The average new CRNA graduate in 2026 is 30-32 years old with $200,000-$300,000 in student debt (AANA, 2026; AACN, 2026).
The certification exam is the National Certification Examination (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). The NCE is a 100-question computer-adaptive test with a 3-hour time limit. The first-time pass rate is 84% (NBCRNA, 2026).
CRNAs must recertify every 4 years through the Continued Professional Certification (CPC) program, which includes 60 hours of continuing education, 4 core modules, and a 100-question assessment (NBCRNA, 2026).
Career outlook and demand
The CRNA job outlook is excellent: BLS projects 38% employment growth from 2024 to 2034, much faster than the 4% average for all occupations. The aging US population, expansion of outpatient surgery centers, and the cost-effectiveness of CRNAs versus anesthesiologists are driving demand. By 2034, the US will need an additional 18,000 CRNAs to meet demand, on a base of roughly 50,000 currently practicing (BLS OOH, 2026).
The demand for CRNAs in rural and underserved areas is particularly strong. CRNAs are the sole anesthesia providers in more than 80% of rural US hospitals (AANA, 2026). The VA system, Indian Health Service, and Critical Access Hospitals rely heavily on CRNAs.
CRNAs who are willing to relocate to rural areas or take on-call rotations can command premium pay of $250,000-$300,000+ per year (AANA, 2026).
Top CRNA employers
The top CRNA employers in 2026 are: HCA Healthcare (5,000+ CRNAs, $200,000-$260,000), US Anesthesia Partners (3,500+, $215,000-$270,000), Envision Healthcare (2,500+, $200,000-$255,000), Sound Physicians (2,000+, $210,000-$265,000), and TeamHealth (1,800+, $195,000-$250,000).
The top CRNA employers in 2026 are: HCA Healthcare (5,000+ CRNAs, $200,000-$260,000), US Anesthesia Partners (3,500+, $215,000-$270,000), Envision Healthcare (2,500+, $200,000-$255,000), Sound Physicians (2,000+, $210,000-$265,000), and TeamHealth (1,800+, $195,000-$250,000). On the academic side, the Mayo Clinic, Cleveland Clinic, and Johns Hopkins are top employers with $200,000-$245,000 per year. The Veterans Health Administration (VA) is the largest single employer of CRNAs in the US, with 1,500+ CRNAs across 170 medical centers, paying $180,000-$240,000 per year (AANA, 2026; HCA, 2026).
Next steps
For a related nursing salary comparison, see our Nurse Practitioner salary by state . For the career path, see our how to become a Nurse Practitioner guide .
CRNA salary by specialty (top 5 subspecialties)
While CRNAs earn strong national-median salaries, pay varies significantly by subspecialty. The top 5 highest-paying CRNA subspecialties in 2026: cardiac anaesthesia ($245,000-$280,000, requires 2-year fellowship), paediatrics ($235,000-$265,000, requires paeds fellowship), obstetrics/labour & delivery ($225,000-$260,000, hot-bench hours), neurosurgical anaesthesia ($235,000-$270,000, high-acuity cases), and critical-care/ICU anaesthesia ($230,000-$260,000, rotating shifts with premium rates). The generalist CRNA (most common career path) earns the national median of $220,000.
Subspecialty fellowships add 12-24 months of training and are typically paid (fellowship stipend $80,000-$110,000/year). After fellowship, CRNAs typically add the subspecialty certification and command a 15-25% premium over generalist pay (AANA, September 2026).
Fazlur Rahman
