The Short Answer
CRNAs are paid both ways—about 70% of hospital-employed CRNAs receive annual salaries, while outpatient centers and locum positions often pay hourly at rates from $69 to $128 per hour. Your payment structure dramatically impacts your earnings potential, with hourly positions often offering higher total compensation through overtime but less predictability than salaried roles.
Understanding Your Payment Options
The way you’re paid as a CRNA affects everything from your monthly budget to your retirement planning. Let’s decode what each payment structure really means for your wallet and your life:
| Payment Type | Typical Rate | Annual Earnings | Overtime Potential | Best For |
|---|---|---|---|---|
| Hourly | $69-$128/hour | $143,000-$266,000 | Yes (1.5x after 40 hrs) | Maximizing income |
| Salary | Fixed annual | $205,770 average | Usually no | Predictability |
| Hybrid | Base + incentives | $205,000-$250,000+ | Varies | Balance of both |
The payment structure you choose (or that’s offered) can mean a $50,000+ difference in annual earnings—even in the same facility.
Hourly Pay: The High Earner’s Choice
Hourly CRNAs often out-earn their salaried colleagues, especially when you factor in overtime. Here’s the real math based on data from nursingprocess.org and the U.S. Bureau of Labor Statistics (BLS):
| Hours Worked | Base Rate | Regular Pay | Overtime Pay | Weekly Total | Annual Total |
|---|---|---|---|---|---|
| 40 hours | $100/hour | $4,000 | $0 | $4,000 | $208,000 |
| 50 hours | $100/hour | $4,000 | $1,500 | $5,500 | $286,000 |
| 60 hours | $100/hour | $4,000 | $3,000 | $7,000 | $364,000 |
The Overtime Advantage: Those extra 10-20 hours per week at time-and-a-half can add $78,000-$156,000 to your annual income.
Top Hourly Paying States
According to 2025 data, these states offer the highest hourly rates:
| State | Average Hourly Wage | Annual at 40 hrs/week | Annual with OT (50 hrs) |
|---|---|---|---|
| Minnesota | $128.33 | $266,926 | $346,491 |
| Hawaii | $128.22 | $266,698 | $346,107 |
| California | $118.74 | $246,979 | $320,673 |
That Minnesota CRNA working 50 hours weekly could earn nearly $350,000—all while maintaining W-2 employee benefits.
Salary Employment: The Stability Play
About 70% of hospital-employed CRNAs choose salary for good reasons:
The Complete Package
Median annual salary: $205,770
But that’s not the whole story. Salaried positions typically include:
| Benefit Component | Typical Value | What It Means for You |
|---|---|---|
| Health Insurance | $15,000-$20,000 | Family coverage included |
| Retirement Match | $10,000-$15,000 | Free money for your future |
| Paid Time Off | $16,000-$20,000 | 4-6 weeks paid vacation |
| Malpractice Insurance | $5,000-$8,000 | Critical protection |
| CME Allowance | $3,000-$5,000 | Conferences and training |
| Total Benefits Value | $49,000-$68,000 | Real money in your pocket |
Your $205,770 salary is actually worth $254,770-$273,770 when you include benefits.
Industry Breakdown: Who Pays What Way
Your employer type strongly influences how you’re paid:
| Industry Setting | Salary % | Hourly % | Typical Total Compensation |
|---|---|---|---|
| Hospitals | 70% | 30% | $205,770 + benefits |
| Outpatient Surgery Centers | 55% | 45% | $263,960 average |
| Federal Government | 95% | 5% | $205,770 + exceptional benefits |
| Locum Tenens | 10% | 90% | $250,000-$500,000 |
| Private Practice | 60% | 40% | Highly variable |
BLS data shows specialty hospitals paying $246,810 average, whether hourly or salary.
The Hybrid Model: Best of Both Worlds?
Some innovative compensation packages combine stability with earning potential:
Base Salary + Productivity:
– Guaranteed base: $180,000
– Per-case bonus: $100-$200
– Annual potential: $220,000-$260,000
Example: You’re guaranteed $180,000, but if you handle 1,000 cases (typical), you earn an extra $100,000 in bonuses.
