permits recovery under the non-bonus depreciation schedule.
41	California	5.0 / 10	$759,500	$5,369	110.7	California does not conform to federal bonus depreciation; compute California depreciation separately.
41	Illinois	5.0 / 10	$280,700	$5,399	100.0	Reverse federal §168(k)/§168(n) amounts and compute the Illinois depreciation modification.
43	Oregon	4.9 / 10	$497,500	$3,895	103.4	Oregon disallows federal bonus depreciation for 2026 to 2027; implementing recovery instructions are pending.
44	New Jersey	4.8 / 10	$496,000	$9,358	108.8	New Jersey does not follow the federal bonus deduction; calculate New Jersey depreciation and basis separately.
45	Connecticut	4.6 / 10	$396,900	$6,573	103.6	Add back 100% of federal bonus, then deduct 25% of the addition in each of the next four years.
46	Delaware	4.6 / 10	$371,600	$1,750	99.8	Ordinary eligible 2026 property retains 20% bonus under the pre-OBBBA schedule; the rest follows regular depreciation.
47	Rhode Island	4.6 / 10	$455,700	$4,886	102.3	Compute depreciation and basis as though federal bonus depreciation had not been enacted.
48	Maryland	4.5 / 10	$436,300	$4,144	105.0	Generally decoupled from federal bonus; qualifying manufacturing property may receive different treatment.
49	New York	4.5 / 10	$449,800	$6,542	107.9	Reverse federal §168(k) and §168(n) deductions and claim New York depreciation.
50	Hawaii	3.6 / 10	$875,900	$2,385	110.0	Hawaii does not allow the federal bonus deduction; compute Hawaii depreciation separately.

Business tax scenariosFixed examples of entity taxes, owner compensation and payroll costs.

Compare owner, entity and payroll tax separately

An S election changes how the business pays its owner. Start with the same $500,000 of operating profit, then compare federal employment taxes, the regular owner-income benchmark and the state entity components that can actually be calculated.

2026 rules · verified September 12, 2026 · educational, not individualized tax advice. These are controlled illustrations, not tax returns. Each state base is a separate input; the tool never assumes gross profit is the state-taxable base.

Published comparison assumptions

$500,000 operating profit before owner pay; $250,000 owner wages; $1.5 million current and prior-year in-state receipts; a separately supplied $500,000 owner state-taxable ordinary-business base and $234,936 state entity-income base. The owner files jointly, has no other wages and conducts all activity in the selected state. The fixed $500,000 non-owner payroll is already deducted in operating profit.

Illinois: the layers behind the decision

Regular owner tax on supplied business base: $24,750
Sole proprietor federal employment taxes: $38,175
S-corp employer + employee FICA/Additional Medicare: $30,128
Remaining S-corp profit after owner pay/employer FICA: $234,936

The federal employment-tax difference is $8,047, before income-tax effects and compliance costs; it is not a net savings recommendation. It is the same nationwide under these facts. The separate state entity base does not automatically change with salary because state additions and deductions may differ.

Illinois DOR current income-tax rates · IRS Publication 15, 2026 employer payroll taxes · IRS: self-employment tax, net earnings and deduction · IRS: Additional Medicare Tax thresholds and mixed wages/self-employment · IRS S corporation compensation and medical insurance issues

Separately calculated Illinois entity components

S corporation replacement tax: $3,524
Regular S corporation replacement-tax base supplied after Illinois adjustments; before credits.
Illinois DOR current income-tax rates

Entity examples use $500,000 non-owner payroll, wages paid evenly each quarter, $250,000 net worth/assets where needed, all in-state activity and no special exemption. New Hampshire models the current-year BET credit against BPT instead of adding both gross taxes. Washington uses ordinary service B&O and the stated prior-year receipts. Local taxes, SUTA/FUTA and other fees remain separate.

Exact scenario assumptions and limits

One full-year resident owner, married filing jointly, no other wages, all business activity in the selected state.
$500,000 operating profit is after non-owner expenses. The separate five-person $500,000 payroll has already been deducted, and is never deducted twice.
$1.5 million revenue and $250,000 owner wages are illustrative controlled inputs, not empirical averages or a reasonable-compensation conclusion.
Owner-income comparison supplies $500,000 of state-taxable ordinary business income. It is a separate rate/base benchmark, not a derivation of state taxable income from gross profit.
Entity illustration separately supplies $234,936 of state entity income after owner wages and employer FICA; state-specific modifications have to be reconciled before an actual return.
No PTET election, local tax, credits, AMT, capital gains, state special-rate election or personalized deductions in the regular owner benchmark. Ohio business-income rules are separately applied.

Search this 50-state component table

50 states: regular owner benchmark and separately sourced entity components; no all-in total
State	Regular owner benchmark	Entity components	Source / scope
Alabama	$24,920	Not fully calculated	Alabama DOR individual tax rates Supplied ordinary-income base; standard schedule.
Alaska	$0	Not fully calculated	Alaska government tax facts Supplied ordinary-income base; standard schedule.
Arizona	$12,500	Not fully calculated	Arizona DOR individual withholding and tax rate Supplied ordinary-income base; standard schedule.
Arkansas	$18,420	Not fully calculated	Arkansas DFA 2026 special-session SB1 fiscal impact · Arkansas SB1, Act 2 of the 2026 special session Supplied ordinary-income base; standard schedule.
California	$39,135	Regular nonfinancial S corporation franchise tax: $3,524 California FTB S corporation tax and minimum tax	California FTB September 3, 2026 indexing memorandum, Attachment 2 (CalTax-hosted copy) · California FTB 2025 Publication 1067: individual-return 1% tax on excess over $1 million Supplied ordinary-income base; standard schedule.
Colorado	$22,000	Not fully calculated	Colorado 2026 DR 0104EP estimate worksheet Supplied ordinary-income base; standard schedule.
Connecticut	$30,800	Not fully calculated	Connecticut 2026 CT-1040ES: initial tax, 2% phaseout and recapture tables Supplied ordinary-income base; standard schedule.
Delaware	$31,984	Not fully calculated	Delaware DOR employer guide, income computation table Supplied ordinary-income base; standard schedule.
Florida	$0	Not fully calculated	Florida DOR individual income-tax FAQ Supplied ordinary-income base; standard schedule.
Georgia	$24,950	Not fully calculated	Georgia DOR important tax updates, 2026 Supplied ordinary-income base; standard schedule.
Hawaii	$37,432	Not fully calculated	Hawaii Department of Taxation tax-year rate tables · Hawaii tax tables for years after December 31, 2024 Supplied ordinary-income base; standard schedule.
Idaho	$25,977	Not fully calculated	Idaho Code 63-3024: 5.3% rate and statutory CPI indexing · BLS CPI-U U.S. city average: 2025 annual average 321.943 · BLS historical CPI-U: 1998 annual average 163.0 · Idaho Commission published annual tables: latest posted year 2025 · BLS archived CPI files: October 2025 data unavailable during funding lapse Supplied ordinary-income base; standard schedule.
Illinois	$24,750	S corporation replacement tax: $3,524 Illinois DOR current income-tax rates	Illinois DOR current income-tax rates Supplied ordinary-income base; standard schedule.
Indiana	$14,750	Not fully calculated	Indiana DOR rates, fees and penalties Supplied ordinary-income base; standard schedule.
Iowa	$19,000	Not fully calculated	Iowa DOR 2026 income-tax rate announcement Supplied ordinary-income base; standard schedule.
Kansas	$27,725	Not fully calculated	Kansas DOR enacted individual tax schedule · Kansas Notice 25-06: no 2026 rate reduction Supplied ordinary-income base; standard schedule.
Kentucky	$17,500	LLET small-business minimum: $175 Kentucky DOR limited liability entity tax	Kentucky DOR software developer tax-year updates Supplied ordinary-income base; standard schedule.
Louisiana	$15,000	Not fully calculated	Louisiana DOR individual income-tax reform rates Supplied ordinary-income base; standard schedule.
Maine	$34,710	Not fully calculated	Maine Revenue Services revised 2026 individual rate schedules Supplied ordinary-income base; standard schedule.
Maryland	$26,573	Not fully calculated	Maryland Tax-General section 10-105 Supplied ordinary-income base; standard schedule.
Massachusetts	$25,000	Not fully calculated	Massachusetts DOR current tax rates Supplied ordinary-income base; standard schedule.
Michigan	$21,250	Not fully calculated	Michigan Treasury 2026 individual rate determination Supplied ordinary-income base; standard schedule.
Minnesota	$39,754	Not fully calculated	Minnesota DOR 2026 rates and brackets Supplied ordinary-income base; standard schedule.
Mississippi	$19,600	S corporation franchise tax: $75 Mississippi DOR current business income and 2026 franchise rates	Mississippi DOR general information, 2026 income tax Supplied ordinary-income base; standard schedule.
Missouri	$23,320	Not fully calculated	Missouri DOR 2026 MO-1040ES tax rate chart Supplied ordinary-income base; standard schedule.
Montana	$27,348	Not fully calculated	Montana DOR HB 337 income-tax changes Supplied ordinary-income base; standard schedule.
Nebraska	$22,148	Not fully calculated	Nebraska DOR 2026 Form 1040N-ES worksheet Supplied ordinary-income base; standard schedule.
Nevada	$0	General-business modified business tax: $6,435 Nevada DOR modified business tax Commerce Tax: $0 Nevada DOR commerce tax FAQ	Nevada Department of Taxation tax notes Supplied ordinary-income base; standard schedule.
New Hampshire	$0	Business enterprise tax: $4,125 New Hampshire DRA: BPT, BET and credit interaction Business profits tax after current-year BET credit: $13,495 New Hampshire DRA: BPT, BET and credit interaction	New Hampshire DRA interest and dividends tax repeal Supplied ordinary-income base; standard schedule.
New Jersey	$27,808	Not fully calculated	New Jersey Treasury resident tax rate schedules, 2020 and after Supplied ordinary-income base; standard schedule.
New Mexico	$25,539	Not fully calculated	New Mexico TRD 2025 tax expenditure report: 2025-and-later income schedule · New Mexico TRD January 2026 SB60 analysis: current-law comparison table Supplied ordinary-income base; standard schedule.
New York	$34,250	Not fully calculated	New York 2026 IT-2105-I estimate schedules and benefit-recapture worksheets Supplied ordinary-income base; standard schedule.
North Carolina	$19,950	Not fully calculated	North Carolina DOR individual rate schedules Supplied ordinary-income base; standard schedule.
North Dakota	$9,209	Not fully calculated	North Dakota 2026 ND-1ES annual tax rate schedules Supplied ordinary-income base; standard schedule.
Ohio	$7,500	Not fully calculated	Ohio Revised Code chapter 5747: business deduction and distinct 3% rate Business base before Ohio deduction.
Oklahoma	$22,071	Not fully calculated	Oklahoma Tax Commission 2025 legislative update, effective 2026 Supplied ordinary-income base; standard schedule.
Oregon	$45,987	S corporation minimum excise tax: $150 Oregon DOR corporate filing requirements and S corporation minimum tax	Oregon Legislative Revenue Office 2026 personal tax schedule Supplied ordinary-income base; standard schedule.
Pennsylvania	$15,350	Not fully calculated	Pennsylvania DOR 2026 REV-413 individual estimated tax Supplied ordinary-income base; standard schedule.
Rhode Island	$26,818	Not fully calculated	Rhode Island Division of Taxation 2026 inflation adjustments · Rhode Island DOR July 2026 enacted-law summary: surtax starts in 2027 Supplied ordinary-income base; standard schedule.
South Carolina	$25,084	Not fully calculated	South Carolina DOR H.4216 2026 income-tax reform Supplied ordinary-income base; standard schedule.
South Dakota	$0	Not fully calculated	South Dakota DOR sales and use tax guide Supplied ordinary-income base; standard schedule.
Tennessee	$0	Excise tax after standard deduction: $12,021 Tennessee DOR franchise and excise rates · Tennessee franchise and excise tax manual, standard deduction Franchise tax on supplied net-worth base: $625 Tennessee DOR franchise and excise rates · Tennessee DOR FT-1: franchise tax net-worth base and minimum	Tennessee DOR Hall income tax repeal Supplied ordinary-income base; standard schedule.
Texas	$0	2026/2027 report franchise tax below threshold: $0 Texas Comptroller 2026 franchise report threshold and information filing	Texas Constitution article VIII section 24-a Supplied ordinary-income base; standard schedule.
Utah	$22,250	Not fully calculated	Utah Tax Commission 2026 legislative summary Supplied ordinary-income base; standard schedule.
Vermont	$35,361	Business entity minimum tax: $250 Vermont Department of Taxes business entity income tax	Vermont Joint Fiscal Office 2026 Fiscal Facts: personal income-tax brackets · Vermont 32 VSA 5822: federal-AGI minimum tax Supplied ordinary-income base; standard schedule.
Virginia	$28,493	Not fully calculated	Virginia Tax individual income-tax computation Supplied ordinary-income base; standard schedule.
Washington	$0	Service and Other Activities B&O: $26,250 Washington DOR: 2026 service B&O tiers	Washington DOR individual income-tax FAQs · Washington Governor: SB6346 income tax signed March 30, 2026; starts January 2028 Supplied ordinary-income base; standard schedule.
West Virginia	$22,103	Not fully calculated	West Virginia Tax Division 2026 personal income-tax reduction Supplied ordinary-income base; standard schedule.
Wisconsin	$27,020	Not fully calculated	Wisconsin DOR 2026 Form 1-ES instructions Supplied ordinary-income base; standard schedule.
Wyoming	$0	Annual license tax: $60 Wyoming Secretary of State annual license tax	State of Wyoming tax overview Supplied ordinary-income base; standard schedule.

