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Best States for Physicians to Build Wealth

See how state taxes, everyday costs, housing and malpractice costs can affect a physician’s ability to build wealth.

Leading states in this comparison · Published 2026 methodology

  1. #1 Texas8.6 / 10
  2. #2 South Dakota8.4 / 10
  3. #3 Tennessee8.2 / 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

See how state taxes, everyday costs, housing and malpractice costs can affect a physician’s ability to build wealth.

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 #31 of 50, with 5.9 / 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

Physician wealth

Illinois

Taxstra’s state comparison

Illinois outline
5.9/ 10

Overall score#31 in the comparison

80% cost and financial score (5.1/10) · 20% quality of life (9.3/10)

How to read this score

The planning margin subtracts controlled state tax and a regional spending basket from $500K; it is not take-home pay, investable savings or a net-worth forecast. Federal/payroll/local taxes, debt and benefits are separate. Pay-to-housing and malpractice indices add market context.

Income after selected costs

#35 of 50 · 56% weight
4.7/10

$375,292 remains after selected state taxes and living costs in our example; federal, payroll and local taxes are still excluded.

Home prices compared with pay

#21 of 50 · 16% weight
8.4/10

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

Malpractice insurance costs

#50 of 50 · 8% 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.

Homeowner property taxes

#45 of 50 · Not in overall score
5.2/10

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

Good fit for

  • Physicians with a strong specific offer who value Illinois amenities and manageable purchase prices
  • Households willing to preserve the gap between earnings and spending

Less suited to

  • Buyers treating an inexpensive listing as proof of low long-term carrying costs
  • Plans requiring the state score to predict investment returns

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

Illinois

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

Illinois’s median home value equals 1.22 times the Family Medicine employee mean, compared with 0.85 in Indiana. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $5,399 versus $1,798, so the purchase ratio and recurring tax point in the same direction. Model the actual offer and assessed property, and keep retirement-income rules separate from taxes during the earning years.

The 2024 ACS home value is $280,700, with median gross monthly rent of $1,322 in a different housing sample. Home value divided by the 2025 physician wage is 1.22 times gross pay (position 21 among numeric observations). Homeowner taxes of $5,399 and historical insurance of $1,480 are context rather than a budget for that median home.

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

Physician wealth: economic observations and tax context
RankStatePhysician planning margin and lifestyle gradeHome value
ACS 2024		Property-tax bill
ACS 2024 median		Price index
BEA 2024		Individual bonus treatment
1Texas8.6 / 10$313,200$4,10897.1Texas does not impose a broad individual income tax.
2South Dakota8.4 / 10$289,600$2,94088.6South Dakota does not impose a broad individual income tax.
3Tennessee8.2 / 10$332,600$1,48891.9Tennessee does not impose a broad individual income tax.
4Wyoming7.9 / 10$339,500$1,94792.7Wyoming does not impose a broad individual income tax.
5Iowa7.9 / 10$227,300$2,93787.8Iowa follows current federal depreciation, including §168(k) and §168(n), for 2026 to 2027.
6Florida7.7 / 10$396,900$2,993103.4Florida does not impose a broad individual income tax.
6North Dakota7.7 / 10$266,100$2,55089.0North Dakota follows the federal deductions through its current federal income starting point.
8Nevada7.7 / 10$455,500$2,143100.0Nevada does not impose a broad individual income tax.
9Ohio7.6 / 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.
10Pennsylvania7.5 / 10$277,600$3,21497.6Pennsylvania personal income tax uses its own depreciation rules rather than the federal bonus amount.
11Indiana7.5 / 10$243,500$1,79893.3Add back federal bonus depreciation and maintain Indiana basis for later depreciation or disposition.
12Washington7.3 / 10$602,200$4,729107.0Washington does not impose a broad individual income tax.
13Louisiana7.1 / 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.
14Oklahoma6.9 / 10$222,100$1,67287.8Oklahoma permits a state 100% expensing election for qualifying property; it is not simple federal bonus conformity.
15Nebraska6.9 / 10$263,100$3,73990.1Nebraska follows the current federal depreciation deduction for 2026 to 2027.
16North Carolina6.8 / 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.
17Kansas6.8 / 10$238,700$2,98390.1Current Kansas statutes recognize federal §168(k); a direct current official statement on §168(n) was not located.
18Alaska6.7 / 10$376,500$3,976102.4Alaska does not impose a broad individual income tax.
19Arkansas6.7 / 10$215,600$1,11386.9Federal bonus depreciation is not adopted; use the Arkansas depreciation computation.
20Arizona6.7 / 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.
21New Hampshire6.7 / 10$458,800$6,707104.2New Hampshire does not impose a broad individual income tax.
22Wisconsin6.7 / 10$294,700$3,68094.1Wisconsin does not adopt federal §168(k) or §168(n); compute Wisconsin depreciation separately.
23Mississippi6.6 / 10$186,500$1,22187.0Mississippi permits a state 100% first-year deduction for qualifying depreciable property; it is not simple federal bonus conformity.
24Michigan6.5 / 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.
25Missouri6.5 / 10$254,400$2,02190.8Missouri follows current federal depreciation and does not require a bonus addback for current property.
26Kentucky6.5 / 10$226,000$1,61190.2Kentucky does not adopt the current federal bonus provisions; use Kentucky depreciation.
27Alabama6.0 / 10$233,300$89088.8Follows the federal §168(k) and §168(n) deductions for 2026 to 2027.
28New Mexico6.0 / 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.
29Georgia6.0 / 10$343,300$2,55496.3Use Georgia depreciation without federal §168(k) or §168(n).
30West Virginia6.0 / 10$170,800$88189.5West Virginia adopted the 2025 federal changes, so §168(k) and §168(n) flow through for 2026 to 2027.
31Illinois5.9 / 10$280,700$5,399100.0Reverse federal §168(k)/§168(n) amounts and compute the Illinois depreciation modification.
32Colorado5.9 / 10$574,600$2,828103.1Colorado follows the federal deductions for §168(k) bonus and §168(n) qualified production property.
33South Carolina5.8 / 10$299,500$1,33793.7Use South Carolina depreciation without federal §168(k) or §168(n).
34Idaho5.8 / 10$446,400$1,91295.5Add back the federal bonus difference in the first year; deduct later Idaho-versus-federal depreciation differences.
35Montana5.6 / 10$425,400$2,93994.6Montana begins with the current federal income base and has no current bonus-depreciation addback.
36Utah5.6 / 10$545,200$2,64898.9Utah starts with current federal adjusted gross income and does not enumerate a §168(k) or §168(n) reversal.
37Massachusetts5.4 / 10$607,400$6,080105.8§168(k) remains disallowed. §168(n) is disallowed for 2026 and follows federal law beginning in 2027.
38Virginia5.3 / 10$403,500$2,872101.1Recompute Virginia depreciation as though the federal bonus provisions did not apply.
39Minnesota5.2 / 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.
40Maine5.1 / 10$341,900$3,10397.1Add back the federal bonus amount and claim depreciation under Maine’s pro-forma computation.
41New Jersey5.0 / 10$496,000$9,358108.8New Jersey does not follow the federal bonus deduction; calculate New Jersey depreciation and basis separately.
42Maryland4.6 / 10$436,300$4,144105.0Generally decoupled from federal bonus; qualifying manufacturing property may receive different treatment.
43Rhode Island4.6 / 10$455,700$4,886102.3Compute depreciation and basis as though federal bonus depreciation had not been enacted.
44New York4.5 / 10$449,800$6,542107.9Reverse federal §168(k) and §168(n) deductions and claim New York depreciation.
45Connecticut4.5 / 10$396,900$6,573103.6Add back 100% of federal bonus, then deduct 25% of the addition in each of the next four years.
46Vermont4.4 / 10$352,800$5,02698.0Vermont disallows §168(k) and §168(n), then permits recovery under the non-bonus depreciation schedule.
47Delaware4.1 / 10$371,600$1,75099.8Ordinary eligible 2026 property retains 20% bonus under the pre-OBBBA schedule; the rest follows regular depreciation.
48Oregon3.9 / 10$497,500$3,895103.4Oregon disallows federal bonus depreciation for 2026 to 2027; implementing recovery instructions are pending.
49California3.8 / 10$759,500$5,369110.7California does not conform to federal bonus depreciation; compute California depreciation separately.
50Hawaii2.1 / 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.

