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Best States for High-Income W-2 Physicians

Where can a physician’s paycheck go further? Compare pay, housing, taxes, malpractice costs and quality of life across all 50 states.

Leading states in this comparison · Published 2026 methodology

  1. #1 Oklahoma7.9 / 10
  2. #2 Iowa7.7 / 10
  3. #3 Pennsylvania7.6 / 10
See all 50 states and the scored factors ↓

By Bryan Martin, CPA, Managing Partner and Founder of Taxstra · Last reviewed September 12, 2026.

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The published 50-state ranking

Where can a physician’s paycheck go further? Compare pay, housing, taxes, malpractice costs and quality of life across all 50 states.

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.

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

Why Illinois scores this way

Illinois ranks #43 of 50, with 5.1 / 10. The category tiles show its strengths and tradeoffs.

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
Taxstra Tax and Accounting Services2026 state guide

W-2 physicians

Illinois

Taxstra’s state comparison

Illinois outline
5.1/ 10

Overall score#43 in the comparison

80% cost and financial score (4.1/10) · 20% quality of life (9.3/10)

How to read this score

Employee-market pay and a separate $500K state-taxable wage benchmark, not an actual $500K gross-offer return. CMS malpractice is a relative insurance-cost index, not a specialty quote or legal-policy score. Benefits, local taxes and contract terms remain separate.

How far physician pay goes

#42 of 50 · 33.6% weight
2.9/10

$229,466 in family-physician pay after adjusting for local prices; before taxes, and not a job offer.

Home prices compared with pay

#21 of 50 · 12% weight
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 · 6.4% weight
5.2/10

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

Tax on $500K taxable wages

#28 of 50 · 16% weight
5.2/10

$24,750 in state tax for a married couple filing jointly at this taxable income; credits and local taxes are excluded.

Malpractice insurance costs

#50 of 50 · 12% 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.

Good fit for

  • Physicians with a strong specific offer who value Illinois amenities and manageable purchase prices
  • Employees comparing an actual specialty offer with local housing

Less suited to

  • Buyers treating an inexpensive listing as proof of low long-term carrying costs
  • Salary-only decisions that ignore call and departure costs

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 reports a $229,370 mean employee wage for Family Medicine Physicians, compared with $285,950 in Indiana. Its regional price level is 7.1% higher than Indiana’s, putting Illinois behind on price-adjusted pay for this occupation. A strong specialty offer or existing housing can improve the personal case; the average does not establish that every Chicago or downstate role pays poorly.

The 2025 BLS mean employee wage is $229,370; dividing by the 2024 BEA price index of 99.958 gives $229,466 in price-adjusted pay (position 42 among numeric observations). The 2024 median home value of $280,700 equals 1.22 times that gross pay.

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.

