| State | 2026 mean salary | Hourly rate | Cost-of-living index |
|---|
| California | $98,000 | $47 | 142, high |
| New York | $93,000 | $45 | 139, high |
| Hawaii | $90,000 | $43 | 192, very high |
| Washington | $87,000 | $42 | 115, moderate |
| Oregon | $85,000 | $41 | 118, moderate |
| Massachusetts | $84,000 | $40 | 135, high |
| Alaska | $83,000 | $40 | 127, high |
| Connecticut | $82,000 | $39 | 129, high |
| New Jersey | $81,000 | $39 | 128, high |
| Maryland | $79,000 | $38 | 113, moderate |
| Texas | $72,000 | $35 | 99, average |
| Florida | $70,000 | $34 | 103, average |
| Illinois | $71,000 | $34 | 96, below average |
| Ohio | $67,000 | $32 | 91, below average |
| Pennsylvania | $68,000 | $33 | 97, average |
| National median | $70,000 | $34 | 100, baseline |
What works: California, New York, and Hawaii pay the highest nominal salaries, but the cost of living in those states is 35% to 90% above the national average. Washington and Oregon often deliver the best balance, with pay 25% above the national median and cost of living only 15% to 20% above. For early-career RTs, Texas and Florida tend to give more take-home pay per dollar, with the cost of living below the national average and the salary at or slightly above the national median, per the BLS May 2025 release and the MERIC 2026 cost-of-living index.
Hourly rate for respiratory therapists
Hourly rates for respiratory therapists in 2026 run from $26 to $46, with a national median of $33 to $35 per hour. Entry-level rates start at $26 to $31, mid-career rates run $31 to $38, and senior or specialty rates reach $38 to $46. Travel RTs earn $43 to $67 per hour, which is 30% to 50% above staff rates, because the higher hourly rate makes up for the lack of benefits and the disruption of relocation, per the AARC 2026 survey and the BLS May 2025 release.
What works: overtime is paid at 1.5x the base rate at most employers, and many hospitals offer crisis or premium shifts at 2.0x the base rate for last-minute coverage. What works less well: hourly rates stay flat in the bottom-quartile-paying states regardless of experience. A practical move is to specialize in NICU or pediatric respiratory therapy, since the specialty differential runs $5 to $10 per hour, and to pick up premium shifts when available, because the 2.0x rate can push a mid-career RT into six-figure annualized income.
Highest-paying employers for respiratory therapists
The highest-paying RT employers in 2026 are HCA Healthcare at $72,000 to $95,000, Kaiser Permanente at $85,000 to $110,000, Cleveland Clinic at $75,000 to $100,000, Mayo Clinic at $80,000 to $105,000, and the U.S. Department of Veterans Affairs at $73,000 to $98,000. Government employers including the VA and the Indian Health Service pay slightly below the top private systems but offer strong benefits and pension plans. Travel agencies such as AMN Healthcare, Aya Healthcare, and Trusted Nurse Staffing pay the highest gross hourly rates at $43 to $67, but the benefits are minimal, per the AARC 2026 survey and employer-reported salary data for 2026.
What works: Kaiser Permanente and the Mayo Clinic offer the highest base salaries with the best benefits, including pension plans, retiree health insurance, and tuition reimbursement for advanced degrees. What works less well: the highest-paying employers are concentrated in California, Minnesota, and Ohio, which means geographic mobility is required. For top pay with career development, Kaiser Permanente in California is often the strongest pick, while a travel contract through Aya or AMN delivers the most flexibility.
Respiratory therapist career outlook through 2034
The RT job outlook through 2034 is strong. The BLS projects 13% employment growth from 2024 to 2034, well above the 4% average for all occupations. By 2034, the US will need around 153,000 respiratory therapists, an increase of 18,000 from the current base of 135,000. The drivers are the aging US population, rising rates of chronic respiratory disease like COPD, asthma, and sleep apnea, the expansion of home healthcare, and the increased acuity of hospitalized patients who need mechanical ventilation. The role is projected to remain in the top quartile of healthcare jobs for employment growth through 2034, per the BLS Occupational Outlook Handbook for 2026.
What works: strong employment growth, geographic mobility, the option to specialize in high-paying niches like sleep, NICU, or transport, and a clear path into management or education. What works less well: shift work including nights, weekends, and holidays is the norm, the work is physically and emotionally demanding, and the pay ceiling without management is around $95,000. A reliable move is to earn the RRT credential within 2 years of graduation, because RRT-credentialed therapists earn 10% to 15% more than CRT-only therapists at every experience level.
How to maximize your respiratory therapist salary in 2026
Four levers move the needle. First, earn the RRT credential within 2 years of graduation, because RRT-credentialed therapists earn 10% to 15% more than CRT-only. Second, specialize in NICU, sleep, or transport, since those specialties add $5 to $10 per hour. Third, target California, New York, Hawaii, Washington, or Oregon, where pay is 25% to 40% above the national median. Fourth, negotiate hard on sign-on bonus and shift differential, since the spread on offers for the same role can run 15% to 25%. For new graduates, the most useful first step is to start at a level 1 or level 2 trauma center to get the strongest clinical experience, then move to a specialty or a travel contract after 2 to 3 years.
What works: multiple paths to higher pay including specialty, geography, employer, and credential. What works less well: it takes 2 to 4 years of focused effort to reach the senior pay band. The fastest route to six figures is to specialize in sleep or NICU, then target California or a Kaiser Permanente role, since the combination adds $20,000 to $30,000 a year over a staff CRT role in a low-cost state.
Photo: secondfromthesun0, Pixabay Content License, via Pixabay (https://pixabay.com/photos/massage-therapist-woman-835468/)
Fazlur Rahman