Wealth starts with the margin between what you earn and what your life costs. Taxstra compares a controlled state-tax-and-spending margin, housing relative to physician pay and malpractice-cost context, with a fixed quality-of-life category weight. This identifies conditions worth investigating; it does not forecast investment returns, take-home pay or future net worth.

What determines this guide’s grade

70% controlled state-tax-and-spending margin, 20% home value relative to family physician pay, 10% 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. The planning margin subtracts controlled state tax and a regional spending basket from $500K; it is not take-home pay, investable savings or a net-worth forecast. Federal/payroll/local taxes, debt and benefits are separate. Pay-to-housing and malpractice indices add market context.

Housing is the large decision that keeps recurring

A home value/pay ratio puts the purchase price on the scale of gross physician earnings. It is not the years required to save for a home, and it does not include a mortgage rate or maintenance. A larger home also ties up cash and can raise recurring expenses. Compare the actual down payment, debt service and reserves before choosing how much of the income advantage to commit to housing.

Distinguish earning capacity from investable surplus

Start with the signed offer or credible net-practice projection. Subtract federal and state/local taxes, household spending, debt payments, coverage and planned capital costs. What remains is a candidate for saving, not a guarantee. The single BLS Family Medicine occupation cannot establish a family’s total earnings, a spouse’s career or the durability of a production bonus.

Why lower homeowner tax and insurance figures are only context

ACS reports taxes paid by the existing owner-occupied housing population, including differences in home values and relief. NAIC reports historical HO-3 premiums across different risks and coverage levels. Neither tells you the bill on a newly purchased doctor’s home. Do not add these survey statistics to a fully priced household budget unless you replace the corresponding actual expense.

Give career durability a place outside the formula

A partnership path, supportive call arrangement or spouse’s career can justify a more expensive state. Conversely, an unsustainable schedule can interrupt the projected saving rate. Review the fixed financial and quality-of-life components separately, then examine the work arrangement directly. Our livability proxy covers statewide amenities and daily-life context; it does not measure a particular employer’s culture or a household’s happiness.

Keep investing separate from tax marketing

A retirement contribution uses cash even when it reduces taxable income. A rental purchase brings financing, operating risk and a second set of records. A state’s housing affordability is not evidence that an investment property will produce a particular yield, nor does a depreciation deduction establish usable current tax savings. Build a surplus first, then compare the specific investment and its tax treatment.

Read state differences as a decision sequence

Use the published financial component to find places with favorable starting economics. Compare those places with states that fit family and career priorities. Obtain two actual offers and two housing budgets, then run the taxes on the same assumptions. Keep the chosen state’s projected surplus visible in an annual plan so future upgrades do not quietly consume it.

Put the numbers in contextA worked example with explicit assumptions.

Budget sensitivity only: two households with the same after-tax cash income differ by $3,000 per month in housing and other recurring spending. The arithmetic difference is $36,000 per year, or $180,000 over five years before investment returns. The example assumes no return and makes no claim about a client or a state’s future home prices.