What changes the comparisonThe tax, legal and financial tradeoffs behind the ranking.

Compare a physician contractor’s home base using owner business-income tax, household costs, relative malpractice insurance costs and a fixed quality-of-life category weight. The guide separates those ranked observations from a $500,000 practice-profit illustration, federal employment taxes and actual entity charges. Your assignments, professional structure and contract determine the final result.

What determines this guide’s grade

30% controlled owner business-income tax, 40% regional spending basket, 30% CMS malpractice cost index within the financial share. The published ranking gives financial evidence 80% and the named quality-of-life category 20%, consistently across all states. These are Taxstra’s editorial weights, not estimated predictors of future results. Uses a separately supplied $500K state-taxable ordinary-business base, regional spending and CMS relative malpractice costs. Does not derive a return from $500K profit or assume a contractor pay premium. Entity charges, retirement contributions, federal payroll and assignment-state sourcing remain separate.

Do not annualize the hourly rate over every week

Build the year from committed paid shifts, expected cancellations, credentialing delays, travel days and time off. A contract with a lower hourly rate can leave more annual profit if it offers more reliable paid hours or covers travel and insurance. A published BLS employee wage cannot fill a missing 1099 rate. The statewide notes therefore show employee pay only as negotiation context.

Resident state and assignment state are two separate decisions

A home in a low-cost state may help the household budget while assignments elsewhere still require nonresident filings. Track where services are performed and reconcile resident credits, withholding and estimates. Organizing an entity elsewhere does not relocate the physician’s actual services. The score awards no point for paper incorporation or for an unverified absence of tax.

Professional structure comes before the S election

Federal tax classification and authority to practice medicine are separate questions. California’s Medical Board, for example, lists practicing through an LLC among prohibited structures in its guidance. Have qualified counsel confirm the lawful professional entity, ownership and clinical-control arrangement before the CPA models an election. A generic online LLC recommendation can miss this first step.

Reasonable compensation is based on the services

IRS guidance requires reasonable compensation for an S-corp shareholder’s services before nonwage distributions. A solo clinical practice relies heavily on that owner’s work. The library’s fixed $250,000 owner wage is an illustrative assumption requiring a facts-based review; it is not a recommended physician salary. Model employer payroll cost, state entity charges, administration and retirement contributions together.

Insurance quotes must follow the specialty and assignment

Ask for policy form, retroactive date, limits, covered services, locations and tail arrangements. In fund states, distinguish the underlying policy from the fund surcharge or assessment. The AMA change series can help identify a renewal question but cannot price your policy, and its insurer/specialty observations are not percentages of doctors experiencing an increase.

Retirement accounts require cash, not just a deduction

A one-participant 401(k) is intended for a business owner without common-law employees, or the owner and spouse; eligible employees change the analysis. IRS guidance says elective deferral limits follow the person across plans. A physician with both hospital employment and contracting should coordinate contributions rather than counting the employee limit twice.

Choose a sustainable operating calendar

Price accounting, licenses, credentialing, coverage renewals and entity filings before comparing state tax savings. Washington physician services, for example, fall within the service-and-other-activities B&O classification; an individual income-tax slogan does not describe that business obligation. Keep a reserve for estimated payments and an assignment ending sooner than expected.

Put the numbers in contextA worked example with explicit assumptions.

Controlled contract example: $300 per hour × 1,800 paid hours produces $540,000 of receipts; $280 × 2,000 paid hours produces $560,000. If expenses are identical, the lower hourly rate produces $20,000 more gross receipts over the year. Neither example is a market-rate claim or a forecast of available shifts.

Illustration only. These assumptions describe the example, not an expected client result.

Every state, explainedBrowse all 50 state chapters, with detailed analysis and linked evidence.

AlabamaRead state analysis

Alabama

Back to comparison ↑

Median home $233,300Monthly gross rent $1,077HO-3 premium, 2023 $1,906

Alabama makes a useful home-base comparison with neighboring Georgia: the imported spending basket, median rent and homeowner property-tax bill are all lower. A contractor with similar reliable net profit in both places should price the actual housing and travel arrangement next. A Birmingham-area assignment and a distant home base can add expenses that a statewide cost index cannot identify.

The 2024 BEA index prices a controlled $100,000 basket at $88,823 (cost position 7). ACS median homeowner tax is $890 for 2024, and the historical NAIC HO-3 premium is $1,906 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.564 for Alabama, using published malpractice RVUs across 67 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Alabama retirement-tax details

AlaskaRead state analysis

Alaska

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Median home $376,500Monthly gross rent $1,444HO-3 premium, 2023 $1,216

Alaska is an example of why a contractor’s home base and an assignment should be priced separately. The local price basket is more expensive than Wyoming’s or Montana’s, while a short engagement may involve distinct transport and temporary-housing costs. Ask who pays those costs and how cancelled travel affects paid shifts before extrapolating a rate over a full year.

The 2024 BEA index prices a controlled $100,000 basket at $102,359 (cost position 38). ACS median homeowner tax is $3,976 for 2024, and the historical NAIC HO-3 premium is $1,216 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.517 for Alaska, using published malpractice RVUs across 29 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Alaska retirement-tax details

ArizonaRead state analysis

Arizona

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Median home $426,000Monthly gross rent $1,672HO-3 premium, 2023 $1,194

Arizona’s household screen benefits from relatively modest historical homeowners insurance, but its statewide rent is much higher than New Mexico’s. A physician moving for several contracts should compare renting near the work with purchasing a permanent base. The apparent stability of owner carrying costs does not establish what a furnished short-term rental or repeated travel will cost.

The 2024 BEA index prices a controlled $100,000 basket at $100,677 (cost position 35). ACS median homeowner tax is $1,828 for 2024, and the historical NAIC HO-3 premium is $1,194 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.870 for Arizona, using published malpractice RVUs across 15 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

Source qualification: PTET: Current primary guidance verified the election and rate, but not a single unqualified statement that every excess owner credit is refundable.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Arizona retirement-tax details

ArkansasRead state analysis

Arkansas

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Median home $215,600Monthly gross rent $982HO-3 premium, 2023 $1,870

Arkansas’s low spending basket is directly relevant when net contract profit is held constant, which is why its contractor screen can look much better than its employee-pay screen. Median rent and homeowner taxes are also modest. The main next step is to establish that actual paid work, travel and insurance allow the assumed profit to remain comparable across destinations.

The 2024 BEA index prices a controlled $100,000 basket at $86,937 (cost position 1). ACS median homeowner tax is $1,113 for 2024, and the historical NAIC HO-3 premium is $1,870 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.519 for Arkansas, using published malpractice RVUs across 74 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

Source qualification: PTET: Owner credit utilization still requires the owner return; payment arithmetic is implemented separately.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Arkansas retirement-tax details

CaliforniaRead state analysis

California

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Median home $759,500Monthly gross rent $2,104HO-3 premium, 2023 $1,655

California’s contractor problem begins before tax optimization: establish a permitted medical-practice structure, then price the assignment against an expensive home base. Its statewide median rent is the highest here, and the owner housing benchmark is also large. A contract premium needs to cover those household costs, paid versus unpaid time and practice expenses; an S election is not a substitute for that comparison.

The 2024 BEA index prices a controlled $100,000 basket at $110,720 (cost position 50). ACS median homeowner tax is $5,369 for 2024, and the historical NAIC HO-3 premium is $1,655 for 2023. These household observations do not include practice expenses or malpractice.

