Somewhere in Fergus Falls, Minnesota — population roughly 14,000, winters roughly forever — a CompHealth listing is offering $480,000 a year to run an emergency department. Meanwhile, in Harrisburg, Pennsylvania, a role tops out at $260,000. Same specialty. Same board certification. Nearly a quarter-million dollars of daylight between them.

The Emergency Medicine market currently shows 762 active listings nationally, sprawling from Alaska to the Northern Mariana Islands. Forty-seven of those listings disclose compensation. The rest ask you to guess.

The data tells a clear story: in Emergency Medicine, geography and setting matter more than the specialty itself.
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The Emergency Medicine Job Market at a Glance

Total listings: 762
Listings with disclosed salary: 47
Full salary range: $250,000 to $480,000 (annualized)
Hourly range observed: $200 to $300 per hour ($416,000 to $624,000 annualized at 2,080 hours)
Approximate national average low end: $470,831

The spread here is enormous. A physician doing essentially the same triage-and-stabilize work can earn anywhere from a quarter million to well over six hundred thousand, depending almost entirely on ZIP code and acuity level. The floor tends to reflect occupational health, corporate clinics, and lower-acuity settings. The ceiling reflects rural hospitals paying premiums for anyone willing to move there.

States with listings in the dataset: TX, FL, TN, IN, OH, AL, SC, CA, KY, NC, IL, PA, NY, GA, MO, OK, VA, WA, NM, MN, IA, ME, AZ, ME, MA, NJ, WI, AR, NH, MI, LA, AK, WV, ND, NE, NV, SD, MS, ID, RI, MD, DC, MP, HI, WY, VT, MT, CO, KS.
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How States Stack Up

Overperformers:

• Iowa: $613,600 average, one listing (rural premium, small sample, take with salt).
• Washington: $569,227 to $606,667 across three listings (one of the few high-payers with actual data density).
• California: $536,264 to $594,504 across five listings (yes, even after cost of living).
• Texas: $535,000 to $612,000 across two listings (high pay and high volume — the rare double).
• Oklahoma: $520,000 to $603,200, one listing (scarcity pricing).
• New York: $515,333 to $532,667 across three listings (surprisingly competitive).
• Missouri: $501,550 to $510,650 across eight listings (the deepest data pool in the top tier).

Near-average:

• Vermont: $495,040, one listing (a single data point in a small state).
• Ohio: $463,440 to $501,680 across five listings (the mid-market benchmark).
• Hawaii: $416,000 to $457,600, one listing (paradise tax applied).
• Illinois: $413,257 to $445,314 across seven listings (solid, reliable, unremarkable).
• Minnesota: $410,000 to $450,000 across two listings (with one Fergus Falls outlier hitting $480,000).
• South Carolina: $396,000 flat across two listings.

Underperformers:

• Michigan: $350,000, one listing.
• Colorado: $345,000 to $365,000, one listing (mountain views apparently priced in).
• Kansas: $330,000 to $355,000, one listing (Premise Health, occupational setting).
• Pennsylvania: $250,000 to $260,000, one listing (the national floor).

Volume leaders: Texas (60), Florida (59), Tennessee (46), Indiana (44), Ohio (34), Alabama (32), South Carolina (27), California (26), Kentucky (25). Tennessee and Indiana are volume monsters that disclosed zero salary data. Florida has 59 listings and only two salaries reported. Texas is the outlier that leads on both fronts.
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What This Means If You’re a Physician

If your priority is maximum compensation: Look at Iowa, Washington, Oklahoma, and rural Minnesota. The single highest annualized listing is a CompHealth role in Fergus Falls, MN at $480,000. San Antonio’s Accolades listing at $250 to $300 per hour annualizes to $520,000 to $624,000 for anyone willing to work a full 2,080-hour year (few will).

If your priority is maximum optionality: Texas, Florida, Tennessee, and Indiana lead on volume. Texas is the only one of the four with published salary data supporting the move.

If your priority is balance: Missouri, Ohio, and Illinois pair meaningful listing volume with mid-to-high compensation and multiple data points. Missouri’s eight-listing average near $500,000 is the most trustworthy number in this entire report.

Watch the cost-of-living mismatch: California pays $536K to $594K but housing eats it. Iowa pays more, on paper, with none of the tax burden.
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What This Means If You’re a Recruiter

Salary transparency rate: 47 of 762 listings = 6.2%.

That is not a rate. That is a rounding error. Ninety-four percent of Emergency Medicine listings ask physicians to inquire, negotiate, or simply trust the process. Candidate pipelines suffer accordingly — high-earning EM physicians comparison-shop aggressively, and an undisclosed range reads as either lowball or lack of confidence.

The volume-pay misalignment is stark. Tennessee (46 listings), Indiana (44), Alabama (32), Kentucky (25), and North Carolina (24) collectively disclosed nothing. If you are recruiting in those markets, lead with schedule, patient volume, physician-to-patient ratio, malpractice environment, and community fit. Because until numbers appear, candidates will assume the worst.
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What’s Driving the Numbers

Rural scarcity commands a premium, and the data proves it. Fergus Falls, Branson, and rural Iowa are not paying $480,000-plus out of generosity. They are paying it because nobody wants to move there, and emergency departments cannot close at 5 p.m. Scarcity pricing is the dominant compensation driver in Emergency Medicine — more than credentials, more than experience, more than fellowship training.

Corporate and occupational health settings are dragging the floor down. Pennsylvania’s $250,000 listing and Kansas’s $330,000 listing are almost certainly not traditional Level I trauma work. They reflect Premise Health, Curare Group, and similar corporate models where acuity is lower, hours are predictable, and compensation reflects the trade. These are not bad jobs. They are different jobs occupying the same specialty tag.

Volume does not equal pay. The most important structural observation in this dataset: Tennessee, Indiana, Alabama, and Kentucky combine to offer 147 listings and zero disclosed salaries. High volume in EM often signals turnover, burnout, or coverage crises — not necessarily premium pay. Texas is the exception that proves the rule.

Hourly rates dominate the high end. When a San Antonio listing quotes $300 per hour, that annualizes past $624,000 — but almost nobody works 2,080 hours in an ED without dying. Hourly locum work skews the ceiling upward while masking the actual annual take-home.

The Bottom Line

Emergency Medicine remains one of the most geographically arbitraged specialties in American medicine. The floor is corporate-clinic territory near $250,000. The ceiling is rural, locum-adjacent, and pushing $600,000. In between sits a wide, largely undisclosed middle where 715 listings decline to name a number. Physicians willing to move — really move, to places where the nearest Whole Foods is a concept rather than a store — will be paid handsomely for the inconvenience.

In Emergency Medicine, the money follows the emergencies nobody else wants to cover.
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Salary data based on 47 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.