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’s median home value equals 1.37 times the Family Medicine employee mean, compared with 1.22 in Georgia. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $890 versus $2,554, so the purchase ratio and recurring tax show a tradeoff. Preserve a separate property-specific coverage reserve rather than letting the low tax bill stand in for the entire cost of owning a home.

The 2024 ACS home value is $233,300, with median gross monthly rent of $1,077 in a different housing sample. Home value divided by the 2025 physician wage is 1.37 times gross pay (position 29 among numeric observations). Homeowner taxes of $890 and historical insurance of $1,906 are context rather than a budget for that median home.

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’s median home value equals 1.23 times the Family Medicine employee mean, compared with 2.20 in Washington. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $3,976 versus $4,729, so the purchase ratio and recurring tax point in the same direction. Stress-test a second job at a lower offer before deciding how much of the initial earnings to commit to a purchase.

The 2024 ACS home value is $376,500, with median gross monthly rent of $1,444 in a different housing sample. Home value divided by the 2025 physician wage is 1.23 times gross pay (position 25 among numeric observations). Homeowner taxes of $3,976 and historical insurance of $1,216 are context rather than a budget for that median home.

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.

Source qualification: Depreciation: Section 168(n) production-property treatment and special industries are outside the reviewed ordinary-equipment scenario.

Read the Alaska retirement-tax details
ArizonaRead state analysis

Arizona

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

Arizona’s median home value equals 1.37 times the Family Medicine employee mean, compared with 1.18 in New Mexico. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $1,828 versus $1,776, so the purchase ratio and recurring tax point in the same direction. Compare the cash required for the specific home and the durability of the pay before using the observed ratio to set a purchase ceiling.

The 2024 ACS home value is $426,000, with median gross monthly rent of $1,672 in a different housing sample. Home value divided by the 2025 physician wage is 1.37 times gross pay (position 29 among numeric observations). Homeowner taxes of $1,828 and historical insurance of $1,194 are context rather than a budget for that median home.

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

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

Arkansas’s median home value equals 0.93 times the Family Medicine employee mean, compared with 0.67 in Oklahoma. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $1,113 versus $1,672, so the purchase ratio and recurring tax show a tradeoff. If earnings instead track the weaker wage observation, repeat the savings calculation before taking on a home purchase.

The 2024 ACS home value is $215,600, with median gross monthly rent of $982 in a different housing sample. Home value divided by the 2025 physician wage is 0.93 times gross pay (position 8 among numeric observations). Homeowner taxes of $1,113 and historical insurance of $1,870 are context rather than a budget for that median home.

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

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

California’s median home value equals 3.00 times the Family Medicine employee mean, compared with 1.81 in Oregon. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $5,369 versus $3,895, so the purchase ratio and recurring tax point in the same direction. Compare renting, staying in an existing home and buying near the new employer using actual cash commitments.

The 2024 ACS home value is $759,500, with median gross monthly rent of $2,104 in a different housing sample. Home value divided by the 2025 physician wage is 3.00 times gross pay (position 49 among numeric observations). Homeowner taxes of $5,369 and historical insurance of $1,655 are context rather than a budget for that median home.

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’s median home value equals 2.30 times the Family Medicine employee mean, compared with 1.84 in Utah. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $2,828 versus $2,648, so the purchase ratio and recurring tax point in the same direction. Test the household saving target after actual mortgage, coverage and property-tax quotes before increasing the home budget with a higher offer.

The 2024 ACS home value is $574,600, with median gross monthly rent of $1,822 in a different housing sample. Home value divided by the 2025 physician wage is 2.30 times gross pay (position 48 among numeric observations). Homeowner taxes of $2,828 and historical insurance of $2,492 are context rather than a budget for that median home.

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’s median home value equals 1.98 times the Family Medicine employee mean, compared with 2.24 in Massachusetts. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $6,573 versus $6,080, so the purchase ratio and recurring tax show a tradeoff. Evaluate carrying costs over the expected ownership period and review the career and family reasons for staying long enough to justify transaction and moving costs.

The 2024 ACS home value is $396,900, with median gross monthly rent of $1,550 in a different housing sample. Home value divided by the 2025 physician wage is 1.98 times gross pay (position 44 among numeric observations). Homeowner taxes of $6,573 and historical insurance of $2,036 are context rather than a budget for that median home.

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’s median home value equals 1.64 times the Family Medicine employee mean, compared with 0.93 in Pennsylvania. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $1,750 versus $3,214, so the purchase ratio and recurring tax show a tradeoff. Compare the actual homes over the intended holding period rather than choosing from either the purchase ratio or property-tax column alone.

The 2024 ACS home value is $371,600, with median gross monthly rent of $1,530 in a different housing sample. Home value divided by the 2025 physician wage is 1.64 times gross pay (position 37 among numeric observations). Homeowner taxes of $1,750 and historical insurance of $1,196 are context rather than a budget for that median home.

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’s median home value equals 1.79 times the Family Medicine employee mean, compared with 1.22 in Georgia. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $2,993 versus $2,554, so the purchase ratio and recurring tax point in the same direction. For Florida, confirm the property’s insurability, deductibles and total ongoing costs before translating a physician offer into a long-term saving target.

The 2024 ACS home value is $396,900, with median gross monthly rent of $1,812 in a different housing sample. Home value divided by the 2025 physician wage is 1.79 times gross pay (position 39 among numeric observations). Homeowner taxes of $2,993 and historical insurance of $2,779 are context rather than a budget for that median home.