California’s Medical Board lists an LLC among prohibited medical-practice structures. Civil Code 3333.2 produces 2026 noneconomic limits of $470,000 for non-death injury and $650,000 for wrongful death in each applicable category; separate categories can apply. Neither figure limits all damages or prices insurance. Have counsel review the structure and coverage.

The CMS underlying malpractice-cost index aggregates to 0.550 for California, using published malpractice RVUs across 57 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
Medical Board of California: Practice information (2026; 2026-09-12)
California Civil Code section 3333.2 (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the California retirement-tax details

ColoradoRead state analysis

Colorado

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Median home $574,600Monthly gross rent $1,822HO-3 premium, 2023 $2,492

Colorado’s household screen faces pressure from both the spending basket and historical homeowners insurance. The insurance observation is more than twice Utah’s, although the coverage and risks differ. A contractor should obtain an address-specific quote before choosing a permanent base and compare housing near the work rather than assuming a statewide average prices a Front Range or mountain assignment.

The 2024 BEA index prices a controlled $100,000 basket at $103,052 (cost position 39). ACS median homeowner tax is $2,828 for 2024, and the historical NAIC HO-3 premium is $2,492 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.744 for Colorado, using published malpractice RVUs across 63 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Colorado retirement-tax details

ConnecticutRead state analysis

Connecticut

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Median home $396,900Monthly gross rent $1,550HO-3 premium, 2023 $2,036

Connecticut’s owner household costs deserve separate attention even when contract profit is strong. The homeowner property-tax observation is several times Delaware’s, and the historical insurance amount is higher too. A physician who rents or maintains a home elsewhere should not treat these owner statistics as assignment expenses; substitute the actual arrangement and track paid travel days.

The 2024 BEA index prices a controlled $100,000 basket at $103,610 (cost position 42). ACS median homeowner tax is $6,573 for 2024, and the historical NAIC HO-3 premium is $2,036 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 1.229 for Connecticut, using published malpractice RVUs across 9 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Connecticut retirement-tax details

DelawareRead state analysis

Delaware

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Median home $371,600Monthly gross rent $1,530HO-3 premium, 2023 $1,196

Delaware compares favorably with nearby New Jersey on the imported homeowner tax and insurance amounts. Those observations can help a contractor screen a home base, but they do not settle the tax consequences of assignments across state lines. Write down the residence, each work location and travel expense before treating a regional practice as a single-state business.

The 2024 BEA index prices a controlled $100,000 basket at $99,808 (cost position 32). ACS median homeowner tax is $1,750 for 2024, and the historical NAIC HO-3 premium is $1,196 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.861 for Delaware, using published malpractice RVUs across 3 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Delaware retirement-tax details

FloridaRead state analysis

Florida

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Median home $396,900Monthly gross rent $1,812HO-3 premium, 2023 $2,779

Florida’s historical homeowners premium is among the largest observations and its rent benchmark is expensive. A contractor choosing a home base needs property-specific insurance and travel quotes before comparing margin with Georgia or Tennessee. The new malpractice-change evidence adds a renewal question, but it cannot substitute for the physician’s specialty, coverage limits and actual insurer quote.

The 2024 BEA index prices a controlled $100,000 basket at $103,414 (cost position 41). ACS median homeowner tax is $2,993 for 2024, and the historical NAIC HO-3 premium is $2,779 for 2023. These household observations do not include practice expenses or malpractice.

AMA 2024–2025: ≥10% increases, 19%; sample 63.

The CMS underlying malpractice-cost index aggregates to 1.716 for Florida, using published malpractice RVUs across 67 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Florida retirement-tax details

GeorgiaRead state analysis

Georgia

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Median home $343,300Monthly gross rent $1,506HO-3 premium, 2023 $1,828

Georgia’s general prices are below the national benchmark, but its median rent is materially higher than Alabama’s and Tennessee’s. A contracting physician should compare the actual home base, airport access and assignment travel costs before choosing a neighborhood. The score does not assume all Georgia locations or locum arrangements inherit the same statewide cost advantage.

The 2024 BEA index prices a controlled $100,000 basket at $96,293 (cost position 25). ACS median homeowner tax is $2,554 for 2024, and the historical NAIC HO-3 premium is $1,828 for 2023. These household observations do not include practice expenses or malpractice.

AMA 2024–2025: ≥10% increases, 12.5%; sample 24.

The CMS underlying malpractice-cost index aggregates to 1.281 for Georgia, using published malpractice RVUs across 154 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 99.9999%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Georgia retirement-tax details

HawaiiRead state analysis

Hawaii

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Median home $875,900Monthly gross rent $1,942HO-3 premium, 2023 $1,549

Hawaii is difficult to reduce to a contractor tax comparison because the household basket and housing are expensive before travel is considered. Decide whether the opportunity is a temporary assignment or a permanent move, then price each accordingly. Paid travel, accommodation and cancellation provisions may be more useful negotiation items than a nominally higher hourly rate.

The 2024 BEA index prices a controlled $100,000 basket at $109,951 (cost position 49). ACS median homeowner tax is $2,385 for 2024, and the historical NAIC HO-3 premium is $1,549 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.605 for Hawaii, using published malpractice RVUs across 4 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 99.9997%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Hawaii retirement-tax details

IdahoRead state analysis

Idaho

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Median home $446,400Monthly gross rent $1,384HO-3 premium, 2023 $1,135

Idaho has a low historical homeowners insurance observation, but a contractor arriving as a buyer faces a substantial home-price benchmark. Renting near an assignment can answer a different financial question from buying a permanent base. Compare the net contract margin after actual housing, travel and paid-time assumptions with alternatives in Wyoming and neighboring states.

The 2024 BEA index prices a controlled $100,000 basket at $95,494 (cost position 23). ACS median homeowner tax is $1,912 for 2024, and the historical NAIC HO-3 premium is $1,135 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.491 for Idaho, using published malpractice RVUs across 42 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Idaho retirement-tax details

IllinoisRead state analysis

Illinois

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Median home $280,700Monthly gross rent $1,322HO-3 premium, 2023 $1,480

AMA 2024–2025: ≥10% increases, 9.7%; sample 93.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Illinois retirement-tax details

IndianaRead state analysis

Indiana

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Median home $243,500Monthly gross rent $1,104HO-3 premium, 2023 $1,259

Indiana’s contractor household screen benefits from moderate property taxes and historical insurance, with prices well below national average. Its malpractice fund adds a distinct operational item: confirm provider qualification and who pays any surcharge. Compare those exact costs and reliable paid hours before deciding whether a W-2 or independent arrangement leaves the better annual margin.

The 2024 BEA index prices a controlled $100,000 basket at $93,329 (cost position 18). ACS median homeowner tax is $1,798 for 2024, and the historical NAIC HO-3 premium is $1,259 for 2023. These household observations do not include practice expenses or malpractice.

Indiana’s Department of Insurance administers provider qualification and surcharges for the Patient’s Compensation Fund. Its guidance says only qualified providers receive the Act’s protections. Verify the physician’s qualification and who pays both policy and fund charges; employment alone does not answer those questions.

The CMS underlying malpractice-cost index aggregates to 0.493 for Indiana, using published malpractice RVUs across 92 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
Indiana Department of Insurance: Medical malpractice (2026; 2026-09-12)
Indiana: Provider qualification and complaints (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Indiana retirement-tax details

IowaRead state analysis

Iowa

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Median home $227,300Monthly gross rent $981HO-3 premium, 2023 $1,342

Iowa’s spending basket is among the least expensive, which matters directly for a contractor with reliable profit. Its homeowner tax observation is less favorable than Indiana’s, so a buyer should not stop at rent or purchase price. Price the home near the intended work and compare travel days if the practice relies on assignments outside the state.

The 2024 BEA index prices a controlled $100,000 basket at $87,762 (cost position 3). ACS median homeowner tax is $2,937 for 2024, and the historical NAIC HO-3 premium is $1,342 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.342 for Iowa, using published malpractice RVUs across 99 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Iowa retirement-tax details

KansasRead state analysis

Kansas

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Median home $238,700Monthly gross rent $1,079HO-3 premium, 2023 $1,733

Kansas can offer a modest household cost base, but a physician’s business budget needs the Health Care Stabilization Fund component. The 2026 surcharge depends on classification and must be paired with the underlying policy. A Kansas City-area practice also deserves a precise work-location record rather than a metro label standing in for the state where services are performed.

The 2024 BEA index prices a controlled $100,000 basket at $90,068 (cost position 10). ACS median homeowner tax is $2,983 for 2024, and the historical NAIC HO-3 premium is $1,733 for 2023. These household observations do not include practice expenses or malpractice.

Kansas publishes a separate Health Care Stabilization Fund surcharge table for calendar 2026. Use the physician’s classification and the correct coverage period, and compare the surcharge plus the underlying policy. The site also posts a future 2027 schedule, which should not be used for a 2026 budget.

AMA 2024–2025: ≥10% increases, 25%; sample 12.

The CMS underlying malpractice-cost index aggregates to 0.474 for Kansas, using published malpractice RVUs across 105 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
Kansas Health Care Stabilization Fund: Surcharges (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Kansas retirement-tax details

KentuckyRead state analysis

Kentucky

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Median home $226,000Monthly gross rent $998HO-3 premium, 2023 $1,525

Kentucky’s low spending basket, rent and homeowner taxes support a contractor’s household budget at a fixed profit. The selected malpractice-change observations make renewal pricing worth investigating separately. A strong cost score should lead to a quote and a paid-shift plan, not an assumption that all practice overhead shares the same low-cost profile.

The 2024 BEA index prices a controlled $100,000 basket at $90,159 (cost position 12). ACS median homeowner tax is $1,611 for 2024, and the historical NAIC HO-3 premium is $1,525 for 2023. These household observations do not include practice expenses or malpractice.

AMA 2024–2025: ≥10% increases, 20%; sample 15.

The CMS underlying malpractice-cost index aggregates to 0.929 for Kentucky, using published malpractice RVUs across 119 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Kentucky retirement-tax details

LouisianaRead state analysis

Louisiana

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Median home $223,200Monthly gross rent $1,064HO-3 premium, 2023 $3,027

Louisiana’s low everyday prices help a contractor at fixed profit, but the historical home-insurance observation is a meaningful counterweight. The physician budget also needs the patient-fund component where participation applies. Price household coverage and professional coverage separately; a low property-tax bill cannot tell you whether either insurance line is manageable.

The 2024 BEA index prices a controlled $100,000 basket at $88,207 (cost position 5). ACS median homeowner tax is $1,187 for 2024, and the historical NAIC HO-3 premium is $3,027 for 2023. These household observations do not include practice expenses or malpractice.