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

W-2 physicians: economic observations and tax context
RankStatePhysician pay, tax, liability cost and lifestyle gradeHome value
ACS 2024		Property-tax bill
ACS 2024 median		Price index
BEA 2024		Individual bonus treatment
1Oklahoma7.9 / 10$222,100$1,67287.8Oklahoma permits a state 100% expensing election for qualifying property; it is not simple federal bonus conformity.
2Iowa7.7 / 10$227,300$2,93787.8Iowa follows current federal depreciation, including §168(k) and §168(n), for 2026 to 2027.
3Pennsylvania7.6 / 10$277,600$3,21497.6Pennsylvania personal income tax uses its own depreciation rules rather than the federal bonus amount.
4Indiana7.4 / 10$243,500$1,79893.3Add back federal bonus depreciation and maintain Indiana basis for later depreciation or disposition.
5Tennessee7.3 / 10$332,600$1,48891.9Tennessee does not impose a broad individual income tax.
6Wisconsin7.3 / 10$294,700$3,68094.1Wisconsin does not adopt federal §168(k) or §168(n); compute Wisconsin depreciation separately.
7Texas7.3 / 10$313,200$4,10897.1Texas does not impose a broad individual income tax.
8Arizona7.2 / 10$426,000$1,828100.7Individuals retain the full federal §168(k) bonus amount for eligible new property in 2026; §168(n) is separately added back.
9Montana7.0 / 10$425,400$2,93994.6Montana begins with the current federal income base and has no current bonus-depreciation addback.
10North Dakota7.0 / 10$266,100$2,55089.0North Dakota follows the federal deductions through its current federal income starting point.
11Wyoming6.9 / 10$339,500$1,94792.7Wyoming does not impose a broad individual income tax.
12South Dakota6.9 / 10$289,600$2,94088.6South Dakota does not impose a broad individual income tax.
13Idaho6.8 / 10$446,400$1,91295.5Add back the federal bonus difference in the first year; deduct later Idaho-versus-federal depreciation differences.
14Washington6.7 / 10$602,200$4,729107.0Washington does not impose a broad individual income tax.
15Louisiana6.5 / 10$223,200$1,18788.2Louisiana offers an optional state 100% expensing deduction for qualifying property; later federal depreciation on the same basis is added back.
16Nebraska6.5 / 10$263,100$3,73990.1Nebraska follows the current federal depreciation deduction for 2026 to 2027.
17Rhode Island6.5 / 10$455,700$4,886102.3Compute depreciation and basis as though federal bonus depreciation had not been enacted.
18Alaska6.4 / 10$376,500$3,976102.4Alaska does not impose a broad individual income tax.
19Nevada6.4 / 10$455,500$2,143100.0Nevada does not impose a broad individual income tax.
20Minnesota6.3 / 10$344,600$3,50198.6For §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.
21Georgia6.3 / 10$343,300$2,55496.3Use Georgia depreciation without federal §168(k) or §168(n).
22Kansas6.3 / 10$238,700$2,98390.1Current Kansas statutes recognize federal §168(k); a direct current official statement on §168(n) was not located.
23Ohio6.3 / 10$239,800$2,93792.8For §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.
24Utah6.2 / 10$545,200$2,64898.9Utah starts with current federal adjusted gross income and does not enumerate a §168(k) or §168(n) reversal.
25Mississippi6.2 / 10$186,500$1,22187.0Mississippi permits a state 100% first-year deduction for qualifying depreciable property; it is not simple federal bonus conformity.
26Florida6.0 / 10$396,900$2,993103.4Florida does not impose a broad individual income tax.
27Colorado5.9 / 10$574,600$2,828103.1Colorado follows the federal deductions for §168(k) bonus and §168(n) qualified production property.
28North Carolina5.9 / 10$333,000$2,04494.3Add back 85% of the federal accelerated-depreciation amount, then deduct 20% of that addition in each of the next five years.
29Massachusetts5.9 / 10$607,400$6,080105.8§168(k) remains disallowed. §168(n) is disallowed for 2026 and follows federal law beginning in 2027.
30Kentucky5.8 / 10$226,000$1,61190.2Kentucky does not adopt the current federal bonus provisions; use Kentucky depreciation.
31Arkansas5.7 / 10$215,600$1,11386.9Federal bonus depreciation is not adopted; use the Arkansas depreciation computation.
32New Jersey5.7 / 10$496,000$9,358108.8New Jersey does not follow the federal bonus deduction; calculate New Jersey depreciation and basis separately.
33South Carolina5.6 / 10$299,500$1,33793.7Use South Carolina depreciation without federal §168(k) or §168(n).
34Virginia5.6 / 10$403,500$2,872101.1Recompute Virginia depreciation as though the federal bonus provisions did not apply.
34West Virginia5.6 / 10$170,800$88189.5West Virginia adopted the 2025 federal changes, so §168(k) and §168(n) flow through for 2026 to 2027.
36Oregon5.5 / 10$497,500$3,895103.4Oregon disallows federal bonus depreciation for 2026 to 2027; implementing recovery instructions are pending.
37Michigan5.5 / 10$254,200$2,98896.2For individuals and flow-through entities, Michigan retains the pre-OBBBA phaseout: 20% federal bonus in 2026 and 0% in 2027; §168(n) is disallowed.
38New Mexico5.5 / 10$279,900$1,77692.2Ordinary §168(k) bonus flows into individual income in 2026. The enacted 2027 depreciation reversal changes the corporate base, not the individual base.
39Missouri5.4 / 10$254,400$2,02190.8Missouri follows current federal depreciation and does not require a bonus addback for current property.
40New Hampshire5.4 / 10$458,800$6,707104.2New Hampshire does not impose a broad individual income tax.
41Maine5.3 / 10$341,900$3,10397.1Add back the federal bonus amount and claim depreciation under Maine’s pro-forma computation.
42Maryland5.2 / 10$436,300$4,144105.0Generally decoupled from federal bonus; qualifying manufacturing property may receive different treatment.
43Illinois5.1 / 10$280,700$5,399100.0Reverse federal §168(k)/§168(n) amounts and compute the Illinois depreciation modification.
44California5.1 / 10$759,500$5,369110.7California does not conform to federal bonus depreciation; compute California depreciation separately.
45Vermont4.7 / 10$352,800$5,02698.0Vermont disallows §168(k) and §168(n), then permits recovery under the non-bonus depreciation schedule.
46New York4.4 / 10$449,800$6,542107.9Reverse federal §168(k) and §168(n) deductions and claim New York depreciation.
47Alabama4.3 / 10$233,300$89088.8Follows the federal §168(k) and §168(n) deductions for 2026 to 2027.
48Delaware4.1 / 10$371,600$1,75099.8Ordinary eligible 2026 property retains 20% bonus under the pre-OBBBA schedule; the rest follows regular depreciation.
49Connecticut3.9 / 10$396,900$6,573103.6Add back 100% of federal bonus, then deduct 25% of the addition in each of the next four years.
50Hawaii3.1 / 10$875,900$2,385110.0Hawaii does not allow the federal bonus deduction; compute Hawaii depreciation separately.
What changes the comparisonThe tax, legal and financial tradeoffs behind the ranking.

A physician’s best state balances compensation, housing, taxes, professional insurance costs and the life the household wants to build. Taxstra scores the published employee market, a controlled state-income-tax benchmark and CMS malpractice-cost context, then adds a fixed quality-of-life category weight. Compare actual specialty offers and coverage terms before making a relocation decision.

What determines this guide’s grade

42% price-adjusted family physician pay, 15% home value relative to family physician pay, 8% median homeowner taxes, 20% controlled wage-tax benchmark, 15% 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. Employee-market pay and a separate $500K state-taxable wage benchmark, not an actual $500K gross-offer return. CMS malpractice is a relative insurance-cost index, not a specialty quote or legal-policy score. Benefits, local taxes and contract terms remain separate.

Why a $500,000 offer and a state wage average answer different questions

The controlled offer holds household wages at $500,000. The state wage observation describes what employers reported for the Family Medicine Physicians occupation. Using an actual offer tests your opportunity; using the same occupation across states screens labor-market context. Do not replace one with the other midway through a comparison. Part-time work, employer setting and local job mix within Family Medicine can change the published mean.

A contract can overturn the state average

List guaranteed compensation, the production formula, call obligations, coverage, tail responsibility, retirement contributions and vesting. Then compare pay for the same expected work. A higher annual guarantee can lose its advantage if it requires enough additional nights or weekends, or if leaving the position creates an unfunded tail bill. These terms are employer-specific and are not assigned imaginary state scores.

What the malpractice evidence adds

The scored CMS index provides comparable relative malpractice-cost context across all 50 states. Separately, the April 2026 AMA study reports selected states’ changes in manual premiums from 2024 to 2025. A rising share identifies renewal exposure; it does not measure the premium you will pay. State funds and coverage arrangements add another contract question: who pays the underlying policy and any fund assessment? Obtain the answer in the employment agreement before treating an offer as comparable.

