Highest Paying States for Ultrasound Techs (2026): State Pay Rankings for Sonographers
Where do ultrasound techs make the most? California leads with $138,355 average median in 2026, while Puerto Rico sits at $46,430. BLS OEWS data spans 52 states and 1677+ metro areas. Top markets share three drivers: HCOL, cardiac echo specialty demand, and academic medical center concentration.
Where Ultrasound Techs Earn Top Pay: 2026 State Rankings
Ultrasound tech pay spreads 60%+ across the US, mainly because of cardiac specialization and metro cost of living. The biggest lever isn't where you work — it's which specialty credentials you hold. A general RDMS earns much less than a tech who adds cardiac (RDCS) or vascular (RVT). California sits at $138,355, Puerto Rico at $46,430.
Top-Paying Markets
- California ($100,000-$120,000) — Bay Area, LA, San Diego academic + Kaiser system.
- Alaska ($98,000-$115,000) — shortage premium + no state income tax.
- Hawaii ($95,000-$110,000) — island shortage + HCOL.
- Washington ($92,000-$108,000) — Seattle + no state income tax.
- Oregon ($90,000-$105,000) — Portland anchor + state licensure barrier.
- Massachusetts ($88,000-$102,000) — Boston academic teaching hospitals.
Strong Second-Tier Markets
- Connecticut ($85,000-$100,000) — Yale New Haven + Fairfield commuter premium.
- New York ($82,000-$100,000) — NYC academic centers.
- New Jersey ($82,000-$98,000) — Bergen / Morris + state license.
- Nevada ($78,000-$92,000) — Las Vegas + no state income tax.
- Minnesota ($75,000-$90,000) — Mayo Rochester anchor.
- Texas ($70,000-$88,000) — Houston Texas Medical Center + no state income tax.
- Florida ($65,000-$82,000) — Miami / Tampa + no state income tax.
Cardiac + Specialty Premium
- Cardiac Sonography / Echo Tech (premier) — $95,000-$120,000+.
- Pediatric Echo — premium niche.
- Vascular Tech (RVT) — premium specialty.
- MSK Sonography (emerging) — premium niche.
- Breast Sonography — premium niche.
- Maternal-Fetal Medicine — premium.
- Multi-cred stack (RDMS + RDCS + RVT) — premier combo.
- Travel ultrasound tech — $2,000-$3,500/week premium.
- Per-diem PRN — $55-$80/hour senior techs.
- Federal VA / DoD — pension + PSLF.
2026 Rankings — Methodology
State rankings reflect 2026 projections from BLS OEWS 2025 CAGR-adjusted. The single biggest individual lever is cardiac echo (RDCS) credentialing — adding cardiac to general RDMS often boosts pay 25-40% in the same metro.
2019 BLS
$74,320
2025 BLS
$96,590
2026 Current Est.
$101,352
2019–2027 Growth
+43.1%
National Average for Context
2019–2025: BLS OEWS actual data. 2026+: CAGR 4.93% projection.
| Year | Median Annual Salary | Status |
|---|---|---|
| 2019 | $74,320 | Actual |
| 2020 | $75,920 | Actual |
| 2021 | $77,740 | Actual |
| 2022 | $81,350 | Actual |
| 2023 | $84,470 | Actual |
| 2024 | $89,340 | Actual |
| 2025 | $96,590 | Actual |
| 2026(current) | $101,352 | Estimated |
| 2027 | $106,349 | Projected |
Understanding the national salary trend helps contextualize state-level differences. The national median provides a baseline for comparing how each state's ultrasound technologist pay stacks up.
Note: BLS actual data is sourced from the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey. Estimated and projected values are calculated using a 4.93% historical CAGR. Actual compensation may vary based on employer, experience, certifications, and local market conditions.
Top 10 Highest Paying States for Ultrasound Technologists
Why Ultrasound Tech Pay Varies State-to-State
Five drivers explain the 60%+ pay spread for ultrasound techs across the US.
1. Cost of Living (30-40%)
- HCOL markets command premium.
- BEA RPP — CA 113, MS 86. 32% spread.
- COL-adjusted real income — Texas / Tennessee net often beat California.
2. Cardiac + Vascular Specialty Demand (20-30%)
- Cardiac echo (RDCS Adult Echo, premier) — premium specialty.
- Pediatric echo (RDCS PE) — premium niche.