Louisiana’s Patient’s Compensation Fund provides an excess-coverage layer for enrolled private providers and collects surcharges. A carrier quote without the fund component is an incomplete cost comparison where participation is part of the arrangement. Confirm enrollment, specialty class and who bears each payment.

The CMS underlying malpractice-cost index aggregates to 0.972 for Louisiana, using published malpractice RVUs across 64 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
Louisiana Patient’s Compensation Fund (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Louisiana retirement-tax details

MaineRead state analysis

Maine

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Median home $341,900Monthly gross rent $1,210HO-3 premium, 2023 $1,150

Maine offers a lower price basket and median rent than the other New England states with high purchase benchmarks. Its historical homeowners premium is also modest. A contractor should ask whether assignments and travel support the assumed annual profit; the employee wage is not evidence of a quoted 1099 rate or the number of paid shifts available.

The 2024 BEA index prices a controlled $100,000 basket at $97,050 (cost position 26). ACS median homeowner tax is $3,103 for 2024, and the historical NAIC HO-3 premium is $1,150 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.608 for Maine, using published malpractice RVUs across 16 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

Source qualification: PTET: Payment arithmetic is supported by enacted law; implementation forms and filing procedures still need confirmation before an actual election.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Maine retirement-tax details

MarylandRead state analysis

Maryland

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Median home $436,300Monthly gross rent $1,721HO-3 premium, 2023 $1,578

Maryland’s contractor home-base costs are higher than Pennsylvania’s across the price basket, median rent and homeowner tax observations. That makes the housing decision meaningful when profit is held constant. A physician working around state boundaries should also document each service location and residence before comparing tax estimates; a regional client list does not create a single tax jurisdiction.

The 2024 BEA index prices a controlled $100,000 basket at $104,959 (cost position 44). ACS median homeowner tax is $4,144 for 2024, and the historical NAIC HO-3 premium is $1,578 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 1.062 for Maryland, using published malpractice RVUs across 24 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

Source qualification: PTET: 2027 base computation requires its own future-year guidance.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Maryland retirement-tax details

MassachusettsRead state analysis

Massachusetts

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Median home $607,400Monthly gross rent $1,848HO-3 premium, 2023 $2,134

Massachusetts’s homeowner tax and insurance observations add to an already expensive regional basket. A contracting physician should compare the full-year home-base budget with the duration and reliability of assignments. A temporary furnished stay, a rented permanent home and an owner-occupied purchase are different arrangements, so the statewide owner statistics should not be copied into all three.

The 2024 BEA index prices a controlled $100,000 basket at $105,757 (cost position 45). ACS median homeowner tax is $6,080 for 2024, and the historical NAIC HO-3 premium is $2,134 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.853 for Massachusetts, using published malpractice RVUs across 14 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Massachusetts retirement-tax details

MichiganRead state analysis

Michigan

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Median home $254,200Monthly gross rent $1,168HO-3 premium, 2023 $1,110

Michigan’s historical home-insurance observation is modest and its price basket is below national average, although it is not as low as Ohio’s or Indiana’s. For a contractor with fixed profit, those differences are worth evaluating alongside actual housing. If work involves several locations, use paid hours and travel expenses to determine whether the cheaper home base preserves the assumed margin.

The 2024 BEA index prices a controlled $100,000 basket at $96,217 (cost position 24). ACS median homeowner tax is $2,988 for 2024, and the historical NAIC HO-3 premium is $1,110 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 1.415 for Michigan, using published malpractice RVUs across 83 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Michigan retirement-tax details

MinnesotaRead state analysis

Minnesota

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Median home $344,600Monthly gross rent $1,291HO-3 premium, 2023 $1,988

Minnesota’s fixed-profit household screen faces higher homeowner taxes and insurance than several low-cost alternatives, even though the general price index remains below national average. A contractor choosing it for family or amenities should price those recurring expenses explicitly. The employee wage can suggest a labor-market question, but cannot establish contract availability or business revenue.

The 2024 BEA index prices a controlled $100,000 basket at $98,621 (cost position 30). ACS median homeowner tax is $3,501 for 2024, and the historical NAIC HO-3 premium is $1,988 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.296 for Minnesota, using published malpractice RVUs across 86 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 99.9995%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Minnesota retirement-tax details

MississippiRead state analysis

Mississippi

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Median home $186,500Monthly gross rent $990HO-3 premium, 2023 $2,029

Mississippi is close to Arkansas on the regional price index, making it an attractive fixed-profit household comparison. Homeowners insurance is less of an advantage than the cheap purchase benchmark suggests. A contractor should establish actual paid work and household coverage before assuming the low-cost base leaves the same annual profit available in every assignment arrangement.

The 2024 BEA index prices a controlled $100,000 basket at $86,953 (cost position 2). ACS median homeowner tax is $1,221 for 2024, and the historical NAIC HO-3 premium is $2,029 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.719 for Mississippi, using published malpractice RVUs across 81 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Mississippi retirement-tax details

MissouriRead state analysis

Missouri

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Median home $254,400Monthly gross rent $1,067HO-3 premium, 2023 $1,589

Missouri’s spending basket, rent and homeowner taxes are modest relative to many states, which can help a contractor holding net profit constant. A practice serving both sides of a state boundary still needs separate location records and tax analysis. The household cost advantage does not remove unpaid commuting, travel or the cost of administering multistate assignments.

The 2024 BEA index prices a controlled $100,000 basket at $90,817 (cost position 13). ACS median homeowner tax is $2,021 for 2024, and the historical NAIC HO-3 premium is $1,589 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.999 for Missouri, using published malpractice RVUs across 115 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Missouri retirement-tax details

MontanaRead state analysis

Montana

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Median home $425,400Monthly gross rent $1,177HO-3 premium, 2023 $1,768

Montana’s price basket and statewide rent are lower than Colorado’s, making it a useful home-base alternative for a contractor with equally reliable earnings. The home purchase benchmark is still substantial. Compare temporary assignment housing with owning a permanent base, and determine whether travel and unpaid gaps consume the savings implied by the household cost screen.

The 2024 BEA index prices a controlled $100,000 basket at $94,645 (cost position 22). ACS median homeowner tax is $2,939 for 2024, and the historical NAIC HO-3 premium is $1,768 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 1.031 for Montana, using published malpractice RVUs across 51 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 99.9896%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

Source qualification: PTET: Entity eligibility can require judgment where an S corporation has instruments that may be treated as a second class of stock.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Montana retirement-tax details

NebraskaRead state analysis

Nebraska

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Median home $263,100Monthly gross rent $1,102HO-3 premium, 2023 $2,142

Nebraska’s spending basket is inexpensive, but its homeowner tax and historical insurance observations are higher than several peers with similar general prices. Its regulator’s year-specific FAQ sets the fund surcharge at 5% for policies issued or renewed in 2026. That percentage is an additional coverage expense, not an annual malpractice premium; obtain the qualifying policy and fund charge together.

The 2024 BEA index prices a controlled $100,000 basket at $90,103 (cost position 11). ACS median homeowner tax is $3,739 for 2024, and the historical NAIC HO-3 premium is $2,142 for 2023. These household observations do not include practice expenses or malpractice.

Nebraska’s Excess Liability Fund requires provider qualification and a separate surcharge. The Department of Insurance’s year-specific FAQ specifies 5% for policies issued or renewed in 2026, versus 35% in 2025. The base is the full qualifying underlying premium before deductible credit. Obtain the policy and fund charge as separate lines; the percentage does not establish a statewide annual malpractice premium.

The CMS underlying malpractice-cost index aggregates to 0.457 for Nebraska, using published malpractice RVUs across 81 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 99.9989%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
Nebraska Department of Insurance: Medical liability fund and 2026 surcharge (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Nebraska retirement-tax details

NevadaRead state analysis

Nevada

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Median home $455,500Monthly gross rent $1,709HO-3 premium, 2023 $1,013

Nevada has a low historical homeowners premium, but the household basket is near national average and median rent is high relative to Wyoming or New Mexico. A contractor seeking a permanent base should compare actual housing before translating a tax headline into spendable margin. Reliable paid hours and assignment travel remain separate from the home’s state.

The 2024 BEA index prices a controlled $100,000 basket at $99,979 (cost position 34). ACS median homeowner tax is $2,143 for 2024, and the historical NAIC HO-3 premium is $1,013 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.833 for Nevada, using published malpractice RVUs across 15 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Nevada retirement-tax details

New HampshireRead state analysis

New Hampshire

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Median home $458,800Monthly gross rent $1,558HO-3 premium, 2023 $1,300

New Hampshire’s historical homeowners insurance is modest, while the median homeowner tax is large. Those two lines should stay separate in a contractor’s budget. A physician based there and accepting assignments elsewhere still needs to review work-state sourcing and paid travel; the home-base choice does not make out-of-state services disappear from the tax analysis.

The 2024 BEA index prices a controlled $100,000 basket at $104,165 (cost position 43). ACS median homeowner tax is $6,707 for 2024, and the historical NAIC HO-3 premium is $1,300 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.863 for New Hampshire, using published malpractice RVUs across 10 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the New Hampshire retirement-tax details

New JerseyRead state analysis

New Jersey

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Median home $496,000Monthly gross rent $1,800HO-3 premium, 2023 $1,551

New Jersey has the largest median homeowner tax observation in this dataset, a meaningful fixed-profit household consideration even before business taxes. Median rent is also high. A contractor comparing it with Pennsylvania or Delaware should separate the cost of residence from the sourcing of each assignment, especially when the practice serves locations on more than one side of a border.

The 2024 BEA index prices a controlled $100,000 basket at $108,805 (cost position 48). ACS median homeowner tax is $9,358 for 2024, and the historical NAIC HO-3 premium is $1,551 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 1.128 for New Jersey, using published malpractice RVUs across 21 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the New Jersey retirement-tax details

New MexicoRead state analysis

New Mexico

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Median home $279,900Monthly gross rent $1,117HO-3 premium, 2023 $1,490

New Mexico’s lower price basket and rent make a useful comparison with Arizona for a contractor who can maintain the same net practice profit. The question is whether paid assignments, coverage and travel preserve that assumption. No current statewide malpractice premium has been verified here, and proposed or changing rules should not be turned into an assumed insurance saving.