Read the retirement benefit before valuing it

For 2026, the IRS lists a $24,500 basic elective deferral limit, subject to compensation and plan rules. Employer contributions, vesting and any separate plan features require their own review. A state ranking cannot tell you what a particular hospital contributes. Use the plan document and the actual benefit schedule when turning salary into a household savings forecast.

Separate the destination from the work arrangement

An employee who lives in one state and covers shifts in another needs a workday and residency analysis. Telemedicine can add licensing and sourcing questions. Local income taxes and payroll programs also belong to the relevant address and work arrangement. The score does not compute a full resident/nonresident return, so the final move decision still needs a current household tax projection.

How to use the shortlist

Inspect the published financial factors and quality-of-life category separately. Their weights are fixed for all readers. Identify whether a state’s advantage comes from compensation, costs or amenities. Visit the actual neighborhood, test the commute after a call shift and review the spouse’s employment options before accepting.

Put the numbers in contextA worked example with explicit assumptions.

Offer illustration, not a tax estimate: Offer A pays $400,000 with 2,000 expected working hours; Offer B pays $440,000 with 2,400 hours. The gross ratios are $200 and about $183 per hour. Benefits, unpaid administration, call intensity and taxes still need separate lines. A salary-only ranking misses that distinction.

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 reports a $169,720 mean employee wage for Family Medicine Physicians, compared with $280,870 in Georgia. Its regional price level is 7.8% lower than Georgia’s, putting Alabama behind on price-adjusted pay for this occupation. The physician wage is less striking than Kentucky’s or Tennessee’s, so its appeal is retaining more room in the budget from a credible offer rather than assuming the state supplies the highest salary.

The 2025 BLS mean employee wage is $169,720; dividing by the 2024 BEA price index of 88.823 gives $191,077 in price-adjusted pay (position 50 among numeric observations). The 2024 median home value of $233,300 equals 1.37 times that gross pay.

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.

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 reports a $307,210 mean employee wage for Family Medicine Physicians, compared with $274,210 in Washington. Its regional price level is 4.3% lower than Washington’s, putting Alaska ahead on price-adjusted pay for this occupation. The statewide amenities category cannot price a particular Alaska community: assess the location, travel arrangements and call schedule directly.

The 2025 BLS mean employee wage is $307,210; dividing by the 2024 BEA price index of 102.359 gives $300,130 in price-adjusted pay (position 15 among numeric observations). The 2024 median home value of $376,500 equals 1.23 times that gross pay.

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.

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 reports a $310,630 mean employee wage for Family Medicine Physicians, compared with $238,170 in New Mexico. Its regional price level is 9.2% higher than New Mexico’s, putting Arizona ahead on price-adjusted pay for this occupation. Sampling error still matters: compare specialty-specific offers and the actual Phoenix, Tucson or other local budget before relying on a small score difference.

The 2025 BLS mean employee wage is $310,630; dividing by the 2024 BEA price index of 100.677 gives $308,541 in price-adjusted pay (position 8 among numeric observations). The 2024 median home value of $426,000 equals 1.37 times that gross pay.

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.

Read the Arizona retirement-tax details
ArkansasRead state analysis

Arkansas

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

Arkansas reports a $232,230 mean employee wage for Family Medicine Physicians, compared with $329,940 in Oklahoma. Its regional price level is 1.0% lower than Oklahoma’s, putting Arkansas behind on price-adjusted pay for this occupation. An actual specialty offer can change the conclusion, but a W-2 applicant should verify compensation before assuming the state’s affordability will dominate the household result.

The 2025 BLS mean employee wage is $232,230; dividing by the 2024 BEA price index of 86.937 gives $267,124 in price-adjusted pay (position 25 among numeric observations). The 2024 median home value of $215,600 equals 0.93 times that gross pay.

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.

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 reports a $252,930 mean employee wage for Family Medicine Physicians, compared with $275,320 in Oregon. Its regional price level is 7.1% higher than Oregon’s, putting California behind on price-adjusted pay for this occupation. A specific role and a realistic local housing plan must justify the financial tradeoff.

The 2025 BLS mean employee wage is $252,930; dividing by the 2024 BEA price index of 110.720 gives $228,441 in price-adjusted pay (position 43 among numeric observations). The 2024 median home value of $759,500 equals 3.00 times that gross pay.

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.

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 reports a $249,500 mean employee wage for Family Medicine Physicians, compared with $297,110 in Utah. Its regional price level is 4.2% higher than Utah’s, putting Colorado behind on price-adjusted pay for this occupation. The employment question is whether the desired community and role warrant committing more of the paycheck to housing than the same household would in Wyoming or New Mexico.

The 2025 BLS mean employee wage is $249,500; dividing by the 2024 BEA price index of 103.052 gives $242,111 in price-adjusted pay (position 38 among numeric observations). The 2024 median home value of $574,600 equals 2.30 times that gross pay.

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.

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 reports a $200,820 mean employee wage for Family Medicine Physicians, compared with $271,340 in Massachusetts. Its regional price level is 2.0% lower than Massachusetts’s, putting Connecticut behind on price-adjusted pay for this occupation. Compare the precise specialty opportunity and household commute with alternatives, because a strong local employer or spouse’s role could be much more valuable than the broad wage series reveals.

The 2025 BLS mean employee wage is $200,820; dividing by the 2024 BEA price index of 103.610 gives $193,823 in price-adjusted pay (position 49 among numeric observations). The 2024 median home value of $396,900 equals 1.98 times that gross pay.

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.

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 reports a $226,230 mean employee wage for Family Medicine Physicians, compared with $298,410 in Pennsylvania. Its regional price level is 2.3% higher than Pennsylvania’s, putting Delaware behind on price-adjusted pay for this occupation. An offer should therefore be assessed on its actual work and location rather than on a broad financial or amenities superlative.

