I’ll save you the suspense: if you look up the single highest-paying occupation in any given state, it’s almost always a doctor. Surgeons, anesthesiologists, cardiologists, orthodontists. The federal survey doesn’t even publish exact salaries for a lot of these because they exceed the reportable ceiling ($239,200+). So yeah, doctors make the most money. You knew that. I knew that. Not very helpful.
What I wanted to figure out for this article is the stuff below the medical ceiling. What’s the highest-paying job in each state that a person could reasonably aim for without going to medical school? That’s where it gets interesting, and that’s where the patterns start to tell you something about each state’s economy that a simple salary table doesn’t.
The National Landscape
The most current federal wage data gives us the 20 highest-paying occupations nationally. Almost all of them are medical: surgeons, anesthesiologists, orthodontists, oral surgeons, psychiatrists, physicians of various kinds. The first non-medical occupation that shows up is airline pilots at a median of $226,600. After that it’s chief executives at around $206,000, then computer and information systems managers at $169,510.
That pilot number stopped me for a second. Higher than CEOs. Higher than any tech job. And it makes sense when you think about it; there’s been a pilot shortage for years, major airlines have been fighting over experienced captains, and senior pilots at Delta or United can clear $350,000+ with international routes. A buddy of mine from college went the pilot route, spent his 20s building hours as a flight instructor making almost nothing, and now in his 40s he’s earning more than any of us who went into tech. Different trajectory, but the ceiling is there.
What I Found State by State
I went through the state data and pulled the top-paying non-medical occupation in each state. Some patterns jumped out.
Tech states are obvious. In California, Washington, and Massachusetts, computer and information systems managers are consistently among the top earners outside of medicine. California’s mean for this role is over $200K. If you’re in the Bay Area (I am), this tracks; half the people I know work in some flavor of tech management. Software developers don’t crack the top-paying list at the state level because the category is so broad that medians get diluted, but in practice, a senior engineer at a company like Google or Apple is earning $250K+ in total comp. The survey doesn’t capture stock grants, which is why the official numbers look low compared to what people in the industry actually take home.
Energy states have their own economy. Alaska and North Dakota pay abnormally well for jobs connected to oil and gas. Chief executives in Alaska average over $190K, and various engineering roles in energy show up high on both states’ lists. Wyoming is similar. These are small-population states where a handful of high-paying industries punch above their weight in the data.
The South and Midwest tell a different story. In Mississippi, Arkansas, West Virginia, and several other southern states, the highest-paying non-medical jobs tend to be management roles: general and operations managers, financial managers, architectural and engineering managers. These are decent-paying jobs ($100K to $140K in most of these states), but the ceiling is lower and there’s less occupational diversity at the top of the pay scale. It’s management or medicine; there isn’t much in between. The absence of a major tech or finance hub keeps the top earners clustered in a narrower band.
Financial hubs skew the data in predictable ways. New York and Connecticut have financial managers and securities/financial services sales agents near the top. New York’s financial manager mean exceeds $200K. New Jersey benefits from spillover. D.C. is heavy on management analysts and lawyers for obvious reasons; the government and the people who sell things to the government drive a lot of the local pay structure.
The Jobs That Show Up Everywhere
Some occupations are in the top 20 in virtually every state. I started tracking which ones and here’s what I noticed:
Pharmacists are top-20 earners in almost every state, usually between $120K and $160K. I just wrote an article about how the retail pharmacy industry is collapsing, but the pay is still there. The irony isn’t lost on me.
Nurse practitioners and nurse anesthetists show up constantly. Nurse anesthetists are pulling $231K nationally, which is physician-adjacent pay for a nursing credential. I’ve mentioned this in a few articles now and it still surprises people every time.
Airline pilots are top-20 in any state with a major airport. $226,600 median nationally. That number was $186K five years ago; the pilot shortage has been very good to people who already had the credentials.
Computer and information systems managers are in the top 20 in most states, not just tech hubs. Even in Iowa or Nebraska, this role pays $130K+. Every industry needs IT leadership; it’s not a coastal-only career anymore.
The Highest-Paying Jobs You Can Get Without a Degree
This felt worth breaking out separately because not everyone reading this has or wants a four-year degree. Based on the federal data, here are the jobs that show up among the highest earners and don’t require a bachelor’s:
Elevator and escalator installers average $106,580 (the survey groups them separately from electricians, but they’re related trades). It’s a niche job but it pays better than a lot of white-collar work. Electrical power line installers average around $82K. Transportation and distribution managers can earn $102K+ and many come up through logistics experience rather than a degree.
I wrote about electricians a few articles back and the Illinois number was $89K. Master electricians with their own businesses clear $100K to $150K. Plumbers in union states do $80K+. These aren’t at the very top of any state’s pay rankings, but they’re solidly upper-middle and the barrier to entry is apprenticeship, not tuition.
The trades are having a moment and the data backs it up. I’ve seen this from every angle now across seven articles: the states with strong union trades (Illinois, Oregon, Washington, New York) consistently show blue-collar earnings that compete with or exceed entry-level white-collar salaries. A journeyman electrician in Chicago out-earns a starting accountant in most of the country. Nobody would’ve believed that twenty years ago.
What This Data Actually Tells You
After seven of these articles, here’s the pattern I keep seeing. Geography matters, but it matters less than people think once you adjust for cost of living. Occupation choice matters more. And within an occupation, the specific employer and setting matter most of all.
A registered nurse in California making $149K sounds like she’s winning. But after Bay Area rent and state taxes she might be saving less than a nurse in Indiana making $80K. A police officer in Mississippi making $45K is just underpaid for the risk, full stop. A pharmacist making $155K in a retail chain that’s falling apart might envy the one making $135K in a hospital with normal hours.
Salary data is a starting point. I try to make it more than that in these articles, but at the end of the day you’ve got to weigh the number against the cost of living in your specific city, the quality of the job, and whether the industry is growing or shrinking. The survey won’t tell you any of that. Your own research will.
For any of the occupations mentioned above, we’ve got full state-by-state breakdowns on the site. Start with the occupation pages: software developers, registered nurses, electricians, pharmacists, financial managers, lawyers, airline pilots, and chief executives. Or browse the state hubs for California, Texas, New York, Illinois, Florida, and Washington to see every occupation ranked by pay in a single state.