- Vascular sonography (RVT) — premium specialty.
- MSK sonography — premium emerging.
- Breast sonography — premium niche.
- Maternal-Fetal Medicine — premium.
- Multi-cred (RDMS + RDCS + RVT) — premier combo.
3. State Licensure (10-15%)
- State licensure (OR, NM, NJ, NH) — barrier to entry → premium pay.
- State endorsement — varies.
- ARDMS universal — entry credential.
4. State Income Tax (5-10% take-home)
- No state income tax — AK, WA, TX, FL, TN, NV, SD, WY, NH.
- High state income tax — CA, NY, OR, NJ, MN, HI.
- NYC + Philadelphia local — additional.
- Property + sales tax — TX, NJ tradeoff.
5. Academic + Setting Premium (10-15%)
- Academic medical center — premium benefits + PSLF.
- Cardiac center — premier specialty.
- Maternal-Fetal Medicine center — premium.
- Children's hospital pediatric echo — premium niche.
- Vascular surgery practice — premium specialty.
- Outpatient imaging center — base.
- Federal VA / DoD — pension + PSLF.
- Travel ultrasound tech — premium contract.
Where Do Ultrasound Technologists Get Paid the Most?
Complete ranking of all 52 states by average ultrasound technologist salary. Click any state to see city-level breakdowns and detailed data.
| Rank | State | Avg Salary |
|---|---|---|
| 1 | California | $138,355 |
| 2 | Oregon | $127,616 |
| 3 | Hawaii | $127,474 |
| 4 | Washington | $125,478 |
| 5 | Colorado | $113,528 |
| 6 | Massachusetts | $112,223 |
| 7 | Alaska | $111,945 |
| 8 | District of Columbia | $110,481 |
| 9 | Montana | $109,765 |
| 10 | New York | $109,582 |
| 11 | New Jersey | $109,266 |
| 12 | Wisconsin | $108,505 |
| 13 | Connecticut | $108,129 |
| 14 | New Hampshire | $107,397 |
| 15 | Arizona | $105,818 |
| 16 | Illinois | $105,433 |
| 17 | Minnesota | $105,184 |
| 18 | Maryland | $104,008 |
| 19 | Maine | $103,622 |
| 20 | Idaho | $101,611 |
| 21 | Missouri | $100,337 |
| 22 | Utah | $99,839 |
| 23 | Delaware | $99,452 |
| 24 | Vermont | $99,108 |
| 25 | Rhode Island | $98,653 |
| 26 | Kentucky | $96,881 |
| 27 | Texas | $95,607 |
| 28 | Virginia | $93,743 |
| 29 | Nevada | $93,664 |
| 30 | North Carolina | $93,552 |
| 31 | Wyoming | $92,937 |
| 32 | Pennsylvania | $91,796 |
| 33 | New Mexico | $90,713 |
| 34 | North Dakota | $90,301 |
| 35 | Kansas | $89,581 |
| 36 | Arkansas | $89,426 |
| 37 | South Carolina | $88,989 |
| 38 | Oklahoma | $88,962 |
| 39 | Georgia | $88,955 |
| 40 | Indiana | $88,660 |
| 41 | Iowa | $88,166 |
| 42 | Ohio | $87,866 |
| 43 | Florida | $87,535 |
| 44 | Nebraska | $86,985 |
| 45 | Tennessee | $86,746 |
| 46 | Michigan | $86,723 |
| 47 | South Dakota | $85,727 |
| 48 | Louisiana | $84,406 |
| 49 | Mississippi | $82,136 |
| 50 | West Virginia | $80,509 |
| 51 | Alabama | $71,633 |
| 52 | Puerto Rico | $46,430 |
Lowest Paying States for Ultrasound Technologists
Even the lowest-paying states offer ultrasound technologist salaries well above the national average for all occupations. Here are the 5 lowest-paying states:
Top Earner Potential by State
The 90th percentile represents what experienced, highly-skilled ultrasound technologists earn in each state. These are the 10 states with the highest earning ceilings:
| # | State | Top Earner (P90) |
|---|---|---|
| 1 | California | $185,369 |
| 2 | Washington | $158,649 |
| 3 | Hawaii | $151,297 |
| 4 | Oregon | $143,602 |
| 5 | Massachusetts | $141,869 |
| 6 | New Jersey | $140,598 |
| 7 | Colorado | $139,508 |
| 8 | New Hampshire | $139,101 |
| 9 | District of Columbia | $137,983 |
| 10 | Connecticut | $136,733 |
Playbook: Moving to a Better-Paying State as an Ultrasound Tech
If you're targeting a relocation for ultrasound tech pay, this playbook combines specialty credential build, license portability, and COL math.