The 2025 BLS mean employee wage is $226,230; dividing by the 2024 BEA price index of 99.808 gives $226,665 in price-adjusted pay (position 45 among numeric observations). The 2024 median home value of $371,600 equals 1.64 times that gross pay.

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.

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 reports a $222,290 mean employee wage for Family Medicine Physicians, compared with $280,870 in Georgia. Its regional price level is 7.4% higher than Georgia’s, putting Florida behind on price-adjusted pay for this occupation. Confirm that the particular job and community justify the cost difference before deciding that a headline tax characteristic settles the move.

The 2025 BLS mean employee wage is $222,290; dividing by the 2024 BEA price index of 103.414 gives $214,952 in price-adjusted pay (position 46 among numeric observations). The 2024 median home value of $396,900 equals 1.79 times that gross pay.

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.

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 reports a $280,870 mean employee wage for Family Medicine Physicians, compared with $222,290 in Florida. Its regional price level is 6.9% lower than Florida’s, putting Georgia ahead on price-adjusted pay for this occupation. The result gives a useful starting question for actual offers: how much compensation or personal value would the Florida option need to add to justify the household cost difference?

The 2025 BLS mean employee wage is $280,870; dividing by the 2024 BEA price index of 96.293 gives $291,683 in price-adjusted pay (position 17 among numeric observations). The 2024 median home value of $343,300 equals 1.22 times that gross pay.

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.

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 reports a $222,540 mean employee wage for Family Medicine Physicians, compared with $252,930 in California. Its regional price level is 0.7% lower than California’s, putting Hawaii behind on price-adjusted pay for this occupation. A household that specifically wants island living needs an actual housing and transport budget before interpreting the wage as a lifestyle upgrade.

The 2025 BLS mean employee wage is $222,540; dividing by the 2024 BEA price index of 109.951 gives $202,399 in price-adjusted pay (position 47 among numeric observations). The 2024 median home value of $875,900 equals 3.94 times that gross pay.

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.

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 reports a $307,400 mean employee wage for Family Medicine Physicians, compared with $337,850 in Montana. Its regional price level is 0.9% higher than Montana’s, putting Idaho behind on price-adjusted pay for this occupation. A Boise-area or other local offer should be judged directly before drawing fine distinctions from the statewide grade.

The 2025 BLS mean employee wage is $307,400; dividing by the 2024 BEA price index of 95.494 gives $321,905 in price-adjusted pay (position 4 among numeric observations). The 2024 median home value of $446,400 equals 1.45 times that gross pay.

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.

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

Illinois reports a $229,370 mean employee wage for Family Medicine Physicians, compared with $285,950 in Indiana. Its regional price level is 7.1% higher than Indiana’s, putting Illinois behind on price-adjusted pay for this occupation. A strong specialty offer or existing housing can improve the personal case; the average does not establish that every Chicago or downstate role pays poorly.

The 2025 BLS mean employee wage is $229,370; dividing by the 2024 BEA price index of 99.958 gives $229,466 in price-adjusted pay (position 42 among numeric observations). The 2024 median home value of $280,700 equals 1.22 times that gross pay.

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.

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 reports a $285,950 mean employee wage for Family Medicine Physicians, compared with $226,800 in Ohio. Its regional price level is 0.6% higher than Ohio’s, putting Indiana ahead on price-adjusted pay for this occupation. The contract still needs scrutiny: ask how fund qualification, underlying malpractice coverage and departure obligations are handled for the particular physician.

The 2025 BLS mean employee wage is $285,950; dividing by the 2024 BEA price index of 93.329 gives $306,389 in price-adjusted pay (position 9 among numeric observations). The 2024 median home value of $243,500 equals 0.85 times that gross pay.

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.

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 reports a $279,120 mean employee wage for Family Medicine Physicians, compared with $259,630 in Nebraska. Its regional price level is 2.6% lower than Nebraska’s, putting Iowa ahead on price-adjusted pay for this occupation. A W-2 physician can use this combination to compare the entire offer against actual local spending without needing an exceptional nominal salary to make the budget work.

The 2025 BLS mean employee wage is $279,120; dividing by the 2024 BEA price index of 87.762 gives $318,042 in price-adjusted pay (position 5 among numeric observations). The 2024 median home value of $227,300 equals 0.81 times that gross pay.

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.

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 reports a $236,160 mean employee wage for Family Medicine Physicians, compared with $259,630 in Nebraska. Its regional price level is 0.0% lower than Nebraska’s, putting Kansas behind on price-adjusted pay for this occupation. Review the specific specialty offer, then separate the malpractice policy and fund surcharge so compensation comparisons use the same responsibilities on each side.

The 2025 BLS mean employee wage is $236,160; dividing by the 2024 BEA price index of 90.068 gives $262,202 in price-adjusted pay (position 28 among numeric observations). The 2024 median home value of $238,700 equals 1.01 times that gross pay.

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.

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.

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 reports a $254,740 mean employee wage for Family Medicine Physicians, compared with $284,650 in Tennessee. Its regional price level is 1.9% lower than Tennessee’s, putting Kentucky behind on price-adjusted pay for this occupation. A household that likes its chosen community may reasonably weigh that statewide proxy less.

The 2025 BLS mean employee wage is $254,740; dividing by the 2024 BEA price index of 90.159 gives $282,545 in price-adjusted pay (position 21 among numeric observations). The 2024 median home value of $226,000 equals 0.89 times that gross pay.

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.

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 reports a $267,230 mean employee wage for Family Medicine Physicians, compared with $265,510 in Mississippi. Its regional price level is 1.4% higher than Mississippi’s, putting Louisiana behind on price-adjusted pay for this occupation. Confirm the actual home’s coverage and the employment agreement’s policy and fund responsibilities before accepting the apparent margin.

