Nursing Home Costs by State (2026): Full Price Table
Nursing homes are the most expensive form of long-term care in America — and the price depends enormously on where you live. The same level of round-the-clock skilled care can cost roughly twice as much in one state as in another, which makes national averages almost useless for actual planning. This guide gives you the verified 2026 national medians, explains which states sit at each end of the price spectrum, and breaks down what drives the differences.
National Nursing Home Costs in 2026
According to 2026 industry cost surveys (CareScout, A Place for Mom), the national medians for nursing home care are:
| Room Type | Median Monthly Cost | Median Annual Cost |
|---|---|---|
| Semi-private room | $9,342 | ~$112,000 |
| Private room | $11,294 | ~$135,000 |
A private room costs roughly $1,950 more per month than a semi-private room — about $23,000 extra per year. That premium is worth understanding, because it is one of the few levers families can control (more on that below). Keep in mind these are medians: half of facilities charge more, half charge less, and your state’s position relative to these figures matters more than the national number itself.
Where Nursing Homes Cost the Most
The most expensive states for nursing home care are, with remarkable consistency, the same states that top every other care-cost ranking. Alaska and Hawaii stand far above the rest — remote locations, high wages, and expensive everything push facility costs well beyond mainland levels. The Northeast corridor follows: Massachusetts, Connecticut, New York, and New Jersey all rank among the priciest states, driven by high labour costs, costly real estate, and stringent staffing requirements.
The West Coast is the third high-cost cluster. California’s nursing homes run well above the national median, in line with its assisted living market — our California cost guide shows the same regional pattern within the state, with coastal metros far pricier than inland areas. Oregon and Washington follow a similar, if slightly less extreme, profile.
Where Nursing Homes Cost the Least
At the other end of the spectrum, the South and parts of the Midwest consistently offer the country’s most affordable nursing home care. Mississippi, Alabama, Arkansas, Louisiana, and Oklahoma rank among the least expensive states year after year — the same states that top our assisted living affordability lists. Lower prevailing wages, cheaper property, and different Medicaid reimbursement structures all contribute.
Texas sits in the affordable group as well, with costs typically below the national median — see our Texas cost guide for the regional detail. Florida is more of a mixed picture: statewide medians sit near or slightly above the national figure, but vary dramatically between Miami and the Panhandle, as our Florida guide explains.
One important note on figures: the state-level medians published in industry surveys are typically reported for assisted living, where the data is most complete. Nursing home costs follow the same geographic pattern — the same states are cheapest and most expensive — but run roughly double the assisted living level. Any source quoting precise state-by-state nursing home medians without a clear methodology should be treated with scepticism.
What Drives the State-by-State Differences
Labour costs dominate. Nursing homes are staffing-intensive by law — federal and state rules set minimum staffing levels, and wages for nurses and aides track local labour markets. A certified nursing assistant earns far more in Boston than in Biloxi, and that gap flows straight into monthly fees.
Real estate and regulation come next. Building and operating a facility costs more where land is expensive, and states with tougher building codes, higher minimum staffing ratios, and certificate-of-need laws (which limit new facilities) tend to have higher prices.
Medicaid reimbursement shapes the market. Because Medicaid pays for a large share of nursing home residents nationally, each state’s reimbursement rate effectively sets a price floor. States that reimburse generously tend to have higher private-pay prices too, since facilities calibrate around those rates.
Urban versus rural matters within states. Even in expensive states, rural facilities often charge meaningfully less than those in major metros — a pattern worth remembering if your family has any flexibility about location.
Semi-Private vs Private Room: Is the Premium Worth It?
At roughly $23,000 a year extra, the private-room premium deserves a deliberate decision rather than a default. Privacy, better sleep, and space for visitors are genuine benefits, particularly for long stays. But semi-private rooms are the norm in the industry, Medicaid typically covers the semi-private rate (leaving families to pay the private-room surcharge out of pocket), and some residents genuinely prefer the company. Tour both, ask about roommate-matching policies, and weigh the premium against how long the stay is likely to last.
How to Use These Numbers in Your Planning
Start with the national medians — $9,342 a month for a semi-private room, $11,294 for private — then adjust for your state using the patterns above. Then get local: call three to five facilities near you and ask for their current private-pay daily rate, which is the figure that actually determines your bill.
For a personalised estimate, use our nursing home cost estimator to model your situation, and compare the result against alternatives with our assisted living vs home care guide and the assisted living cost calculator. Nursing home care is rarely anyone’s first choice — but knowing the real numbers early gives your family options instead of surprises.