Illinois is currently offering neurosurgeons up to $1,000,000 annually, while Alabama—one of the volume leaders with five listings—is offering as little as $250,000 for the same specialty. The national Neurosurgery market contains 53 active listings spread across 23 states, but only four employers felt compelled to disclose what they’re actually paying. The data shows a market where compensation transparency is rare, geographic arbitrage is extreme, and the Midwest is quietly writing the biggest checks.
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The Neurosurgery Job Market at a Glance

Fifty-three total listings. Four with salary data. Range: $250,000 to $1,000,000. Average: $756,250 to $818,750.

That’s a 300% spread between floor and ceiling, and a transparency rate that would make a defense contractor blush. The four disclosed positions cluster at the extremes: three pay $900,000 or more, one pays $400,000 or less. There’s no middle class in this dataset. The average is elevated entirely by the top three listings, meaning most neurosurgeons navigating this market are flying blind on 92.5% of available roles.

The 49 undisclosed listings span the full national footprint, but compensation intelligence exists only in four states: Illinois, Missouri, Ohio, and Alabama. Everyone else is keeping their cards face-down.

States represented: Alabama, Arkansas, California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Michigan, Mississippi, Missouri, Nebraska, North Carolina, Ohio, Pennsylvania, Texas, Virginia, Washington, West Virginia, and Wisconsin.
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How States Stack Up

Overperformers

• Illinois: $900,000 to $1,000,000 across two listings—the highest disclosed ceiling nationally and proof that Chicago-area systems are paying for scarcity.
• Missouri: $975,000 in Springfield, the single highest flat salary in the dataset and a reminder that mid-sized Midwest markets will pay top dollar when they need subspecialty coverage.
• Ohio: $900,000 across three listings, making it both a volume and compensation leader—a rare combination that signals sustained institutional demand.

Near-average states

No states fall near the national average of $756,250 to $818,750. The disclosed market is bimodal: you’re either well above $900,000 or well below $400,000.

Underperformers

• Alabama: $250,000 to $400,000, a 62% discount to the national average and the lowest disclosed range in the dataset—despite leading the nation in listing volume with five postings.

Volume leaders

Pennsylvania and Alabama lead with five listings each. Wisconsin, Texas, and Florida follow with four apiece. Ohio, Iowa, Idaho, and Kentucky each posted three.

Alabama leads on volume but trails catastrophically on pay. Pennsylvania, the other volume leader, disclosed nothing (which may be strategic after seeing Alabama’s numbers). Texas and Florida—traditional physician employment hubs—also remain silent on compensation, suggesting either competitive sensitivity or market softness they’d prefer not to advertise.
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What This Means If You’re a Physician

If your priority is maximum compensation: Target Illinois and Missouri. The highest single listing is Springfield, Missouri at $975,000 annually, but Illinois offers the highest ceiling at $1,000,000. Ohio provides a safer volume bet at the same $900,000 threshold. All three are in the Midwest, all three disclosed, and all three are paying at or near seven figures.

If your priority is maximum optionality: Pennsylvania offers five listings with no salary data, meaning you’ll need to negotiate blind—but the volume suggests sustained demand. Texas and Florida each have four postings and name recognition, though their silence on pay is conspicuous. Wisconsin’s four listings and cost-of-living advantage may be worth the transparency trade-off.

If your priority is balance: Ohio delivers three listings at $900,000 with reasonable cost-of-living and geographic centrality. Avoid Alabama unless you have non-financial priorities; the $250,000 floor represents a 72% discount to Missouri’s high and a cost-of-living arbitrage that doesn’t exist between Huntsville and Springfield.
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What This Means If You’re a Recruiter

Salary transparency rate: 7.5% (four of 53 listings).

That’s not a pipeline problem—it’s a disclosure problem. Ninety-two percent of employers in this dataset are asking neurosurgeons to express interest without knowing whether the role pays $400,000 or $975,000. In a specialty where the national range spans 300%, that’s not strategy, it’s friction. Candidates with leverage will route around you.

Alabama’s volume-pay misalignment is the most acute risk in the dataset. Five listings at $250,000 to $400,000 will generate applications, but not closures—not when Ohio is offering $900,000 for the same scope 400 miles north. Recruiters in undisclosed markets like Pennsylvania, Texas, and Florida will need to lead with lifestyle, partnership track, or subspecialty focus, because they’ve ceded the compensation conversation to the Midwest.

If you’re hiring in a non-disclosed state, your competitors in Illinois, Missouri, and Ohio just set the benchmark. Price accordingly or differentiate aggressively.
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What’s Driving the Numbers

Geographic arbitrage is extreme and unexplained by cost-of-living.

The $725,000 gap between Alabama’s floor and Missouri’s ceiling cannot be reconciled by regional price indices. Springfield and Huntsville are both mid-sized Southern/Heartland markets with comparable living costs. The differential suggests Alabama is either pricing for part-time roles, undervaluing subspecialty work, or facing institutional budget constraints that Missouri systems are not. Without scope-of-practice details, it’s impossible to know whether Alabama is underpaying or Missouri is overpaying—but the gap is wide enough to drive interstate migration.

Transparency is concentrated in high-pay markets, which distorts the average upward.

The four states that disclosed salaries are three of the four highest payers. That’s selection bias. The national average of $756,250 to $818,750 is not representative—it’s a ceiling masquerading as a midpoint. The 49 undisclosed listings almost certainly include roles paying below $700,000, but they’re invisible in the aggregate data. Physicians using this average as a benchmark are overestimating the market.

Volume does not correlate with pay, and may inversely correlate.

Alabama and Pennsylvania lead on listings but occupy opposite ends of the information spectrum: Alabama disclosed the lowest range, Pennsylvania disclosed nothing. High volume traditionally signals demand, which should drive price upward. That’s not happening here. Either these states are saturated with supply, constrained by reimbursement models, or competing on non-cash value propositions. Neurosurgeons should treat volume as a measure of opportunity, not compensation.

The Midwest is the only region with consistent seven-figure data.

Illinois, Missouri, and Ohio account for three of the four disclosed salaries, and all three are at or above $900,000. The coasts—California, Washington, Connecticut—are present in the dataset but silent on pay. That silence is unusual. Coastal markets typically lead on physician compensation due to cost-of-living and competitive density. Their absence from the top tier suggests either strategic non-disclosure or a geographic rebalancing where Heartland systems are now outbidding traditional high-pay regions.

The Bottom Line

The Neurosurgery job market is geographically broad, numerically robust, and informationally opaque. Fifty-three listings across 23 states suggest healthy demand, but only four employers are willing to name a number—and those four span a $750,000 range. The Midwest is paying at or above $900,000 with transparency. The South is paying as low as $250,000 with transparency. Everyone else is paying something, but they’re not saying what.

Neurosurgery is a million-dollar specialty in four states and a quarter-million-dollar specialty in one, and the other 49 listings would prefer you didn’t ask which.
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Salary data based on 4 listings with disclosed compensation. Figures may reflect part-time or specialized roles. This report is informational and should not replace professional judgment or financial planning.