The 2025 BLS mean employee wage is $267,230; dividing by the 2024 BEA price index of 88.207 gives $302,958 in price-adjusted pay (position 13 among numeric observations). The 2024 median home value of $223,200 equals 0.84 times that gross pay.

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.

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 reports a $239,970 mean employee wage for Family Medicine Physicians, compared with $250,990 in New Hampshire. Its regional price level is 6.8% lower than New Hampshire’s, putting Maine ahead on price-adjusted pay for this occupation. Maine’s lower observed wage than New Hampshire calls for a direct specialty-offer comparison; verify the hours and precise community before choosing between New England locations.

The 2025 BLS mean employee wage is $239,970; dividing by the 2024 BEA price index of 97.050 gives $247,264 in price-adjusted pay (position 35 among numeric observations). The 2024 median home value of $341,900 equals 1.42 times that gross pay.

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.

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 reports a $279,010 mean employee wage for Family Medicine Physicians, compared with $252,590 in Virginia. Its regional price level is 3.8% higher than Virginia’s, putting Maryland ahead on price-adjusted pay for this occupation. Compare the actual residence and commute instead of assuming the statewide average represents every Baltimore-area or Washington-area opportunity.

The 2025 BLS mean employee wage is $279,010; dividing by the 2024 BEA price index of 104.959 gives $265,828 in price-adjusted pay (position 27 among numeric observations). The 2024 median home value of $436,300 equals 1.56 times that gross pay.

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.

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 reports a $271,340 mean employee wage for Family Medicine Physicians, compared with $250,990 in New Hampshire. Its regional price level is 1.5% higher than New Hampshire’s, putting Massachusetts ahead on price-adjusted pay for this occupation. Evaluate research, teaching or specialty opportunities on their real contract terms without claiming the state average prices those benefits.

The 2025 BLS mean employee wage is $271,340; dividing by the 2024 BEA price index of 105.757 gives $256,569 in price-adjusted pay (position 31 among numeric observations). The 2024 median home value of $607,400 equals 2.24 times that gross pay.

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.

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 reports a $219,610 mean employee wage for Family Medicine Physicians, compared with $292,050 in Wisconsin. Its regional price level is 2.3% higher than Wisconsin’s, putting Michigan behind on price-adjusted pay for this occupation. The strongest personal case may combine a better-than-benchmark offer with the state’s manageable household costs.

The 2025 BLS mean employee wage is $219,610; dividing by the 2024 BEA price index of 96.217 gives $228,244 in price-adjusted pay (position 44 among numeric observations). The 2024 median home value of $254,200 equals 1.16 times that gross pay.

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.

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 reports a $272,380 mean employee wage for Family Medicine Physicians, compared with $292,050 in Wisconsin. Its regional price level is 4.8% higher than Wisconsin’s, putting Minnesota behind on price-adjusted pay for this occupation. This is a more balanced starting profile than a state relying entirely on cheap living or entirely on an amenities rank.

The 2025 BLS mean employee wage is $272,380; dividing by the 2024 BEA price index of 98.621 gives $276,189 in price-adjusted pay (position 22 among numeric observations). The 2024 median home value of $344,600 equals 1.27 times that gross pay.

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.

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 reports a $265,510 mean employee wage for Family Medicine Physicians, compared with $169,720 in Alabama. Its regional price level is 2.1% lower than Alabama’s, putting Mississippi ahead on price-adjusted pay for this occupation. A household with local ties and a confirmed stronger offer may reasonably find more value than the statewide composite suggests.

The 2025 BLS mean employee wage is $265,510; dividing by the 2024 BEA price index of 86.953 gives $305,349 in price-adjusted pay (position 12 among numeric observations). The 2024 median home value of $186,500 equals 0.70 times that gross pay.

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.

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 reports a $214,250 mean employee wage for Family Medicine Physicians, compared with $279,120 in Iowa. Its regional price level is 3.5% higher than Iowa’s, putting Missouri behind on price-adjusted pay for this occupation. Use the actual St. Louis, Kansas City or other local housing and work arrangement to decide whether the economics improve.

The 2025 BLS mean employee wage is $214,250; dividing by the 2024 BEA price index of 90.817 gives $235,914 in price-adjusted pay (position 40 among numeric observations). The 2024 median home value of $254,400 equals 1.19 times that gross pay.

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.

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 reports a $337,850 mean employee wage for Family Medicine Physicians, compared with $307,400 in Idaho. Its regional price level is 0.9% lower than Idaho’s, putting Montana ahead on price-adjusted pay for this occupation. The key employment check is whether the actual specialty and workload support the reported advantage; the statewide mean does not promise an available job at that wage.

The 2025 BLS mean employee wage is $337,850; dividing by the 2024 BEA price index of 94.645 gives $356,966 in price-adjusted pay (position 3 among numeric observations). The 2024 median home value of $425,400 equals 1.26 times that gross pay.

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.

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 reports a $259,630 mean employee wage for Family Medicine Physicians, compared with $236,160 in Kansas. Its regional price level is 0.0% higher than Kansas’s, putting Nebraska ahead on price-adjusted pay for this occupation. A W-2 offer should also clarify the underlying malpractice policy and any fund qualification or surcharge responsibilities.

The 2025 BLS mean employee wage is $259,630; dividing by the 2024 BEA price index of 90.103 gives $288,148 in price-adjusted pay (position 20 among numeric observations). The 2024 median home value of $263,100 equals 1.01 times that gross pay.

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.

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 reports a $242,460 mean employee wage for Family Medicine Physicians, compared with $310,630 in Arizona. Its regional price level is 0.7% lower than Arizona’s, putting Nevada behind on price-adjusted pay for this occupation. The state’s amenities-category result is more favorable than several low-cost alternatives, so a particular Las Vegas, Reno or other opportunity needs a deliberate price-versus-preference decision.

The 2025 BLS mean employee wage is $242,460; dividing by the 2024 BEA price index of 99.979 gives $242,511 in price-adjusted pay (position 37 among numeric observations). The 2024 median home value of $455,500 equals 1.88 times that gross pay.