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’s median home value equals 1.22 times the Family Medicine employee mean, compared with 1.79 in Florida. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $2,554 versus $2,993, so the purchase ratio and recurring tax point in the same direction. Preserve flexibility if the physician’s work and the spouse’s career point to different communities.

The 2024 ACS home value is $343,300, with median gross monthly rent of $1,506 in a different housing sample. Home value divided by the 2025 physician wage is 1.22 times gross pay (position 21 among numeric observations). Homeowner taxes of $2,554 and historical insurance of $1,828 are context rather than a budget for that median home.

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’s median home value equals 3.94 times the Family Medicine employee mean, compared with 3.00 in California. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $2,385 versus $5,369, so the purchase ratio and recurring tax show a tradeoff. Existing homeowners and arriving buyers face different cash requirements; evaluate the actual household position instead of treating the state’s wealth score as an instruction to buy.

The 2024 ACS home value is $875,900, with median gross monthly rent of $1,942 in a different housing sample. Home value divided by the 2025 physician wage is 3.94 times gross pay (position 50 among numeric observations). Homeowner taxes of $2,385 and historical insurance of $1,549 are context rather than a budget for that median home.

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’s median home value equals 1.45 times the Family Medicine employee mean, compared with 1.26 in Montana. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $1,912 versus $2,939, so the purchase ratio and recurring tax show a tradeoff. A household pursuing wealth accumulation should keep a firm saving target when comparing actual homes; a favorable daily-life preference does not make the larger capital commitment disappear.

The 2024 ACS home value is $446,400, with median gross monthly rent of $1,384 in a different housing sample. Home value divided by the 2025 physician wage is 1.45 times gross pay (position 33 among numeric observations). Homeowner taxes of $1,912 and historical insurance of $1,135 are context rather than a budget for that median home.

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’s median home value equals 1.22 times the Family Medicine employee mean, compared with 0.85 in Indiana. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $5,399 versus $1,798, so the purchase ratio and recurring tax point in the same direction. Model the actual offer and assessed property, and keep retirement-income rules separate from taxes during the earning years.

The 2024 ACS home value is $280,700, with median gross monthly rent of $1,322 in a different housing sample. Home value divided by the 2025 physician wage is 1.22 times gross pay (position 21 among numeric observations). Homeowner taxes of $5,399 and historical insurance of $1,480 are context rather than a budget for that median home.

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’s median home value equals 0.85 times the Family Medicine employee mean, compared with 1.06 in Ohio. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $1,798 versus $2,937, so the purchase ratio and recurring tax point in the same direction. Use the offer advantage to preserve recurring surplus instead of automatically expanding the housing search.

The 2024 ACS home value is $243,500, with median gross monthly rent of $1,104 in a different housing sample. Home value divided by the 2025 physician wage is 0.85 times gross pay (position 6 among numeric observations). Homeowner taxes of $1,798 and historical insurance of $1,259 are context rather than a budget for that median home.

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’s median home value equals 0.81 times the Family Medicine employee mean, compared with 1.01 in Nebraska. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $2,937 versus $3,739, so the purchase ratio and recurring tax point in the same direction. Keep the homeowner tax line visible and compare the actual house with renting during the first year of a new role.

The 2024 ACS home value is $227,300, with median gross monthly rent of $981 in a different housing sample. Home value divided by the 2025 physician wage is 0.81 times gross pay (position 4 among numeric observations). Homeowner taxes of $2,937 and historical insurance of $1,342 are context rather than a budget for that median home.

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’s median home value equals 1.01 times the Family Medicine employee mean, compared with 1.01 in Nebraska. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $2,983 versus $3,739, so the purchase ratio and recurring tax point in the same direction. Compare the complete household budget and preserve cash for practice interruptions before allocating the apparent savings to a larger home.

The 2024 ACS home value is $238,700, with median gross monthly rent of $1,079 in a different housing sample. Home value divided by the 2025 physician wage is 1.01 times gross pay (position 11 among numeric observations). Homeowner taxes of $2,983 and historical insurance of $1,733 are context rather than a budget for that median home.

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.

Source qualification: Depreciation: Confirm Kansas treatment of IRC §168(n) from a current Department of Revenue instruction or enacted statute before describing Kansas as fully conforming.

Read the Kansas retirement-tax details
KentuckyRead state analysis

Kentucky

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

Kentucky’s median home value equals 0.89 times the Family Medicine employee mean, compared with 1.17 in Tennessee. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $1,611 versus $1,488, so the purchase ratio and recurring tax show a tradeoff. Verify the specialty offer and how sustainable its workload is before treating that combination as a recurring annual surplus.

The 2024 ACS home value is $226,000, with median gross monthly rent of $998 in a different housing sample. Home value divided by the 2025 physician wage is 0.89 times gross pay (position 7 among numeric observations). Homeowner taxes of $1,611 and historical insurance of $1,525 are context rather than a budget for that median home.

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’s median home value equals 0.84 times the Family Medicine employee mean, compared with 0.70 in Mississippi. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $1,187 versus $1,221, so the purchase ratio and recurring tax show a tradeoff. Build property-specific coverage, deductibles and reserves into the plan, then evaluate whether the actual compensation leaves the desired recurring saving capacity.

The 2024 ACS home value is $223,200, with median gross monthly rent of $1,064 in a different housing sample. Home value divided by the 2025 physician wage is 0.84 times gross pay (position 5 among numeric observations). Homeowner taxes of $1,187 and historical insurance of $3,027 are context rather than a budget for that median home.

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’s median home value equals 1.42 times the Family Medicine employee mean, compared with 1.83 in New Hampshire. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $3,103 versus $6,707, so the purchase ratio and recurring tax point in the same direction. Stress-test the actual offer and a lower-pay replacement job before setting a purchase budget around the observed housing relationship.