1. Lock In ARDMS Multi-Specialty + State License
- ARDMS RDMS / RDCS / RVT — universal credentials.
- CAAHEP-accredited sonography program — required.
- State licensure (OR, NM, NJ, NH) — verify per state.
- State endorsement — varies.
- BLS / ACLS certification — required at most hospitals.
- Multi-cred (RDMS + RDCS + RVT) — premier stack.
- MSK / breast specialty cert — premium niche.
- Background check + fingerprint — typical.
2. Run the Real-Income Math
- COL-adjusted income — Texas tech at $78,000 may exceed California tech at $108,000 net of housing + tax.
- State + local income tax — effective rate.
- Property + sales tax — TX, NJ tradeoff.
- Childcare cost — major regional variance.
- Health + benefits — academic vs outpatient.
- 401(k) match + pension — federal + university.
- Shift differential (call, evening, night) — 10-30% premium.
3. Add Cardiac Before You Move
- RDCS Adult Echo (premier specialty) — premium $95,000-$120,000+.
- Pediatric Echo (RDCS PE) — premium niche.
- Vascular (RVT) — premium.
- MSK sonography — premium emerging.
- Breast sonography — premium niche.
- Maternal-Fetal Medicine — premium.
- Multi-cred triple-stack (RDMS + RDCS + RVT) — premier combo.
- Travel ultrasound tech — premium contract.
4. Negotiate the Move Package
- Sign-on bonus ($5,000-$15,000) — common at shortage + cardiac.
- Relocation assistance ($3,000-$10,000) — standard.
- PSLF stack (501(c)(3) + government) — 10-year forgiveness.
- Tuition reimbursement (specialty cert, BSRT) — premium.
- Call pay (cardiac, MFM) — significant supplemental.
- Shift differential — 10-30% premium.
- Specialty stipend (cardiac, vascular) — premium.
- Federal VA / DoD pension + PSLF — long-term.
5. Pick the Right Setting
- Cardiac echo lab (premier specialty) — top pay.
- Academic medical center (premier benefits + PSLF) — long-term.
- Maternal-Fetal Medicine center — premium specialty.
- Children's hospital pediatric echo — premium niche.
- Vascular surgery practice — premium specialty.
- Outpatient imaging center — base.
- Federal VA / DoD — pension + PSLF.
- Travel ultrasound tech / per-diem — premium hourly.
- Lead tech / sonography educator — admin path.
- Clinical applications specialist (Philips, GE, Siemens, Mindray) — premium industry.
Additional Geographic + Lifestyle Considerations
- Climate fit + lifestyle preference — extreme heat (TX, FL, AZ) vs winter (MN, ME, AK) — major lifestyle differential beyond paycheck.
- School district quality (for families with children) — major hidden cost. Top suburban districts in NJ / NY / MA / CA add significant value.
- Healthcare access + cost-of-living index — verify metro-specific data on BLS / BEA.
- Spousal employment market — coordinate timing with partner career.
- Aging parent proximity — major life consideration.
- Network + alumni density (professional + social) — major.
- Recreation + outdoor access — varies dramatically by state.
- State + local political climate fit — major lifestyle differential.
More Salary Resources
Frequently Asked Questions
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Written by Ravi Patel, RDMS, RVT
Career Analyst
Ravi has 10 years of experience as an ultrasound technologist. He specializes in abdominal and pelvic imaging. He works in a community hospital.
Methodology & Data Source
State salary rankings on this page are 2026 projections based on the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey, May 2026 release. A 4.93% compound annual growth rate (CAGR), derived from 6-year national BLS wage trends, was applied to each state's average salary. Cost-of-living adjustments use BEA Regional Price Parity data. Individual pay varies by city, employer, certifications, and experience.
Data Sources & Methodology
Source: BLS, OEWS , released .
Compiled and verified by Ravi Patel, RDMS, RVT, a licensed ultrasound technologist with 10+ years of clinical experience. · View source data at BLS.gov