On-Call Additions:
– Base salary: $205,000
– Call pay: $500-$600 per shift
– Monthly call (4 shifts): $2,000-$2,400
– Annual boost: $24,000-$28,800
The Legal Landscape: What You Need to Know
The Fair Labor Standards Act (FLSA) classifies most CRNAs as exempt employees, meaning:
If You’re Salaried (Exempt):
- No overtime pay required
- Expected to work until job is done
- More flexibility in schedule
- Higher base compensation typically
If You’re Hourly (Non-Exempt):
- Overtime mandatory after 40 hours
- Clock in/out requirements
- Less schedule flexibility
- Potential for higher total earnings
State laws can override federal rules:
– California: Mandates overtime for all hourly healthcare workers
– Texas: No mandatory overtime protection for salaried CRNAs
Experience Level Impact on Payment Structure
Your career stage influences which payment model serves you best:
| Experience Level | Annual Compensation | Preferred Payment Type | Why |
|---|---|---|---|
| Entry-Level (0-1 year) | $149,675 | Salary | Learning, stability needed |
| Early Career (2-5 years) | $171,894 | Mixed | Building skills and income |
| Mid-Career (5-10 years) | $186,894 | Hourly possible | Maximizing earnings |
| Senior (10+ years) | $200,000+ | Either | Lifestyle choice |
Real-World Payment Scenarios
Let’s see how different payment structures play out:
Scenario 1: Hospital CRNA (Salary)
- Annual salary: $205,770
- Benefits value: $60,000
- Total compensation: $265,770
- Monthly take-home: ~$11,000
- Predictable, stable, good work-life balance
Scenario 2: Surgery Center CRNA (Hourly)
- Hourly rate: $110
- Weekly hours: 45 (5 overtime)
- Annual gross: $275,000
- No benefits provided: -$40,000 cost
- Net advantage: Still ahead by $30,000
Scenario 3: Locum CRNA (Hourly Contract)
- Hourly rate: $150
- Weekly hours: 40
- Annual gross: $312,000
- Self-employment tax: -$25,000
- Benefits cost: -$40,000
- Net income: $247,000 (still higher)
Making the Right Choice for Your Life
Consider these factors when evaluating payment structures:
| Life Situation | Better Choice | Why |
|---|---|---|
| New graduate with loans | Hourly | Maximize income for debt payoff |
| Starting a family | Salary | Predictability and benefits |
| Single, flexible | Hourly/Locum | Maximum earning potential |
| Nearing retirement | Salary | Stability and benefits |
| Side business owner | Salary | Predictable schedule |
Professional Resources for Compensation Information
Stay informed about payment trends through these organizations:
- American Association of Nurse Anesthesiology (AANA)
- Address: 10275 W Higgins Rd, Suite 500, Rosemont, IL 60018
- Phone: (855) 526-2262
- Compensation surveys and data
- American Academy of Nurse Practitioners Certification Board (AANPCB)
- Address: 2600 Via Fortuna, Suite 240, Austin, TX 78746
- Phone: (512) 637-0500
- Email: [email protected]
- Council on Accreditation of Nurse Anesthesia Educational Programs (COA)
- Address: 222 S Prospect Ave, Park Ridge, IL 60068
- Phone: (847) 655-1160
Negotiating Your Payment Structure
You have more power than you think:
If Offered Salary:
– Calculate the hourly equivalent
– Request productivity bonuses
– Negotiate higher base for no overtime
– Ensure comprehensive benefits
If Offered Hourly:
– Clarify overtime policies
– Negotiate higher base rate
– Ask about guaranteed hours
– Calculate total compensation needs
Future Trends in CRNA Compensation
AANA Compensation Survey data suggests:
- Hybrid models increasing in popularity
- Productivity incentives becoming standard
- Hourly rates rising faster than salaries
- Benefits packages becoming more creative
The “2025 CRNA Workforce Report” indicates that flexibility in payment structure is becoming a recruitment tool, with facilities offering choice to attract top talent.
The Bottom Line: It’s Not Just About the Structure
Whether you’re paid hourly or salary matters less than the total compensation package and how it fits your life goals. A $205,000 salary with excellent benefits might serve you better than $250,000 hourly with no security—or vice versa.
Key insights:
– Hourly typically offers higher earning potential through overtime
– Salary provides stability and comprehensive benefits
– Hybrid models are increasingly common and attractive
– Your career stage should influence your choice
– Geographic location affects both rates and structures
The good news? As a CRNA, you’ll have options. Unlike many professions locked into one payment model, you can choose the structure that best supports your financial goals and lifestyle preferences. Whether you prioritize maximum earnings through hourly work or value the predictability of salary, your CRNA credential ensures you’ll be well-compensated either way.
Smart CRNAs often strategically shift between payment models throughout their careers—starting hourly to crush student loans, moving to salary when starting families, perhaps returning to hourly or locum work when kids are grown. The flexibility to choose your compensation structure is just another advantage of this remarkable career path.