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.

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 reports a $250,990 mean employee wage for Family Medicine Physicians, compared with $271,340 in Massachusetts. Its regional price level is 1.5% lower than Massachusetts’s, putting New Hampshire behind on price-adjusted pay for this occupation. An employee choosing between the two should compare the actual residence, work location and commute rather than assume a state-level headline determines take-home economics.

The 2025 BLS mean employee wage is $250,990; dividing by the 2024 BEA price index of 104.165 gives $240,954 in price-adjusted pay (position 39 among numeric observations). The 2024 median home value of $458,800 equals 1.83 times that gross pay.

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.

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 reports a $291,470 mean employee wage for Family Medicine Physicians, compared with $298,410 in Pennsylvania. Its regional price level is 11.5% higher than Pennsylvania’s, putting New Jersey behind on price-adjusted pay for this occupation. A particular specialty opportunity, family network or spouse’s career may justify the location; use that actual value and an address-specific budget rather than expect the broad wage screen to settle the question.

The 2025 BLS mean employee wage is $291,470; dividing by the 2024 BEA price index of 108.805 gives $267,883 in price-adjusted pay (position 24 among numeric observations). The 2024 median home value of $496,000 equals 1.70 times that gross pay.

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.

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 reports a $238,170 mean employee wage for Family Medicine Physicians, compared with $310,630 in Arizona. Its regional price level is 8.4% lower than Arizona’s, putting New Mexico behind on price-adjusted pay for this occupation. The employment decision still needs an actual coverage arrangement and local offer; the score does not measure professional liability premiums, a specific hospital’s resources or the availability of a particular specialty position.

The 2025 BLS mean employee wage is $238,170; dividing by the 2024 BEA price index of 92.212 gives $258,285 in price-adjusted pay (position 30 among numeric observations). The 2024 median home value of $279,900 equals 1.18 times that gross pay.

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.

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 reports a $211,570 mean employee wage for Family Medicine Physicians, compared with $298,410 in Pennsylvania. Its regional price level is 10.6% higher than Pennsylvania’s, putting New York behind on price-adjusted pay for this occupation. A role-specific budget is essential before interpreting the balanced score as a compensation advantage.

The 2025 BLS mean employee wage is $211,570; dividing by the 2024 BEA price index of 107.921 gives $196,042 in price-adjusted pay (position 48 among numeric observations). The 2024 median home value of $449,800 equals 2.13 times that gross pay.

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.

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 reports a $220,360 mean employee wage for Family Medicine Physicians, compared with $244,960 in South Carolina. Its regional price level is 0.6% higher than South Carolina’s, putting North Carolina behind on price-adjusted pay for this occupation. An actual specialty offer can change that comparison, so the next step is to match compensation and work expectations in the specific communities.

The 2025 BLS mean employee wage is $220,360; dividing by the 2024 BEA price index of 94.326 gives $233,615 in price-adjusted pay (position 41 among numeric observations). The 2024 median home value of $333,000 equals 1.51 times that gross pay.

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.

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 reports a $272,470 mean employee wage for Family Medicine Physicians, compared with $258,390 in South Dakota. Its regional price level is 0.4% higher than South Dakota’s, putting North Dakota ahead on price-adjusted pay for this occupation. Confirm that an actual specialty offer and work expectations support the statewide wage advantage before using it as a relocation forecast.

The 2025 BLS mean employee wage is $272,470; dividing by the 2024 BEA price index of 88.959 gives $306,287 in price-adjusted pay (position 10 among numeric observations). The 2024 median home value of $266,100 equals 0.98 times that gross pay.

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.

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 reports a $226,800 mean employee wage for Family Medicine Physicians, compared with $285,950 in Indiana. Its regional price level is 0.6% lower than Indiana’s, putting Ohio behind on price-adjusted pay for this occupation. The next comparison is local: match the specialty offer, actual work schedule and housing near the employer before assuming each metropolitan or smaller market shares the same statewide result.

The 2025 BLS mean employee wage is $226,800; dividing by the 2024 BEA price index of 92.774 gives $244,465 in price-adjusted pay (position 36 among numeric observations). The 2024 median home value of $239,800 equals 1.06 times that gross pay.

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.

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 reports a $329,940 mean employee wage for Family Medicine Physicians, compared with $232,230 in Arkansas. Its regional price level is 1.0% higher than Arkansas’s, putting Oklahoma ahead on price-adjusted pay for this occupation. A W-2 offer should be evaluated against both sides of that cost profile rather than assuming low daily prices mean every household expense will also be low.

The 2025 BLS mean employee wage is $329,940; dividing by the 2024 BEA price index of 87.843 gives $375,602 in price-adjusted pay (position 1 among numeric observations). The 2024 median home value of $222,100 equals 0.67 times that gross pay.

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.

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 reports a $275,320 mean employee wage for Family Medicine Physicians, compared with $274,210 in Washington. Its regional price level is 3.4% lower than Washington’s, putting Oregon ahead on price-adjusted pay for this occupation. Its favorable amenities category gives it a credible balanced case, but the actual city, specialty and contract terms must establish whether those state-level differences translate into the household budget.

The 2025 BLS mean employee wage is $275,320; dividing by the 2024 BEA price index of 103.361 gives $266,367 in price-adjusted pay (position 26 among numeric observations). The 2024 median home value of $497,500 equals 1.81 times that gross pay.

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.

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 reports a $298,410 mean employee wage for Family Medicine Physicians, compared with $291,470 in New Jersey. Its regional price level is 10.3% lower than New Jersey’s, putting Pennsylvania ahead on price-adjusted pay for this occupation. The employment comparison should also identify who funds the primary malpractice policy and Mcare assessment rather than treating employer-paid coverage as one undifferentiated benefit.