The 2024 BEA index prices a controlled $100,000 basket at $92,212 (cost position 15). ACS median homeowner tax is $1,776 for 2024, and the historical NAIC HO-3 premium is $1,490 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 1.245 for New Mexico, using published malpractice RVUs across 32 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

Source qualification: PTET: No claim of universal refundability; owner credit use must be reconciled.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the New Mexico retirement-tax details

New YorkRead state analysis

New York

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Median home $449,800Monthly gross rent $1,634HO-3 premium, 2023 $1,801

New York’s contractor household screen is expensive relative to Pennsylvania on prices, homeowner taxes and historical insurance. Those statewide statistics do not establish the costs of a particular city or a temporary assignment. Track the actual work locations and who pays housing and travel before comparing net margin; the malpractice-change sample supplies a renewal question rather than an annual premium.

The 2024 BEA index prices a controlled $100,000 basket at $107,921 (cost position 47). ACS median homeowner tax is $6,542 for 2024, and the historical NAIC HO-3 premium is $1,801 for 2023. These household observations do not include practice expenses or malpractice.

AMA 2024–2025: ≥10% increases, 4.3%; sample 69.

The CMS underlying malpractice-cost index aggregates to 1.485 for New York, using published malpractice RVUs across 62 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the New York retirement-tax details

North CarolinaRead state analysis

North Carolina

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Median home $333,000Monthly gross rent $1,338HO-3 premium, 2023 $1,852

North Carolina’s price basket and household carrying-cost observations sit between several cheaper inland alternatives and more expensive coastal-state comparisons. For a contractor, the choice should follow reliable net profit and the actual home near work or travel routes. A state mean does not establish that Raleigh, Charlotte and other communities share the same assignment housing costs.

The 2024 BEA index prices a controlled $100,000 basket at $94,326 (cost position 21). ACS median homeowner tax is $2,044 for 2024, and the historical NAIC HO-3 premium is $1,852 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.621 for North Carolina, using published malpractice RVUs across 100 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the North Carolina retirement-tax details

North DakotaRead state analysis

North Dakota

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Median home $266,100Monthly gross rent $980HO-3 premium, 2023 $1,414

North Dakota’s low spending basket and rent are relevant to a contractor’s home base at fixed profit. Its BLS Family Medicine wage should not be copied into a 1099 revenue projection; the series measures employees. Build the year from committed paid hours and actual travel before deciding whether the household cost advantage survives the full assignment schedule.

The 2024 BEA index prices a controlled $100,000 basket at $88,959 (cost position 8). ACS median homeowner tax is $2,550 for 2024, and the historical NAIC HO-3 premium is $1,414 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.299 for North Dakota, using published malpractice RVUs across 49 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 99.9943%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the North Dakota retirement-tax details

OhioRead state analysis

Ohio

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Median home $239,800Monthly gross rent $1,090HO-3 premium, 2023 $1,116

Ohio’s price basket is modest and its historical homeowners insurance observation is low, while homeowner taxes are higher than Indiana’s. A contractor holding profit constant should compare the complete recurring budget rather than just the home purchase. If assignments cross into neighboring states, separate paid clinical time from travel and maintain an accurate location record.

The 2024 BEA index prices a controlled $100,000 basket at $92,774 (cost position 17). ACS median homeowner tax is $2,937 for 2024, and the historical NAIC HO-3 premium is $1,116 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.996 for Ohio, using published malpractice RVUs across 88 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Ohio retirement-tax details

OklahomaRead state analysis

Oklahoma

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Median home $222,100Monthly gross rent $1,044HO-3 premium, 2023 $2,486

Oklahoma’s spending basket is among the least expensive, making it relevant for a contractor with dependable profit. The homeowners insurance observation is considerably higher than Missouri’s and Kansas’s, so a buyer needs a specific quote before choosing a base. Keep professional malpractice coverage separate; neither the home premium nor the state’s general affordability prices the practice.

The 2024 BEA index prices a controlled $100,000 basket at $87,843 (cost position 4). ACS median homeowner tax is $1,672 for 2024, and the historical NAIC HO-3 premium is $2,486 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.750 for Oklahoma, using published malpractice RVUs across 77 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Oklahoma retirement-tax details

OregonRead state analysis

Oregon

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Median home $497,500Monthly gross rent $1,597HO-3 premium, 2023 $1,003

Oregon’s historical homeowners insurance is low in this series, but the spending basket and home-price benchmark remain relatively expensive. A contractor should distinguish a low quoted household coverage cost from total business margin. Determine actual paid hours, professional insurance and work locations before assuming the home-base comparison establishes a lower overall tax or practice cost.

The 2024 BEA index prices a controlled $100,000 basket at $103,361 (cost position 40). ACS median homeowner tax is $3,895 for 2024, and the historical NAIC HO-3 premium is $1,003 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.785 for Oregon, using published malpractice RVUs across 34 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 99.9985%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Oregon retirement-tax details

PennsylvaniaRead state analysis

Pennsylvania

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Median home $277,600Monthly gross rent $1,252HO-3 premium, 2023 $1,217

Pennsylvania’s household costs are lower than New Jersey’s on several imported measures, but the contractor budget needs the 2026 Mcare assessment calculated on its correct schedule base. Do not simply apply the percentage to an insurer’s quoted premium. Match the specialty, territory, actual paid shifts and assessment responsibility before comparing contracts with a neighboring state.

The 2024 BEA index prices a controlled $100,000 basket at $97,572 (cost position 28). ACS median homeowner tax is $3,214 for 2024, and the historical NAIC HO-3 premium is $1,217 for 2023. These household observations do not include practice expenses or malpractice.

Pennsylvania’s official 2026 Mcare assessment is 29% of the JUA prevailing primary premium for the provider. That is a defined schedule base, not necessarily the commercial premium on a quote. Ask for the underlying policy and Mcare assessment as separate dollar lines before comparing offers or locum contracts.

AMA 2024–2025: ≥10% increases, 52.9%; sample 51.

The CMS underlying malpractice-cost index aggregates to 1.073 for Pennsylvania, using published malpractice RVUs across 67 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
Pennsylvania Mcare: 2026 assessment rating information (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Pennsylvania retirement-tax details

Rhode IslandRead state analysis

Rhode Island

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Median home $455,700Monthly gross rent $1,418HO-3 premium, 2023 $2,396

Rhode Island’s cost basket is slightly cheaper than Massachusetts’s, but its historical homeowners premium is higher and the owner property-tax observation remains substantial. A contractor should compare exact housing arrangements rather than choose from the general price index alone. The malpractice-change exhibit is another reason to request a current quote, not a numeric substitute for that quote.

The 2024 BEA index prices a controlled $100,000 basket at $102,280 (cost position 37). ACS median homeowner tax is $4,886 for 2024, and the historical NAIC HO-3 premium is $2,396 for 2023. These household observations do not include practice expenses or malpractice.

AMA 2024–2025: ≥10% increases, 25%; sample 12.

The CMS underlying malpractice-cost index aggregates to 0.948 for Rhode Island, using published malpractice RVUs across 5 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

Source qualification: PTET: The current source did not support a universal refundability label for every owner class.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Rhode Island retirement-tax details

South CarolinaRead state analysis

South Carolina

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Median home $299,500Monthly gross rent $1,272HO-3 premium, 2023 $1,753

South Carolina’s median homeowner tax is low, while general prices remain below national average. A contractor should still distinguish the actual property and assignment location from the state mean, especially when comparing a permanent base with temporary housing. The selected liability-change observations justify checking renewal terms without claiming a statewide annual malpractice price.

The 2024 BEA index prices a controlled $100,000 basket at $93,749 (cost position 19). ACS median homeowner tax is $1,337 for 2024, and the historical NAIC HO-3 premium is $1,753 for 2023. These household observations do not include practice expenses or malpractice.

AMA 2024–2025: ≥10% increases, 20%; sample 15.

The CMS underlying malpractice-cost index aggregates to 0.893 for South Carolina, using published malpractice RVUs across 46 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the South Carolina retirement-tax details

South DakotaRead state analysis

South Dakota

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Median home $289,600Monthly gross rent $999HO-3 premium, 2023 $1,614

South Dakota’s contractor screen compares a controlled business-income tax base, household spending and malpractice-cost context; its published Family Medicine employee wage remains separate negotiation context. Its low spending basket and median rent can help price a home base. Check the actual paid assignment calendar and coverage, then compare owner property taxes and insurance if buying rather than renting.

The 2024 BEA index prices a controlled $100,000 basket at $88,586 (cost position 6). ACS median homeowner tax is $2,940 for 2024, and the historical NAIC HO-3 premium is $1,614 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.294 for South Dakota, using published malpractice RVUs across 62 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 99.9933%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the South Dakota retirement-tax details

TennesseeRead state analysis

Tennessee

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Median home $332,600Monthly gross rent $1,284HO-3 premium, 2023 $1,649

Tennessee’s low regional basket and modest homeowner carrying-cost observations make it a useful contractor home-base candidate at fixed profit. Median rent is higher than Kentucky’s or Alabama’s, however. Compare the actual neighborhood, travel pattern and paid hours before assuming a statewide affordability advantage translates equally to each assignment arrangement.

The 2024 BEA index prices a controlled $100,000 basket at $91,870 (cost position 14). ACS median homeowner tax is $1,488 for 2024, and the historical NAIC HO-3 premium is $1,649 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.536 for Tennessee, using published malpractice RVUs across 95 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Tennessee retirement-tax details

TexasRead state analysis

Texas

Back to comparison ↑

Median home $313,200Monthly gross rent $1,475HO-3 premium, 2023 $2,864

Texas’s household cost screen is held back by larger homeowner tax and insurance observations despite its below-national price index. A physician contractor should price the actual home and professional policy separately. The statutory noneconomic-damages provision is useful legal context, but it cannot establish a low malpractice quote, eliminate coverage needs or price the business’s state obligations.

The 2024 BEA index prices a controlled $100,000 basket at $97,057 (cost position 27). ACS median homeowner tax is $4,108 for 2024, and the historical NAIC HO-3 premium is $2,864 for 2023. These household observations do not include practice expenses or malpractice.

Texas section 74.301(a) limits noneconomic liability for physicians and other noninstitution providers collectively to $250,000 per claimant. Institutional defendants follow separate provisions. This is not a total damages cap or evidence that every specialty has inexpensive coverage.

The CMS underlying malpractice-cost index aggregates to 0.954 for Texas, using published malpractice RVUs across 242 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 99.9996%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
Texas Civil Practice and Remedies Code section 74.301 (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Texas retirement-tax details

UtahRead state analysis

Utah

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Median home $545,200Monthly gross rent $1,593HO-3 premium, 2023 $1,107

Utah’s historical homeowners insurance is modest, but its general price basket is not among the cheapest and statewide rent is substantial. A contractor bringing reliable earnings may fare differently from the employee-pay screen because profit is held constant. Build a local housing budget first, then price professional coverage and paid-time assumptions to test the margin.