The 2024 ACS home value is $341,900, with median gross monthly rent of $1,210 in a different housing sample. Home value divided by the 2025 physician wage is 1.42 times gross pay (position 32 among numeric observations). Homeowner taxes of $3,103 and historical insurance of $1,150 are context rather than a budget for that median home.

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’s median home value equals 1.56 times the Family Medicine employee mean, compared with 1.60 in Virginia. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $4,144 versus $2,872, so the purchase ratio and recurring tax show a tradeoff. Put those actual earnings into the budget and test the home commitment if one income changes.

The 2024 ACS home value is $436,300, with median gross monthly rent of $1,721 in a different housing sample. Home value divided by the 2025 physician wage is 1.56 times gross pay (position 35 among numeric observations). Homeowner taxes of $4,144 and historical insurance of $1,578 are context rather than a budget for that median home.

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

Source qualification: Depreciation: Apply the Maryland manufacturing exception only after confirming the taxpayer and property meet the state definition; do not map federal §168(n) eligibility directly to the Maryland exception.

Read the Maryland retirement-tax details
MassachusettsRead state analysis

Massachusetts

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

Massachusetts’s median home value equals 2.24 times the Family Medicine employee mean, compared with 1.83 in New Hampshire. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $6,080 versus $6,707, so the purchase ratio and recurring tax show a tradeoff. Consider how renting, delaying a purchase or choosing a different local housing market changes cash available for other priorities.

The 2024 ACS home value is $607,400, with median gross monthly rent of $1,848 in a different housing sample. Home value divided by the 2025 physician wage is 2.24 times gross pay (position 47 among numeric observations). Homeowner taxes of $6,080 and historical insurance of $2,134 are context rather than a budget for that median home.

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’s median home value equals 1.16 times the Family Medicine employee mean, compared with 1.01 in Wisconsin. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $2,988 versus $3,680, so the purchase ratio and recurring tax show a tradeoff. Use the state statistics to identify the negotiation and budgeting questions, then set a savings plan from real earnings and a specific home.

The 2024 ACS home value is $254,200, with median gross monthly rent of $1,168 in a different housing sample. Home value divided by the 2025 physician wage is 1.16 times gross pay (position 16 among numeric observations). Homeowner taxes of $2,988 and historical insurance of $1,110 are context rather than a budget for that median home.

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’s median home value equals 1.27 times the Family Medicine employee mean, compared with 1.01 in Wisconsin. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $3,501 versus $3,680, so the purchase ratio and recurring tax show a tradeoff. Preserve the housing-to-income advantage by checking the actual property’s annual costs and the household’s target contributions before upgrading to a larger purchase.

The 2024 ACS home value is $344,600, with median gross monthly rent of $1,291 in a different housing sample. Home value divided by the 2025 physician wage is 1.27 times gross pay (position 28 among numeric observations). Homeowner taxes of $3,501 and historical insurance of $1,988 are context rather than a budget for that median home.

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’s median home value equals 0.70 times the Family Medicine employee mean, compared with 1.37 in Alabama. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $1,221 versus $890, so the purchase ratio and recurring tax show a tradeoff. Assess the actual community fit so a later move does not add transaction costs to a short stay.

The 2024 ACS home value is $186,500, with median gross monthly rent of $990 in a different housing sample. Home value divided by the 2025 physician wage is 0.70 times gross pay (position 3 among numeric observations). Homeowner taxes of $1,221 and historical insurance of $2,029 are context rather than a budget for that median home.

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’s median home value equals 1.19 times the Family Medicine employee mean, compared with 0.81 in Iowa. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $2,021 versus $2,937, so the purchase ratio and recurring tax show a tradeoff. A household with a stronger actual specialty offer should rerun the budget; that is more informative than letting the broad occupation decide the home purchase.

The 2024 ACS home value is $254,400, with median gross monthly rent of $1,067 in a different housing sample. Home value divided by the 2025 physician wage is 1.19 times gross pay (position 19 among numeric observations). Homeowner taxes of $2,021 and historical insurance of $1,589 are context rather than a budget for that median home.

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’s median home value equals 1.26 times the Family Medicine employee mean, compared with 1.45 in Idaho. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $2,939 versus $1,912, so the purchase ratio and recurring tax show a tradeoff. Compare a lower replacement offer and the actual property costs before treating the state’s favorable ratio as permission to increase the purchase price.

The 2024 ACS home value is $425,400, with median gross monthly rent of $1,177 in a different housing sample. Home value divided by the 2025 physician wage is 1.26 times gross pay (position 27 among numeric observations). Homeowner taxes of $2,939 and historical insurance of $1,768 are context rather than a budget for that median home.

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’s median home value equals 1.01 times the Family Medicine employee mean, compared with 1.01 in Kansas. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $3,739 versus $2,983, so the purchase ratio and recurring tax point in the same direction. A favorable purchase ratio does not remove the need to fund income interruptions and practice changes.

The 2024 ACS home value is $263,100, with median gross monthly rent of $1,102 in a different housing sample. Home value divided by the 2025 physician wage is 1.01 times gross pay (position 11 among numeric observations). Homeowner taxes of $3,739 and historical insurance of $2,142 are context rather than a budget for that median home.

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’s median home value equals 1.88 times the Family Medicine employee mean, compared with 1.37 in Arizona. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $2,143 versus $1,828, so the purchase ratio and recurring tax point in the same direction. A physician with an existing home or unusually strong offer may face a different situation, so use the actual balance sheet and contract before taking the statewide score as a wealth forecast.

