While emergency medicine remains the one specialty in the health care arena without standardization of income nationwide or, in many cases, statewide, there is now a benchmark to shoot for: $200 an hour. It crops up throughout the Midwest, Southeast, and Western regions regularly and can be found in parts of the Middle Atlantic and even the Northeast, but it remains elusive in the Pacific Northwest. This is a picture of that market from the perspective of dollars only, with data drawn from primary emergency medicine job Web sites, including EDPhysician.com, EDSource.com, EDOpenings.com, and ACEP’s Career Central, as well as from inquiries sent to all large national contract management groups. The annual income levels are based on an average of 1,632 clinical hours and include average RVU earnings and a benefits package valued at $25,000 where applicable. No sign-on bonuses, perks, or loan payback programs were included. Rankings are based on state averages, not the sporadic highs.

The highest regional income is found in the nine states of the Southeast, primarily due to the elevated incomes in Mississippi and the high hourly rate of $200+ throughout the region.

Mississippi: Average: $240 hr./$400K annually, high of $337 hr./$550K annually

Tennessee: Average: $195 hr./$345K annually, high of $239 hr./$390K annually

South Carolina: Average: $190 hr./$335K annually, high of $240 hr./$400K annually

Georgia: Average: $190 hr./$335K annually, high of $250 hr./$430K annually

Arkansas: Average: $185 hr./$326K annually, high of $200 hr./$350K annually

North Carolina: Average: $185 hr./$326K annually, high of $220 hr./$400K annually

Florida: Average: $180 hr./$315K annually, high of $200 hr./$350K annually, sign-ons average $30K

Alabama: Average: $176 hr./$300K annually, high of $230 hr./$380K annually

Louisiana: Average: $170 hr./$300K annually, high of $200 hr./$350K annually

The Midwest region has the most states in the top 10 but a wider range of incomes throughout the 12. The new leader in the region is North Dakota, edging out the usual Wisconsin.

North Dakota: Average: $215 hr./$390K annually, high of $330 hr./$550K annually

Wisconsin: Average: $215 hr./$375K annually, high of $300 hr./$515K annually

Illinois: Average: $200 hr./$350K annually, high of $338 hr./$550K annually; Chicago: Average: $180 hr./$325K annually

Indiana: Average: $200 hr./$350K annually, high of $250 hr./$433K annually

Nebraska: Average: $200 hr./$350K annually, no significant highs

Kansas: Average: $190 hr./$335K annually, high of $210 hr./$345K annually;

Kansas City: Average: $200 hr.

Kentucky: Average: $185 hr./$326K annually, high of $298 hr./$500K annually; Nashville: Average: $200 hr.