The 2024 BEA index prices a controlled $100,000 basket at $98,864 (cost position 31). ACS median homeowner tax is $2,648 for 2024, and the historical NAIC HO-3 premium is $1,107 for 2023. These household observations do not include practice expenses or malpractice.

AMA 2024–2025: ≥10% increases, 25%; sample 12.

The CMS underlying malpractice-cost index aggregates to 0.878 for Utah, using published malpractice RVUs across 28 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 99.9999%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Utah retirement-tax details

VermontRead state analysis

Vermont

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Median home $352,800Monthly gross rent $1,319HO-3 premium, 2023 $1,215

Vermont’s fixed-profit home-base comparison benefits from modest historical homeowners insurance, but homeowner taxes remain a significant recurring line. A contractor should compare those owner costs with renting near the work and with actual travel arrangements. The employee wage does not establish a contract rate or enough assignments to sustain the assumed profit.

The 2024 BEA index prices a controlled $100,000 basket at $97,958 (cost position 29). ACS median homeowner tax is $5,026 for 2024, and the historical NAIC HO-3 premium is $1,215 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.501 for Vermont, using published malpractice RVUs across 14 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Vermont retirement-tax details

VirginiaRead state analysis

Virginia

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Median home $403,500Monthly gross rent $1,646HO-3 premium, 2023 $1,537

Virginia’s contractor household basket is more expensive than North Carolina’s, and median rent is higher. A permanent base should therefore be chosen with actual assignments and travel costs in view. A physician with work on both sides of a state line needs specific location records; household residence and practice revenue cannot be collapsed into one statewide cost statistic.

The 2024 BEA index prices a controlled $100,000 basket at $101,104 (cost position 36). ACS median homeowner tax is $2,872 for 2024, and the historical NAIC HO-3 premium is $1,537 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.695 for Virginia, using published malpractice RVUs across 131 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 99.9999%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Virginia retirement-tax details

WashingtonRead state analysis

Washington

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Median home $602,200Monthly gross rent $1,824HO-3 premium, 2023 $1,232

Washington combines an expensive household basket with a separate professional-services B&O question for physician contractors. Keep the household and business calculations apart: low historical home insurance does not offset every cost, and a personal income-tax headline does not settle gross-receipts obligations. Price the assignment and obtain current sourcing and classification analysis before choosing the permanent base.

The 2024 BEA index prices a controlled $100,000 basket at $107,013 (cost position 46). ACS median homeowner tax is $4,729 for 2024, and the historical NAIC HO-3 premium is $1,232 for 2023. These household observations do not include practice expenses or malpractice.

Washington WAC 458-20-224 includes physician services in the service-and-other-business-activities B&O classification. A contractor must review gross-receipts obligations and sourcing separately from household income taxes. The score contains no assumed B&O rate or deduction.

The CMS underlying malpractice-cost index aggregates to 0.748 for Washington, using published malpractice RVUs across 38 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
Washington WAC 458-20-224: Professional services (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Washington retirement-tax details

West VirginiaRead state analysis

West Virginia

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Median home $170,800Monthly gross rent $883HO-3 premium, 2023 $1,179

West Virginia’s low spending basket, median rent and homeowner tax can make a lean contractor home base if the assumed profit is reliable. The practice still needs actual assignment and coverage costs. A favorable household score does not establish available shifts or a low malpractice premium; use the cited change observation only to inform renewal due diligence.

The 2024 BEA index prices a controlled $100,000 basket at $89,497 (cost position 9). ACS median homeowner tax is $881 for 2024, and the historical NAIC HO-3 premium is $1,179 for 2023. These household observations do not include practice expenses or malpractice.

AMA 2024–2025: ≥10% increases, 8.3%; sample 12.

The CMS underlying malpractice-cost index aggregates to 1.548 for West Virginia, using published malpractice RVUs across 55 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
AMA: Medical liability premiums, April 2026 (2025; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the West Virginia retirement-tax details

WisconsinRead state analysis

Wisconsin

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Median home $294,700Monthly gross rent $1,142HO-3 premium, 2023 $923

Wisconsin’s historical homeowners insurance is the lowest observation in the dataset, helping the fixed-profit household screen. Homeowner taxes are higher than in Indiana, so the owner budget is not uniformly cheap. A contractor should price the actual home and assignments, and should not import the strong employee wage as expected self-employed earnings.

The 2024 BEA index prices a controlled $100,000 basket at $94,095 (cost position 20). ACS median homeowner tax is $3,680 for 2024, and the historical NAIC HO-3 premium is $923 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.289 for Wisconsin, using published malpractice RVUs across 72 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Wisconsin retirement-tax details

WyomingRead state analysis

Wyoming

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Median home $339,500Monthly gross rent $998HO-3 premium, 2023 $1,853

Wyoming’s spending basket and median rent are well below Colorado’s, making it a useful contractor home-base comparison at fixed profit. The actual travel pattern matters: a low-cost residence can require unpaid time and transport to reach assignments. Price those terms and professional coverage before treating the home’s affordability as the practice’s annual cost advantage.

The 2024 BEA index prices a controlled $100,000 basket at $92,691 (cost position 16). ACS median homeowner tax is $1,947 for 2024, and the historical NAIC HO-3 premium is $1,853 for 2023. These household observations do not include practice expenses or malpractice.

The CMS underlying malpractice-cost index aggregates to 0.750 for Wyoming, using published malpractice RVUs across 23 county or planning-region observations. This contributes to the physician score as relative insurance-cost context. The 2026 update uses 2023 mature claims-made premiums and RVUs, with a $1 million/$3 million coverage target; it is not a 2026 premium quote or an assessment of courtroom rules. Observed RVU coverage is 100.0000%. County premiums reflect state-specific specialty mix, and RVU coverage does not measure insurer-market coverage. CMS excludes risk-retention-group filings and imputes some source values, so your specialty, carrier and coverage arrangement still require an actual quote.

BLS May 2025 OEWS state occupation estimates (2025; 2026-09-12)
BLS OEWS definitions, coverage and publication limits (2025; 2026-09-12)
BEA regional price parities, 2024 (2024; 2026-09-12)
Census ACS 2024 housing value, rent and real estate taxes (2024; 2026-09-12)
NAIC 2023 homeowners insurance report, HO-3 (2023; 2026-09-12)
WalletHub 2026 quality-of-life category (2026; 2026-09-12)
CMS: CY2026 malpractice cost data and RVU weights (2026 update; 2023 premiums and RVUs; 2026-09-12)
CMS: CY2026 GPCI and malpractice methodology report (2026; 2026-09-12)
Census ACS housing, rent and property-tax data
NAIC 2023 homeowner premium table

Read the Wyoming retirement-tax details

Taxstra methodologyScoring factors, weights, research profiles and limitations.

How Taxstra grades each state out of 10

We score every state using the same rules. Costs and financial factors make up 80% of the overall score, and WalletHub’s Quality of Life category makes up 20%. Each category tile shows how much it counts. Tiles marked “Not in overall score” offer extra context without changing the ranking.

What counts toward the score

State tax on $500K of taxable business income: 30% of the financial share
Everyday living costs: 40% of the financial share
Malpractice insurance costs: 30% of the financial share

What does a score out of 10 mean?

For financial categories, 10 is the strongest result in the comparison and 1 is the weakest. Lower costs generally score better; higher pay scores better. A 7.9 is a comparison tool, not a promise about your finances.

Why can scores and ranks look different?

Cards show one decimal place, while rankings use two. Two states can both display 7.9 and still have slightly different ranks. States with the same ranking value share a rank.

Which WalletHub ranking do we use?

We use WalletHub’s Quality of Life category, not its overall ranking. For example, Illinois is fifth for Quality of Life and eighteenth overall in the cited study. Those are two different measures.

What if information is missing?

We leave it missing instead of guessing. If a required factor is unavailable, we label the score provisional and do not give it an overall rank.

Technical formulas and source definitions

Financial categories: actual measurement spread: The most favorable observed value receives 10 and the least favorable receives 1. Intermediate grades are scaled linearly between them: 1 + 9 × the favorable share of the observed range. Lower costs score higher; higher pay scores higher. If every observation is identical, each receives 5.5. These relative grades do not have a universal pass/fail cutoff. Extreme observations can widen the range and compress other grades. We do not narrow a genuine gap just to produce a tighter leaderboard; a change to a source population must have a documented measurement reason. The STR grade is a regional spending-cost screen. Hotel employment is excluded from its score because hotel jobs do not measure residential STR demand; actual occupancy and booking revenue require local property research.
Malpractice and rental taxes: defined samples: The physician index weights CMS county malpractice-cost observations by their malpractice RVUs within each state. It uses the underlying 2026 update, based on 2023 premiums and RVUs, before Medicare payment adjustments. State-specific specialty mix, missing insurer types and CMS imputation limit its use as a quote comparison. Apartment-tax comparisons hold building and fixture values constant and average the study’s named urban and rural municipalities equally. Including both reduces dependence on one city; it still does not represent all localities. They are neither statewide tax rates nor single-family STR bills.
Quality of life: the source category, not the overall WalletHub rank: We use the quality-of-life category of WalletHub’s 2026 state study, published August 10, 2026. Taxstra converts its rank to a grade using 1 + 9 × (50 − rank) / 49. The publisher’s category includes amenities, mobility, leisure, weather and environmental conditions. WalletHub’s overall ranking also includes affordability, economy, education and health, and safety. We use its narrower quality-of-life category as an amenities and daily-life input; our financial factors already measure costs separately. For example, Illinois is #5 in that category and #18 overall in WalletHub. Taxstra’s own guide ranking is a third, separately calculated result. Differences in these rank-based grades are not measured differences in happiness.
Overall grade and rank: Multiply each unrounded component grade by its published weight, add the results, then display one decimal place. Round the composite to two decimals for ranking and retain genuine ties at that precision. Cards display one decimal for readability; two cards displaying 7.9 can therefore have different positions. The table tooltip and downloadable dataset include the ranking value. For example, financial 6.0 and quality of life 9.0 produce 6.6 at 80% financial / 20% quality-of-life weights. Direct tax and deduction comparisons rank their displayed dollar outcomes and show a separate normalized category grade.
Incomplete evidence: Unavailable category data receives no grade. When a weighted component is missing, the remaining components are reweighted and the card labels the result provisional, shows evidence coverage and excludes it from the overall rank. The presence of a numeric provisional grade is not evidence that the missing category was measured.
What a grade does not claim: These are screening grades, not completed all-factor tax or legal rankings. The named tax benchmarks and CMS malpractice-cost index are included only where the displayed weights say so. Full-return taxes, individual insurance quotes and legal-policy judgments remain separate. A high amenities grade does not mean that everyone prefers the state. Family ties, local neighborhoods, climate preferences and a particular job can outweigh statewide observations.