The 2024 ACS home value is $455,500, with median gross monthly rent of $1,709 in a different housing sample. Home value divided by the 2025 physician wage is 1.88 times gross pay (position 43 among numeric observations). Homeowner taxes of $2,143 and historical insurance of $1,013 are context rather than a budget for that median home.

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’s median home value equals 1.83 times the Family Medicine employee mean, compared with 2.24 in Massachusetts. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $6,707 versus $6,080, so the purchase ratio and recurring tax show a tradeoff. A tax-label comparison alone would miss this property-level cash commitment.

The 2024 ACS home value is $458,800, with median gross monthly rent of $1,558 in a different housing sample. Home value divided by the 2025 physician wage is 1.83 times gross pay (position 41 among numeric observations). Homeowner taxes of $6,707 and historical insurance of $1,300 are context rather than a budget for that median home.

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.

Source qualification: Depreciation: Confirm New Hampshire Business Profits Tax treatment of IRC §168(n) from 2026 legislation or Department of Revenue Administration instructions.

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’s median home value equals 1.70 times the Family Medicine employee mean, compared with 0.93 in Pennsylvania. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $9,358 versus $3,214, so the purchase ratio and recurring tax point in the same direction. Compare an existing housing arrangement with the cost of a new purchase before assigning the same conclusion to both.

The 2024 ACS home value is $496,000, with median gross monthly rent of $1,800 in a different housing sample. Home value divided by the 2025 physician wage is 1.70 times gross pay (position 38 among numeric observations). Homeowner taxes of $9,358 and historical insurance of $1,551 are context rather than a budget for that median home.

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’s median home value equals 1.18 times the Family Medicine employee mean, compared with 1.37 in Arizona. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $1,776 versus $1,828, so the purchase ratio and recurring tax point in the same direction. Budget coverage, maintenance and an income interruption before treating the remaining cash as investable surplus.

The 2024 ACS home value is $279,900, with median gross monthly rent of $1,117 in a different housing sample. Home value divided by the 2025 physician wage is 1.18 times gross pay (position 18 among numeric observations). Homeowner taxes of $1,776 and historical insurance of $1,490 are context rather than a budget for that median home.

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’s median home value equals 2.13 times the Family Medicine employee mean, compared with 0.93 in Pennsylvania. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $6,542 versus $3,214, so the purchase ratio and recurring tax point in the same direction. Compare those actual positions and the durability of the offer rather than assume the state’s quality-of-life lead produces a higher saving rate.

The 2024 ACS home value is $449,800, with median gross monthly rent of $1,634 in a different housing sample. Home value divided by the 2025 physician wage is 2.13 times gross pay (position 45 among numeric observations). Homeowner taxes of $6,542 and historical insurance of $1,801 are context rather than a budget for that median home.

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’s median home value equals 1.51 times the Family Medicine employee mean, compared with 1.22 in South Carolina. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $2,044 versus $1,337, so the purchase ratio and recurring tax point in the same direction. Identify the career or family benefit of the chosen community, then test whether the actual home budget leaves the intended annual saving capacity.

The 2024 ACS home value is $333,000, with median gross monthly rent of $1,338 in a different housing sample. Home value divided by the 2025 physician wage is 1.51 times gross pay (position 34 among numeric observations). Homeowner taxes of $2,044 and historical insurance of $1,852 are context rather than a budget for that median home.

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’s median home value equals 0.98 times the Family Medicine employee mean, compared with 1.12 in South Dakota. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $2,550 versus $2,940, so the purchase ratio and recurring tax point in the same direction. Set the home budget using the signed offer and a realistic replacement-income case rather than letting a statewide average dictate borrowing.

The 2024 ACS home value is $266,100, with median gross monthly rent of $980 in a different housing sample. Home value divided by the 2025 physician wage is 0.98 times gross pay (position 10 among numeric observations). Homeowner taxes of $2,550 and historical insurance of $1,414 are context rather than a budget for that median home.

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’s median home value equals 1.06 times the Family Medicine employee mean, compared with 0.85 in Indiana. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $2,937 versus $1,798, so the purchase ratio and recurring tax point in the same direction. A household can preserve the favorable starting economics by selecting housing from a saving target and actual cash costs, rather than from the maximum loan a salary might support.

The 2024 ACS home value is $239,800, with median gross monthly rent of $1,090 in a different housing sample. Home value divided by the 2025 physician wage is 1.06 times gross pay (position 14 among numeric observations). Homeowner taxes of $2,937 and historical insurance of $1,116 are context rather than a budget for that median home.

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’s median home value equals 0.67 times the Family Medicine employee mean, compared with 0.93 in Arkansas. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $1,672 versus $1,113, so the purchase ratio and recurring tax show a tradeoff. Test insurance, deductibles, maintenance and an income gap before assigning the remaining earnings to long-term investments.

The 2024 ACS home value is $222,100, with median gross monthly rent of $1,044 in a different housing sample. Home value divided by the 2025 physician wage is 0.67 times gross pay (position 2 among numeric observations). Homeowner taxes of $1,672 and historical insurance of $2,486 are context rather than a budget for that median home.

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.

Source qualification: Depreciation: Confirm Oklahoma treatment of IRC §168(n) and the current state election mechanics from 2026 return instructions before describing the state as fully conforming.

Read the Oklahoma retirement-tax details
OregonRead state analysis

Oregon

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

Oregon’s median home value equals 1.81 times the Family Medicine employee mean, compared with 2.20 in Washington. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $3,895 versus $4,729, so the purchase ratio and recurring tax point in the same direction. A wealth plan should price the specific house and recurring costs, then decide how much of any superior offer to retain rather than spend on housing.

The 2024 ACS home value is $497,500, with median gross monthly rent of $1,597 in a different housing sample. Home value divided by the 2025 physician wage is 1.81 times gross pay (position 40 among numeric observations). Homeowner taxes of $3,895 and historical insurance of $1,003 are context rather than a budget for that median home.