The 2025 BLS mean employee wage is $298,410; dividing by the 2024 BEA price index of 97.572 gives $305,836 in price-adjusted pay (position 11 among numeric observations). The 2024 median home value of $277,600 equals 0.93 times that gross pay.

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.

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.

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 reports a $365,960 mean employee wage for Family Medicine Physicians, compared with $271,340 in Massachusetts. Its regional price level is 3.3% lower than Massachusetts’s, putting Rhode Island ahead on price-adjusted pay for this occupation. The strong Family Medicine observation warrants an offer-level comparison, with the sample uncertainty, expected hours and local housing budget kept visible.

The 2025 BLS mean employee wage is $365,960; dividing by the 2024 BEA price index of 102.280 gives $357,802 in price-adjusted pay (position 2 among numeric observations). The 2024 median home value of $455,700 equals 1.25 times that gross pay.

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.

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 reports a $244,960 mean employee wage for Family Medicine Physicians, compared with $220,360 in North Carolina. Its regional price level is 0.6% lower than North Carolina’s, putting South Carolina ahead on price-adjusted pay for this occupation. Match the actual community and specialty offer to see whether the pay-and-housing advantage outweighs the household’s preference for an alternative location.

The 2025 BLS mean employee wage is $244,960; dividing by the 2024 BEA price index of 93.749 gives $261,293 in price-adjusted pay (position 29 among numeric observations). The 2024 median home value of $299,500 equals 1.22 times that gross pay.

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.

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 reports a $258,390 mean employee wage for Family Medicine Physicians, compared with $272,470 in North Dakota. Its regional price level is 0.4% lower than North Dakota’s, putting South Dakota behind on price-adjusted pay for this occupation. Compare the actual specialty, paid hours and call responsibilities in Sioux Falls, Rapid City or the intended community before treating a statewide employee average as an offer.

The 2025 BLS mean employee wage is $258,390; dividing by the 2024 BEA price index of 88.586 gives $291,683 in price-adjusted pay (position 17 among numeric observations). The 2024 median home value of $289,600 equals 1.12 times that gross pay.

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.

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 reports a $284,650 mean employee wage for Family Medicine Physicians, compared with $254,740 in Kentucky. Its regional price level is 1.9% higher than Kentucky’s, putting Tennessee ahead on price-adjusted pay for this occupation. The amenities category is also lower than several other states, making the actual community and household preferences important to the balanced result.

The 2025 BLS mean employee wage is $284,650; dividing by the 2024 BEA price index of 91.870 gives $309,840 in price-adjusted pay (position 7 among numeric observations). The 2024 median home value of $332,600 equals 1.17 times that gross pay.

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.

Read the Tennessee retirement-tax details
TexasRead state analysis

Texas

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

Texas reports a $262,580 mean employee wage for Family Medicine Physicians, compared with $329,940 in Oklahoma. Its regional price level is 10.5% higher than Oklahoma’s, putting Texas behind on price-adjusted pay for this occupation. An actual specialty offer can make the state attractive, yet the household comparison needs those recurring costs rather than relying on a single income-tax characteristic.

The 2025 BLS mean employee wage is $262,580; dividing by the 2024 BEA price index of 97.057 gives $270,542 in price-adjusted pay (position 23 among numeric observations). The 2024 median home value of $313,200 equals 1.19 times that gross pay.

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.

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 reports a $297,110 mean employee wage for Family Medicine Physicians, compared with $249,500 in Colorado. Its regional price level is 4.1% lower than Colorado’s, putting Utah ahead on price-adjusted pay for this occupation. Compare the actual specialty offer before committing to housing around the state’s reputation.

The 2025 BLS mean employee wage is $297,110; dividing by the 2024 BEA price index of 98.864 gives $300,524 in price-adjusted pay (position 14 among numeric observations). The 2024 median home value of $545,200 equals 1.84 times that gross pay.

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.

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 reports a $249,620 mean employee wage for Family Medicine Physicians, compared with $250,990 in New Hampshire. Its regional price level is 6.0% lower than New Hampshire’s, putting Vermont ahead on price-adjusted pay for this occupation. A physician who values the local setting should compare the actual Vermont role, housing budget and travel needs directly; the published quality-of-life weight stays fixed.

The 2025 BLS mean employee wage is $249,620; dividing by the 2024 BEA price index of 97.958 gives $254,823 in price-adjusted pay (position 33 among numeric observations). The 2024 median home value of $352,800 equals 1.41 times that gross pay.

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.

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 reports a $252,590 mean employee wage for Family Medicine Physicians, compared with $220,360 in North Carolina. Its regional price level is 7.2% higher than North Carolina’s, putting Virginia ahead on price-adjusted pay for this occupation. The statewide screen does not settle the choice between different Virginia communities; match the actual role, residence and household commute before interpreting a state-level grade.

The 2025 BLS mean employee wage is $252,590; dividing by the 2024 BEA price index of 101.104 gives $249,832 in price-adjusted pay (position 34 among numeric observations). The 2024 median home value of $403,500 equals 1.60 times that gross pay.

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.

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 reports a $274,210 mean employee wage for Family Medicine Physicians, compared with $275,320 in Oregon. Its regional price level is 3.5% higher than Oregon’s, putting Washington behind on price-adjusted pay for this occupation. A specific role may justify the housing commitment, but the offer needs to support the actual community and commute rather than an assumed statewide purchasing-power advantage.

The 2025 BLS mean employee wage is $274,210; dividing by the 2024 BEA price index of 107.013 gives $256,240 in price-adjusted pay (position 32 among numeric observations). The 2024 median home value of $602,200 equals 2.20 times that gross pay.

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.

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 reports a $260,430 mean employee wage for Family Medicine Physicians, compared with $254,740 in Kentucky. Its regional price level is 0.7% lower than Kentucky’s, putting West Virginia ahead on price-adjusted pay for this occupation. Its low amenities-category position makes local family fit and the actual employment opportunity particularly important to the balanced decision.