For investment guides, livability describes market context; it does not forecast rent growth or returns and does not assume that the investor lives in the property’s state. In guides about tax bills, the tax calculations stay separate from lifestyle grades.

Research examples and calculation assumptions

Taxstra's research profiles

A useful comparison holds the household and property constant. These are the exact starting profiles for the tax research; a scenario is not a completed tax estimate unless its result is explicitly shown.

Physician employment: $500,000 in wages, one earner, no dependents, no elective retirement contributions. Married filing jointly and single results are separate. The score’s separate tax sensitivity uses $500,000 of state taxable wage income with state AGI equal to that base; it is not a gross-to-taxable return calculation. Compensation observations use the BLS occupation specified beside the result and exclude self-employment.
Contracting and business ownership: $500,000 of profit before owner compensation. An S-corp example tests a $250,000 owner wage; that is a sensitivity assumption, not a reasonable-compensation opinion. The separate employee-payroll example is five employees at $100,000 each. Employee wages already included in operating expenses are never deducted twice.
Retirement: Both spouses are 67, married filing jointly, receiving $120,000 from traditional retirement accounts, $60,000 in private pensions, $60,000 in Social Security, $30,000 in ordinary investment income and $30,000 in long-term capital gains. Each spouse receives half. Total cash income is $300,000; taxable income depends on the income category and applicable rules. Full-year residents. Qualified traditional distributions; employer-funded defined-benefit pension; 401(k) entirely employee elective deferrals with no employer contributions; IRA entirely self-funded with no exempt pension rollover; Pennsylvania-eligible retirement distributions after retirement. Exclusions are applied to qualifying plan income first where several income categories are eligible. No federal or state tax bill is estimated.
Property acquisition: A debt-free $1 million purchase, with $200,000 allocated to land. The long-term rental example assumes $90,000 of rent and $30,000 of expenses before property tax, insurance and depreciation. The STR example assumes $150,000 of bookings and $75,000 of expenses on the same basis. These are research starting profiles, not market forecasts. The standardized scored apartment example is different: $600,000 land and building plus $30,000 fixtures, with the same values across named municipalities. The STR worked example uses a separately labeled fixed property scenario. It does not change the statewide ranking or represent forecast bookings.
Depreciation: A sensitivity considers an additional $100,000 deduction that the taxpayer can currently use. An addback can defer a state benefit even when federal expensing is available. A current deduction, a future recovery and a permanent tax reduction are different results.
State and local scope: Property location and owner residence are separate inputs. There is no assumed “average” local income tax. A combined state/local result needs a named locality and its resident or nonresident rules. Figures explicitly labeled state-only exclude local tax.

How to reproduce a comparison

Choose the named measure and its source year.
Apply the formula displayed beside the map to the source observation for each state.
Round money to whole dollars, ratios to two decimal places and grades to one decimal place. Rank in the direction stated by the measure: the tax-penalty guide places the largest burden first, while its tax-cost grade still rewards a lower bill. Changing display order does not change a state’s rank.
Give equal ranking values the same competition rank (composites use two decimals; cards show one). After a tie, skip the occupied positions.
Leave suppressed or unavailable observations unranked. Retain the state in the table and describe the gap.

A price-adjusted wage, a homeowner tax bill and a lodging-employment concentration answer different questions. The balanced view explicitly combines the guide’s named financial factors with livability at the displayed weights. Other categories provide context. A favorable legal policy is not treated as a measured dollar saving. Material modeling assumptions require review before a full financial ranking is released.

The financial profiles are a $500,000 W-2 household, a business with $500,000 profit before owner compensation, a five-person $500,000 payroll, and a married age-67 household with $300,000 of mixed retirement and investment income. Investor examples assume the purchase location is separate from the owner’s residence.

These scenarios define the research questions. Unless a completed calculation is explicitly shown, a profile is not an estimated return. Tax sensitivities use separately supplied state-taxable wage or ordinary-business bases, exclude local tax and do not replace full-return calculations. We do not calculate with unverified secondary-source schedules.

Published survey estimates have sampling error. We preserve available Census margins of error and BLS relative errors in the source data. Small apparent differences should not be treated as certainty. A comprehensive state decision still requires the actual locality, household, property, employer and coverage terms.

Sources and measurement datesOriginal datasets, primary authority, verification dates and downloadable research.

Download the published 50-state dataset (CSV) · Dataset definitions and coverage

Economic observations were retrieved September 12, 2026. Measurement years differ because the agencies publish on different schedules. Existing retirement rules retain their August 4, 2026 review date; existing PTET and depreciation research retain August 30, 2026. Unresolved entries remain identified.

BEA regional price parities, 2024Source year / applicable rules: 2024 · Verified 2026-09-12
Census ACS 2024 housing value, rent and real estate taxesSource year / applicable rules: 2024 · Verified 2026-09-12
NAIC 2023 homeowners insurance report, HO-3Source year / applicable rules: 2023 · Verified 2026-09-12
WalletHub 2026 quality-of-life categorySource year / applicable rules: 2026 · Verified 2026-09-12
BLS OEWS definitions, coverage and publication limitsSource year / applicable rules: 2025 · Verified 2026-09-12
IRS: S corporation compensation and medical insuranceSource year / applicable rules: 2026 · Verified 2026-09-12
IRS: One-participant 401(k) plansSource year / applicable rules: 2026 · Verified 2026-09-12
AMA: Medical liability premiums, April 2026Source year / applicable rules: 2025 · Verified 2026-09-12
Medical Board of California: Practice informationSource year / applicable rules: 2026 · Verified 2026-09-12
Washington WAC 458-20-224: Professional servicesSource year / applicable rules: 2026 · Verified 2026-09-12
Alabama DOR individual tax ratesSource year / applicable rules: 2026 · Verified 2026-09-12
BEA regional price parities, via FREDSource year / applicable rules: 2024 · Retrieved 2026-09-12
CMS: CY2026 malpractice cost data and RVU weightsSource year / applicable rules: 2026 update; 2023 premiums and RVUs · Verified 2026-09-12
CMS: CY2026 GPCI and malpractice methodology reportSource year / applicable rules: 2026 · Verified 2026-09-12
WalletHub 2026 quality-of-life categorySource year / applicable rules: 2026 · Retrieved 2026-09-12
The Quality of Life Rank column, not Overall Rank. Overall also includes affordability, economy, education and health, and safety. Illinois is #5 in the quality-of-life category and #18 overall. Category ranks are converted to Taxstra grades; overall ranks are shown only for source context.
Alaska government tax factsSource year / applicable rules: 2026 · Verified 2026-09-12
Arizona DOR individual withholding and tax rateSource year / applicable rules: 2026 · Verified 2026-09-12
Arkansas DFA 2026 special-session SB1 fiscal impactSource year / applicable rules: 2026 · Verified 2026-09-12
Arkansas SB1, Act 2 of the 2026 special sessionSource year / applicable rules: 2026 · Verified 2026-09-12
California FTB September 3, 2026 indexing memorandum, Attachment 2 (CalTax-hosted copy)Source year / applicable rules: 2026 · Verified 2026-09-12
California FTB 2025 Publication 1067: individual-return 1% tax on excess over $1 millionSource year / applicable rules: 2026 · Verified 2026-09-12
Colorado 2026 DR 0104EP estimate worksheetSource year / applicable rules: 2026 · Verified 2026-09-12
Connecticut 2026 CT-1040ES: initial tax, 2% phaseout and recapture tablesSource year / applicable rules: 2026 · Verified 2026-09-12
Delaware DOR employer guide, income computation tableSource year / applicable rules: 2026 · Verified 2026-09-12
Florida DOR individual income-tax FAQSource year / applicable rules: 2026 · Verified 2026-09-12
Georgia DOR important tax updates, 2026Source year / applicable rules: 2026 · Verified 2026-09-12
Hawaii Department of Taxation tax-year rate tablesSource year / applicable rules: 2026 · Verified 2026-09-12
Hawaii tax tables for years after December 31, 2024Source year / applicable rules: 2026 · Verified 2026-09-12
Idaho Code 63-3024: 5.3% rate and statutory CPI indexingSource year / applicable rules: 2026 · Verified 2026-09-12
BLS CPI-U U.S. city average: 2025 annual average 321.943Source year / applicable rules: 2025 · Verified 2026-09-12
BLS historical CPI-U: 1998 annual average 163.0Source year / applicable rules: 1998 · Verified 2026-09-12
Idaho Commission published annual tables: latest posted year 2025Source year / applicable rules: 2025 · Verified 2026-09-12
BLS archived CPI files: October 2025 data unavailable during funding lapseSource year / applicable rules: 2025 · Verified 2026-09-12
Illinois DOR current income-tax ratesSource year / applicable rules: 2026 · Verified 2026-09-12
Indiana DOR rates, fees and penaltiesSource year / applicable rules: 2026 · Verified 2026-09-12
Iowa DOR 2026 income-tax rate announcementSource year / applicable rules: 2026 · Verified 2026-09-12
Kansas DOR enacted individual tax scheduleSource year / applicable rules: 2026 · Verified 2026-09-12
Kansas Notice 25-06: no 2026 rate reductionSource year / applicable rules: 2026 · Verified 2026-09-12
Kentucky DOR software developer tax-year updatesSource year / applicable rules: 2026 · Verified 2026-09-12
Louisiana DOR individual income-tax reform ratesSource year / applicable rules: 2026 · Verified 2026-09-12
Maine Revenue Services revised 2026 individual rate schedulesSource year / applicable rules: 2026 · Verified 2026-09-12
Maryland Tax-General section 10-105Source year / applicable rules: 2026 · Verified 2026-09-12
Massachusetts DOR current tax ratesSource year / applicable rules: 2026 · Verified 2026-09-12
Michigan Treasury 2026 individual rate determinationSource year / applicable rules: 2026 · Verified 2026-09-12
Minnesota DOR 2026 rates and bracketsSource year / applicable rules: 2026 · Verified 2026-09-12
Mississippi DOR general information, 2026 income taxSource year / applicable rules: 2026 · Verified 2026-09-12
Missouri DOR 2026 MO-1040ES tax rate chartSource year / applicable rules: 2026 · Verified 2026-09-12
Montana DOR HB 337 income-tax changesSource year / applicable rules: 2026 · Verified 2026-09-12
Nebraska DOR 2026 Form 1040N-ES worksheetSource year / applicable rules: 2026 · Verified 2026-09-12
Nevada Department of Taxation tax notesSource year / applicable rules: 2026 · Verified 2026-09-12
New Hampshire DRA interest and dividends tax repealSource year / applicable rules: 2026 · Verified 2026-09-12
New Jersey Treasury resident tax rate schedules, 2020 and afterSource year / applicable rules: 2026 · Verified 2026-09-12
New Mexico TRD 2025 tax expenditure report: 2025-and-later income scheduleSource year / applicable rules: 2026 · Verified 2026-09-12
New Mexico TRD January 2026 SB60 analysis: current-law comparison tableSource year / applicable rules: 2026 · Verified 2026-09-12
New York 2026 IT-2105-I estimate schedules and benefit-recapture worksheetsSource year / applicable rules: 2026 · Verified 2026-09-12
North Carolina DOR individual rate schedulesSource year / applicable rules: 2026 · Verified 2026-09-12
North Dakota 2026 ND-1ES annual tax rate schedulesSource year / applicable rules: 2026 · Verified 2026-09-12
Ohio Revised Code chapter 5747: business deduction and distinct 3% rateSource year / applicable rules: 2026 · Verified 2026-09-12
Oklahoma Tax Commission 2025 legislative update, effective 2026Source year / applicable rules: 2026 · Verified 2026-09-12
Oregon Legislative Revenue Office 2026 personal tax scheduleSource year / applicable rules: 2026 · Verified 2026-09-12
Pennsylvania DOR 2026 REV-413 individual estimated taxSource year / applicable rules: 2026 · Verified 2026-09-12
Rhode Island Division of Taxation 2026 inflation adjustmentsSource year / applicable rules: 2026 · Verified 2026-09-12
Rhode Island DOR July 2026 enacted-law summary: surtax starts in 2027Source year / applicable rules: 2026 · Verified 2026-09-12
South Carolina DOR H.4216 2026 income-tax reformSource year / applicable rules: 2026 · Verified 2026-09-12
South Dakota DOR sales and use tax guideSource year / applicable rules: 2026 · Verified 2026-09-12
Tennessee DOR Hall income tax repealSource year / applicable rules: 2026 · Verified 2026-09-12
Texas Constitution article VIII section 24-aSource year / applicable rules: 2026 · Verified 2026-09-12
Utah Tax Commission 2026 legislative summarySource year / applicable rules: 2026 · Verified 2026-09-12
Vermont Joint Fiscal Office 2026 Fiscal Facts: personal income-tax bracketsSource year / applicable rules: 2026 · Verified 2026-09-12
Vermont 32 VSA 5822: federal-AGI minimum taxSource year / applicable rules: 2026 · Verified 2026-09-12
Virginia Tax individual income-tax computationSource year / applicable rules: 2026 · Verified 2026-09-12
Washington DOR individual income-tax FAQsSource year / applicable rules: 2026 · Verified 2026-09-12
Washington Governor: SB6346 income tax signed March 30, 2026; starts January 2028Source year / applicable rules: 2026 · Verified 2026-09-12
West Virginia Tax Division 2026 personal income-tax reductionSource year / applicable rules: 2026 · Verified 2026-09-12
Wisconsin DOR 2026 Form 1-ES instructionsSource year / applicable rules: 2026 · Verified 2026-09-12
State of Wyoming tax overviewSource year / applicable rules: 2026 · Verified 2026-09-12
BLS May 2025 OEWS state occupation estimatesSource year / applicable rules: 2025 · Verified 2026-09-12
California Civil Code section 3333.2Source year / applicable rules: 2026 · Verified 2026-09-12
Indiana Department of Insurance: Medical malpracticeSource year / applicable rules: 2026 · Verified 2026-09-12
Indiana: Provider qualification and complaintsSource year / applicable rules: 2026 · Verified 2026-09-12
Kansas Health Care Stabilization Fund: SurchargesSource year / applicable rules: 2026 · Verified 2026-09-12
Louisiana Patient’s Compensation FundSource year / applicable rules: 2026 · Verified 2026-09-12
Nebraska Department of Insurance: Medical liability fund and 2026 surchargeSource year / applicable rules: 2026 · Verified 2026-09-12
Pennsylvania Mcare: 2026 assessment rating informationSource year / applicable rules: 2026 · Verified 2026-09-12
Texas Civil Practice and Remedies Code section 74.301Source year / applicable rules: 2026 · Verified 2026-09-12
Census ACS 1-year: B25077, B25103, B25064Source year / applicable rules: 2024 · Retrieved 2026-09-12
NAIC homeowners report, HO-3 average premiumsSource year / applicable rules: 2023 · Retrieved 2026-09-12