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’s median home value equals 0.93 times the Family Medicine employee mean, compared with 1.70 in New Jersey. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $3,214 versus $9,358, so the purchase ratio and recurring tax point in the same direction. Price the actual home and professional obligations, then test how much recurring cash remains under the physician’s signed offer.

The 2024 ACS home value is $277,600, with median gross monthly rent of $1,252 in a different housing sample. Home value divided by the 2025 physician wage is 0.93 times gross pay (position 8 among numeric observations). Homeowner taxes of $3,214 and historical insurance of $1,217 are context rather than a budget for that median home.

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’s median home value equals 1.25 times the Family Medicine employee mean, compared with 2.24 in Massachusetts. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $4,886 versus $6,080, so the purchase ratio and recurring tax point in the same direction. Compare renting and buying against a fixed saving target before turning a higher offer into a larger capital commitment.

The 2024 ACS home value is $455,700, with median gross monthly rent of $1,418 in a different housing sample. Home value divided by the 2025 physician wage is 1.25 times gross pay (position 26 among numeric observations). Homeowner taxes of $4,886 and historical insurance of $2,396 are context rather than a budget for that median home.

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’s median home value equals 1.22 times the Family Medicine employee mean, compared with 1.51 in North Carolina. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $1,337 versus $2,044, so the purchase ratio and recurring tax point in the same direction. Preserve the housing advantage by comparing actual spending against the income supported by the offer, not against hoped-for bonuses or future appreciation.

The 2024 ACS home value is $299,500, with median gross monthly rent of $1,272 in a different housing sample. Home value divided by the 2025 physician wage is 1.22 times gross pay (position 21 among numeric observations). Homeowner taxes of $1,337 and historical insurance of $1,753 are context rather than a budget for that median home.

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’s median home value equals 1.12 times the Family Medicine employee mean, compared with 0.98 in North Dakota. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $2,940 versus $2,550, so the purchase ratio and recurring tax point in the same direction. Use the actual home, confirmed earnings and a replacement-income budget to decide how much of the household margin can stay invested.

The 2024 ACS home value is $289,600, with median gross monthly rent of $999 in a different housing sample. Home value divided by the 2025 physician wage is 1.12 times gross pay (position 15 among numeric observations). Homeowner taxes of $2,940 and historical insurance of $1,614 are context rather than a budget for that median home.

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’s median home value equals 1.17 times the Family Medicine employee mean, compared with 0.89 in Kentucky. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $1,488 versus $1,611, so the purchase ratio and recurring tax show a tradeoff. Compare a desired higher-priced home with a smaller purchase and make the recurring saving difference visible before committing to the upgrade.

The 2024 ACS home value is $332,600, with median gross monthly rent of $1,284 in a different housing sample. Home value divided by the 2025 physician wage is 1.17 times gross pay (position 17 among numeric observations). Homeowner taxes of $1,488 and historical insurance of $1,649 are context rather than a budget for that median home.

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’s median home value equals 1.19 times the Family Medicine employee mean, compared with 0.67 in Oklahoma. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $4,108 versus $1,672, so the purchase ratio and recurring tax point in the same direction. Use the actual assessment and coverage quote with a conservative earnings plan before deciding how much of the physician income to convert into housing.

The 2024 ACS home value is $313,200, with median gross monthly rent of $1,475 in a different housing sample. Home value divided by the 2025 physician wage is 1.19 times gross pay (position 19 among numeric observations). Homeowner taxes of $4,108 and historical insurance of $2,864 are context rather than a budget for that median home.

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’s median home value equals 1.84 times the Family Medicine employee mean, compared with 2.30 in Colorado. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $2,648 versus $2,828, so the purchase ratio and recurring tax point in the same direction. A household pursuing wealth accumulation should compare renting, a smaller purchase and the actual specialty offer before assuming a desirable location also offers favorable saving economics.

The 2024 ACS home value is $545,200, with median gross monthly rent of $1,593 in a different housing sample. Home value divided by the 2025 physician wage is 1.84 times gross pay (position 42 among numeric observations). Homeowner taxes of $2,648 and historical insurance of $1,107 are context rather than a budget for that median home.

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’s median home value equals 1.41 times the Family Medicine employee mean, compared with 1.83 in New Hampshire. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $5,026 versus $6,707, so the purchase ratio and recurring tax point in the same direction. Build the intended holding-period budget and stress-test the actual income before deciding how much of the favorable wage observation to commit to a home.

The 2024 ACS home value is $352,800, with median gross monthly rent of $1,319 in a different housing sample. Home value divided by the 2025 physician wage is 1.41 times gross pay (position 31 among numeric observations). Homeowner taxes of $5,026 and historical insurance of $1,215 are context rather than a budget for that median home.

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’s median home value equals 1.60 times the Family Medicine employee mean, compared with 1.51 in North Carolina. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $2,872 versus $2,044, so the purchase ratio and recurring tax point in the same direction. Put those actual earnings and the desired home into a budget, then decide whether the location preserves the required saving capacity.

The 2024 ACS home value is $403,500, with median gross monthly rent of $1,646 in a different housing sample. Home value divided by the 2025 physician wage is 1.60 times gross pay (position 36 among numeric observations). Homeowner taxes of $2,872 and historical insurance of $1,537 are context rather than a budget for that median home.

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’s median home value equals 2.20 times the Family Medicine employee mean, compared with 1.81 in Oregon. This is a larger purchase-to-pay commitment; the median annual homeowner tax is $4,729 versus $3,895, so the purchase ratio and recurring tax point in the same direction. The right choice still depends on actual offers, existing housing and how much the household values the destination’s amenities.

