If you're a CRNA thinking about locum work — or already doing it and wondering if you're getting paid fairly — the short answer is that locum CRNAs are earning more in 2026 than they have in years. Demand is up, rates have climbed across the board, and there's no sign of it slowing down.
Here's what the market actually looks like, based on real assignments — not job board estimates:
| State | Rate | Shift Structure | Notes |
|---|---|---|---|
| Texas | $230/hr | 5x8, 5x10, or 5x12 | General CRNA, flexible shifts, no state income tax |
| Arizona | $265/hr | 5x8 + call | Higher rate reflects call coverage |
| South Carolina | $240/hr | 10-hour shifts | Straight shift, no call |
| New York | $295/hr | 4x10 | Premium rate, four-day work week |
| Minnesota | $250/hr | Varies | Strong Midwest demand |
Texas
Arizona
South Carolina
New York
Minnesota
A few things jump out. New York leads at $295/hr, which tracks — the Northeast consistently pays the highest locum CRNA rates because of cost of living and facility competition. Texas at $230/hr looks lower on paper, but there's no state income tax. A CRNA earning $230/hr in Houston takes home more than one earning $260/hr in California after state taxes eat into it.
Arizona's $265/hr includes call. That's a meaningful bump over straight-shift assignments — typically $30 to $50/hr more when call is involved.
The National Range
Across the country, locum CRNA assignments are pulling $200 to $325 per hour in 2026. Where you land depends on:
Where you work. Northeast and West Coast pay the highest raw rates. But no-income-tax states (Texas, Florida, Nevada, Washington, Tennessee, Wyoming) have an effective raise that doesn't show up in the hourly number. Worth doing the math before chasing the highest rate on paper.
Whether you take call. Call adds $30-$50/hr on average. The Arizona assignment above is a clean example — $265 with call vs $230 straight in Texas.
Shift structure. Facilities offering 4x10s or 3x12s tend to pay slightly higher hourly because the schedule is more attractive. Five-day weeks at 8 hours are the most common but sit on the lower end of the pay scale.
Rural vs metro. Smaller hospitals and critical access facilities pay more because they can't attract permanent hires. If you're willing to work in a town most people haven't heard of, you can often add $20-$40/hr over the same assignment in a major city.
Assignment length. Short coverage (2-4 weeks) pays more per hour than longer contracts (3-6 months). Facilities pay a premium when they need someone fast.
What's Included Beyond the Hourly Rate
Most locum CRNA packages cover more than just the hourly pay. A solid agency includes:
- Malpractice insurance — $1M/$3M occurrence-based, carried by the agency
- Flights or mileage — to and from the assignment
- Housing — furnished accommodation near the facility
- Rental car — if needed for the location
- Licensing and <a href="/blog/credentialing-101">credentialing</a> — state license fees and paperwork handled
When you add it up, the total package is usually worth $15,000 to $30,000 per assignment than the hourly rate alone.
Some agencies do all-inclusive billing — one rate that covers everything including travel, call, and housing. No surprise invoices, no chasing down reimbursements. That's the cleanest model for both you and the facility.
Locum CRNA Pay vs Permanent
A permanently employed CRNA earns a national average of roughly $210,000 to $230,000 per year. A locum CRNA working full-time at $250/hr pulls approximately $520,000 annualized — more than double.
Most locum CRNAs don't work 52 weeks though. That's the whole point. Pick your weeks, take time off when you want. Working 30 weeks at $250/hr still puts you around $300,000 — well above the permanent average with a lot more flexibility.
The Tax Side
Locum CRNAs work as 1099 independent contractors. The agency pays your full hourly rate, and you're responsible for setting aside money for taxes. Here's what that looks like:
Set aside 28% to 35% of gross income. The exact amount depends on your state tax situation, filing status, and deductions. When in doubt, set aside more.
Track every unreimbursed expense. Travel, housing, licensing fees, CME courses, professional dues — these are all deductible. At locum CRNA income levels, deductions can easily add up to $15,000 to $30,000 per year.