The Census property-tax figure is a median dollar bill on owner-occupied homes, not a tax rate on rentals. BLS physician wages exclude self-employment. NAIC premiums describe owner-occupied HO-3 policies. CMS healthcare spending includes several payers and all ages. BLS accommodation employment includes hotels and other lodging; it is not STR revenue.

State-specific primary-authority links appear with each state. A source listed for one tax category does not verify a different category.

Common questions

Is the cheapest state to live in the best state for locums?

Not necessarily. The home-base cost ranking holds net practice profit constant. Assignment availability, work-state sourcing, coverage and travel can reverse the household comparison.

Can I use the BLS physician salary as my expected 1099 income?

No. BLS OEWS excludes self-employed physicians. A locum projection must use actual contracted rates, paid hours and expenses.

Does incorporating in another state remove my home-state obligations?

Formation alone does not determine residency, work-state sourcing, professional licensure or business activity. Review where the physician actually lives and performs services.

Does the guide assume every physician should elect S-corp taxation?

No. The election requires a lawful professional structure and a combined comparison of wages, payroll, state charges, retirement plans and administration. The illustrated owner salary is not a compensation opinion.

What is the difference between a malpractice premium and a fund surcharge?

The premium purchases the underlying insurance policy. Certain state arrangements add a separate payment for fund participation or excess coverage. Obtain both amounts and determine whether the agency, hospital or physician bears each cost.

Why is a malpractice increase percentage not part of the score?

A share of sampled premiums that increased is not an annual dollar cost. A low-premium state can have a large percentage increase, while an expensive policy can stay unchanged. Scoring the increase as affordability would confuse different measurements.

Can a hospital 401(k) and solo 401(k) each get the full employee deferral?

The IRS says the elective deferral limit is by person, not by plan. Employer contributions and other limits require a separate earnings and plan review.

Is this a business-profit tax calculator?

No. It compares a controlled owner-tax benchmark, regional costs, CMS malpractice-cost context and quality of life. The owner-tax base is supplied separately from practice profit. Federal, local, entity and resident-credit reconciliation remain separate.

Does the score calculate tax on my practice profit?

No. The score compares a separately supplied $500,000 state-taxable business-income base; it does not convert gross collections or net profit into taxable income. The interactive operating example reconciles owner wages and employer FICA separately, and shows verified entity components. Review those published inputs to investigate your facts, then reconcile a full return.

How much should lifestyle matter for a traveling physician?

Consider your home base and assignment locations separately. School, family and recurring living costs belong to the home-base decision. Travel time, schedule quality and temporary housing belong to the contract comparison. One statewide score cannot settle both.

Can employee wage data predict my 1099 income?

No. Employee wage observations provide labor-market context. A contractor needs actual rates, paid hours, cancellations and expenses to estimate profit. The guide does not turn employee wages into invented locum compensation.

How should I compare two locum contracts?

Compare expected annual net collections after unpaid time, travel, lodging, licensing and insurance costs. Then compare schedule flexibility and the locations where you will actually work. Keep your household budget separate from practice expenses.

Does the balanced score include every S-corp cost?

No. Its financial component is the named screening measure, not a complete entity calculation. Payroll, professional-entity requirements, administration and multistate obligations still need an individual comparison.

Why can the WalletHub rank differ from the rank on this card?

The card identifies WalletHub’s Quality of Life category rank. The linked study also has a separate Overall Rank column that incorporates affordability, economy, education and health, and safety. Illinois is #5 in Quality of Life but #18 overall in the 2026 WalletHub study. Taxstra’s headline rank combines the named financial factors with that quality-of-life category using our published weights; it is not WalletHub’s overall ranking.

Can readers customize the published ranking?

No. Each guide uses one fixed methodology and the same assumptions for every state. State search, map selection, shared links and embedded cards all use that published ranking. Separate financial examples explain the assumptions without changing the leaderboard.

How does Taxstra include livability in the ranking?

Composite guides combine their named financial factors with WalletHub’s Quality of Life category at fixed, guide-specific weights: 80% financial and 20% quality of life for physician and retirement composites; 90% financial and 10% quality of life for business and property composites. Direct tax, PTET and depreciation comparisons do not include quality of life in their ranking. Everyone sees the same ranking; choosing a state changes the displayed card, not the methodology. The score is a comparison tool, not an estimate of happiness or a completed tax return.

What does the livability measure include?

We use WalletHub’s 2026 quality-of-life category, which considers amenities, mobility, environmental conditions and leisure. Its methodology is linked in the sources. This category does not fully capture family ties, personal climate preferences, a particular school district or an individual neighborhood.

Does a score of 8.0 mean a state is 80% better?

No. The 1–10 grades describe relative results within the comparison. A score of 8.0 is neither a percentage tax saving nor a probability that you will enjoy living there. Review the underlying measures, fixed weights and limitations before making a shortlist.

Why can two states share a rank?

Taxstra ranks composite scores rounded to two decimals while cards display one decimal. Equal ranking values share the same competition rank. Direct dollar comparisons rank whole-dollar outcomes. Missing observations remain unranked when the selected calculation needs them; they are not replaced with zero.

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The published 50-state ranking

Pick a state. See how it fits.

Why Illinois scores this way

Illinois

State tax on $500K of taxable business income

Everyday living costs

Malpractice insurance costs

Quality of life

Home prices compared with pay

Homeowner property taxes

Good fit for

Less suited to

Cite the state. Include the method.

Compare owner, entity and payroll tax separately

Illinois: the layers behind the decision

Separately calculated Illinois entity components

What determines this guide’s grade

Do not annualize the hourly rate over every week

Resident state and assignment state are two separate decisions

Professional structure comes before the S election

Reasonable compensation is based on the services

Insurance quotes must follow the specialty and assignment

Retirement accounts require cash, not just a deduction

Choose a sustainable operating calendar

How Taxstra grades each state out of 10

What counts toward the score

What does a score out of 10 mean?

Why can scores and ranks look different?

Which WalletHub ranking do we use?

What if information is missing?

Taxstra's research profiles

How to reproduce a comparison

Common questions

Continue your research

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Make the comparison yours.