The 2024 ACS home value is $602,200, with median gross monthly rent of $1,824 in a different housing sample. Home value divided by the 2025 physician wage is 2.20 times gross pay (position 46 among numeric observations). Homeowner taxes of $4,729 and historical insurance of $1,232 are context rather than a budget for that median home.

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’s median home value equals 0.66 times the Family Medicine employee mean, compared with 0.89 in Kentucky. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $881 versus $1,611, so the purchase ratio and recurring tax point in the same direction. Confirm the actual offer and the community’s fit before assuming that the low purchase price alone supports a durable saving plan over several years.

The 2024 ACS home value is $170,800, with median gross monthly rent of $883 in a different housing sample. Home value divided by the 2025 physician wage is 0.66 times gross pay (position 1 among numeric observations). Homeowner taxes of $881 and historical insurance of $1,179 are context rather than a budget for that median home.

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’s median home value equals 1.01 times the Family Medicine employee mean, compared with 1.16 in Michigan. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $3,680 versus $2,988, so the purchase ratio and recurring tax show a tradeoff. The actual offer and property-tax bill still control the household result; protect the potential surplus by setting the home budget from the saving plan rather than the largest available mortgage.

The 2024 ACS home value is $294,700, with median gross monthly rent of $1,142 in a different housing sample. Home value divided by the 2025 physician wage is 1.01 times gross pay (position 11 among numeric observations). Homeowner taxes of $3,680 and historical insurance of $923 are context rather than a budget for that median home.

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’s median home value equals 1.22 times the Family Medicine employee mean, compared with 2.30 in Colorado. This is a smaller purchase-to-pay commitment; the median annual homeowner tax is $1,947 versus $2,828, so the purchase ratio and recurring tax point in the same direction. Test a specific purchase against reserves, career flexibility and a lower-income year before committing the apparent budget room.

The 2024 ACS home value is $339,500, with median gross monthly rent of $998 in a different housing sample. Home value divided by the 2025 physician wage is 1.22 times gross pay (position 21 among numeric observations). Homeowner taxes of $1,947 and historical insurance of $1,853 are context rather than a budget for that median home.

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

  • Income after selected costs: 70% of the financial share
  • Home prices compared with pay: 20% of the financial share
  • Malpractice insurance costs: 10% 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

The planning margin subtracts controlled state tax and a regional spending basket from $500K; it is not take-home pay, investable savings or a net-worth forecast. Federal/payroll/local taxes, debt and benefits are separate. Pay-to-housing and malpractice indices add market context.

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

Does the wealth score predict future net worth?

No. It grades current published economic context and a fixed quality-of-life category weight. Career changes, taxes, spending, debt and investment outcomes are not predicted.

What does a home-value-to-pay ratio of 1.0 mean?

The statewide median owner-occupied value equals one year of the selected occupation’s gross mean employee pay. It does not mean a physician can save for the whole home in one year.

Does the housing factor subtract another household expense?

No. Housing is already included in the regional spending basket. Home value relative to Family Medicine pay adds a separate purchase-affordability preference; it does not deduct a second housing bill from the controlled planning margin.

Should a physician always buy a cheaper home after moving?

The guide does not prescribe a purchase. Compare the actual ownership and renting options, how long you expect to stay, liquidity and the effect on your saving capacity.

Why can an expensive state still earn a competitive grade?

The published grade assigns 20% to the cited quality-of-life category and 80% to financial evidence. Strong amenities can help an expensive state, while the same fixed weights apply to every state and every reader.

Are property-tax medians an estimate for my new house?

No. The median reflects existing owner-occupied homes. Your purchase price, assessment rules, classification and exemptions determine the relevant bill.

Do no-income-tax states automatically rank first?

No. The controlled state-tax benchmark recognizes a verified zero where applicable, but regional spending, purchase affordability, malpractice-cost context and quality of life also affect the score. A complete household tax return remains separate.

Does the livability grade cover schools, healthcare quality and safety?

Not comprehensively. We use the publisher’s quality-of-life category, which emphasizes amenities and daily-life conditions. Education and health, and safety, are separate categories in that study and are not included in this grade. Research those priorities for the actual community, especially when a move involves children, ongoing care or a spouse’s career.

Is the planning margin money I can invest?

No. It subtracts a controlled state-tax benchmark and regional spending basket from $500,000, while leaving federal taxes, payroll taxes, local taxes, debt service and benefit contributions separate. The housing factor adds a relative purchase-cost preference; it does not subtract a second housing bill. Complete those missing household lines before setting an investment budget.

Can a physician build wealth in an expensive state?

Yes. Income, saving behavior, household preferences and career opportunities all matter. A lower-cost state can make saving easier, but the statewide averages do not determine an individual household’s long-term outcome.

What does home value divided by physician pay tell me?

It compares a statewide median home value with a statewide mean employee-physician wage. It is an affordability screening ratio, not the number of years needed to buy a home or a mortgage approval estimate.

Why separate career fit from the tax calculation?

A job that supports a sustainable workload and a durable career can affect the household plan. Model income and taxes numerically, then make the professional and lifestyle tradeoffs explicit rather than hiding them inside a tax estimate.

Should I maximize salary or investable surplus?

Compare what remains after the costs required to support your household and work. A larger salary can produce less available cash if housing and recurring spending rise enough. The guide supplies context; your actual budget supplies the answer.

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 High-Income W-2 Physicians

Compare physician pay, purchasing power, housing and income-tax considerations across all 50 states.

Family physician pay · Housing / pay · Homeowner taxes · State wage tax · Malpractice cost index · Quality of life

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

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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