Consider S-Corp election above $200K net income. The S-Corp structure can save $2,000 to $6,000 per year in self-employment tax at that income level. It's not the magic bullet some accountants pitch, but the savings are real.
File in every state where you worked. You need a nonresident return in every state where you earned income. The good news: states with no income tax (Texas, Florida, Nevada, Washington, Tennessee, Wyoming) mean no return needed for those assignments.
For a complete breakdown of how 1099 contractor status works for locum providers, see our independent contractor guide. Use our free tax calculator to model your actual numbers.
How to Decide Which Is Right for You
Ask yourself these questions:
Do you prefer high-volume, fast-paced environments or lower-volume, broader-scope work?
- High volume → Urban
- Broader scope → Rural
Are you comfortable being the only physician in the building?
- Yes → Rural
- No → Urban
Do you want access to city amenities during your time off?
- Yes → Urban
- No (or you prefer outdoor recreation) → Rural
Is maximizing income your top priority?
- Yes → Rural (higher pay, lower cost of living)
- No (lifestyle matters more) → Urban
What does your specialty demand look like?
- Subspecialty → Urban
- Generalist or EM/hospitalist → Both work
The Locums One Difference
21-day credentialing — industry average is 60–90 days
15–22% margins — vs. 30–50% at traditional agencies
Free tax professional connections — for every 1099 physician
Occurrence-based malpractice — $1M/$3M through ProAssurance, no tail needed
Weekly direct deposit — no waiting for biweekly or monthly pay cycles
Frequently Asked Questions
How much do locum CRNAs make per hour in 2026?
Locum CRNAs earn $200–$325 per hour in 2026, depending on state, setting, and call requirements. Rural and underserved facilities typically pay 10–20% above urban rates. On-call shifts add $30–$50/hr in premium.
Do locum CRNAs earn more than permanent CRNAs?
Yes. Locum CRNAs typically earn 30–50% more than permanently employed counterparts. A CRNA earning $210,000 permanently can earn $300,000–$400,000+ doing locums, with full schedule control and no administrative burden.
Which locum tenens agencies offer the best CRNA rates?
Agencies with lower overhead pass more to the provider. At 15–22% margins, Locums One CRNAs keep significantly more per hour than with agencies charging 30–50% markup on the same bill rate. On a $350/hr bill rate, that's $50–$70/hr more in your pocket.
Do CRNAs need separate state licenses for locum work?
Yes. CRNAs need an active nursing license and APRN certification in each state where they practice. The Nurse Licensure Compact (NLC) covers 41 states for RN licenses, but APRN compact adoption varies by state. Most agencies cover licensing costs for the assignment state.
What is included in a CRNA locum tenens assignment?
Most assignments include malpractice insurance ($1M/$3M occurrence-based), travel (flights or mileage), furnished housing or stipend, rental car, and licensing/credentialing support — all covered by the agency at no cost to the CRNA.
The Bottom Line
Rural locum assignments pay more — typically 15% to 25% higher than urban assignments in the same specialty. They also offer broader clinical scope, more autonomy, and lower cost of living. But they require comfort with independent decision-making and limited subspecialty backup.
Urban locum assignments offer higher patient volume, more support staff, and access to city amenities. They're a better fit for physicians who prefer working within a well-defined scope and want the structure of a larger healthcare system.
Neither is objectively better. The right choice depends on your clinical comfort level, income goals, and what you want your life to look like between shifts.
For CRNA work in cardiac settings, see our cardiac anesthesia locums guide. For rate negotiation strategies, see our contract negotiation guide. For the full anesthesiology specialty picture, visit our anesthesiology specialty page. For how agency markups affect your take-home, see our guide on how locum tenens pricing works. For 1099 tax structuring, see our independent contractor guide. For rural vs urban assignment comparison, see our rural vs urban locums guide. At Locums One, we place physicians in both rural and urban settings across the country. Talk to our team about current assignments and which markets are paying the most right now.