The 2025 BLS mean employee wage is $260,430; dividing by the 2024 BEA price index of 89.497 gives $290,993 in price-adjusted pay (position 19 among numeric observations). The 2024 median home value of $170,800 equals 0.66 times that gross pay.

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.

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 reports a $292,050 mean employee wage for Family Medicine Physicians, compared with $219,610 in Michigan. Its regional price level is 2.2% lower than Michigan’s, putting Wisconsin ahead on price-adjusted pay for this occupation. Confirm the actual specialty and work terms, but this is a case where several measured factors point in the same financial direction.

The 2025 BLS mean employee wage is $292,050; dividing by the 2024 BEA price index of 94.095 gives $310,378 in price-adjusted pay (position 6 among numeric observations). The 2024 median home value of $294,700 equals 1.01 times that gross pay.

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.

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 reports a $278,070 mean employee wage for Family Medicine Physicians, compared with $249,500 in Colorado. Its regional price level is 10.1% lower than Colorado’s, putting Wyoming ahead on price-adjusted pay for this occupation. Verify the actual specialty offer and location; the statewide compensation average cannot establish a job opening or whether a particular call arrangement is sustainable.

The 2025 BLS mean employee wage is $278,070; dividing by the 2024 BEA price index of 92.691 gives $299,997 in price-adjusted pay (position 16 among numeric observations). The 2024 median home value of $339,500 equals 1.22 times that gross pay.

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.

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

  • How far physician pay goes: 42% of the financial share
  • Home prices compared with pay: 15% of the financial share
  • Homeowner property taxes: 8% of the financial share
  • State wage tax: $500,000 taxable, joint: 20% of the financial share
  • Malpractice insurance costs: 15% 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

Employee-market pay and a separate $500K state-taxable wage benchmark, not an actual $500K gross-offer return. CMS malpractice is a relative insurance-cost index, not a specialty quote or legal-policy score. Benefits, local taxes and contract terms remain separate.

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

  1. Choose the named measure and its source year.
  2. Apply the formula displayed beside the map to the source observation for each state.
  3. 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.
  4. Give equal ranking values the same competition rank (composites use two decimals; cards show one). After a tie, skip the occupied positions.
  5. 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.

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

Which states should a high-income employed physician investigate first?

Use the ranked screening results, then compare actual specialty offers. Inspect price-adjusted Family Medicine pay, housing, the controlled tax example and malpractice-cost context together. The published quality-of-life weight is fixed at 20%; actual family and career priorities can still lead you to choose a more expensive state. None of those observations establishes your salary or tax bill.

Why do you use Family Medicine Physicians rather than average doctor pay?

It is one consistent BLS occupation across states. This single specialty has a published numeric mean in every state. It is not an average of every physician or a subspecialty salary survey.

Are benefits and call pay included in the wage figures?

BLS OEWS measures straight-time wages and excludes employer nonwage benefits, on-call pay and overtime premiums. Add your actual employment benefits and contract terms separately.

How is South Dakota included in the physician ranking?

BLS publishes a 2025 mean annual Family Medicine Physician wage of $258,390 for South Dakota. Taxstra uses that same occupation in all 50 states. The broader Physicians, All Other row is suppressed in South Dakota, so it is not the scored wage benchmark.

Does employer-paid malpractice eliminate the issue?

No. Verify policy form, limits, who is insured, prior-acts coverage and responsibility after departure. An employer’s current premium payment does not establish who must fund tail coverage later.

Can a low-scoring state still be the best career move?

Yes. A specific academic role, practice partnership, spouse’s career or local support network can outweigh the statewide screen. The model does not price those personal opportunities.

Is the score a 2026 take-home-pay ranking?

No. It combines dated wage, cost and livability observations. A 2026 household tax return requires filing status, gross-to-taxable adjustments, work locations, local taxes and other income.

Does a one-tenth-point lead establish a better physician job market?

No. Scores round to one decimal place, and composite positions use two-decimal scores and retain ties at that precision. BLS wages are survey estimates with sampling error and different employer and job mixes within Family Medicine. A small score difference is a shortlist signal, not a statistically established compensation advantage. Compare offers for the same specialty and expected hours.

Can California be a good choice for a high-income physician?

Yes. A physician may reasonably prefer California for a particular practice, partner’s career, family network or lifestyle even when another state has lower costs. The balanced view makes lifestyle part of the comparison. Model the actual job offer, housing and taxes before deciding whether its financial tradeoff works for you.

Why can a lower-cost state rank well on pay but fall in the balanced view?

Price-adjusted pay measures purchasing power. It does not measure whether you want to live there. Adding the quality-of-life component changes the question and can change the ranking substantially. A low-cost state can still be the right choice for someone whose work and personal preferences fit it.

Should I compare statewide physician averages or actual offers?

Use statewide averages to screen locations, then compare actual offers within the same specialty. Base pay, call, workload, bonuses, benefits and employer-paid coverage can outweigh the difference between state averages.

What should I compare before accepting an out-of-state physician job?

Build a household budget around the written offer. Include the work location, residence, housing, partner’s employment, childcare, travel to family and coverage obligations. Bring the contract and income mix to your tax planning discussion.

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.

Continue your research

Best States for 1099 Physicians

Compare the costs and state-specific tax questions behind a $500,000 physician contracting practice.

Owner income-tax benchmark · Regional prices · Malpractice cost index · Quality of life

Best States for Physicians to Build Wealth

Compare physician earnings with housing costs and the recurring decisions that shape investable surplus.

State-tax-and-spending margin · Housing / family physician pay · Malpractice cost index · Quality of life

Where Bonus Depreciation Is Most Valuable

State conformity, individual versus corporate treatment, addbacks and recovery timing.

First-year deduction tax value · Retained bonus by taxpayer type · State expensing assumptions

Use the related calculator · View all 14 guides

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