Pennsylvania is offering Emergency Medicine physicians $250,000 a year while Iowa is offering $613,600 for the same job title. The national Emergency Medicine market contains 774 active listings spread across 47 states, with only 41 brave enough to disclose what they actually pay. The data reveals a market where geography determines compensation more than almost any other factor, salary transparency remains the exception rather than the rule, and a $467,600 gap separates the top from the bottom.
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The Emergency Medicine Job Market at a Glance
Total listings: 774. Listings with salary data: 41. Salary range: $250,000 to $717,600. National average range: $470,817 to $503,740.
The spread is extraordinary, even for a specialty that spans critical access hospitals in Wyoming and Level I trauma centers in Manhattan. A physician at the 25th percentile earns roughly half what a physician at the 90th percentile commands, and the floor of $250,000 would be considered insultingly low in most markets (Pennsylvania, apparently, is not most markets). The average range sits comfortably in the mid-$400,000s to low-$500,000s, but this figure masks wild state-level variation and the fact that 94.7% of employers chose not to share numbers at all.
States represented: Illinois, Hawaii, Minnesota, Missouri, Oklahoma, Ohio, Kansas, Texas, Pennsylvania, Georgia, New York, Louisiana, North Carolina, South Carolina, Florida, Kentucky, Tennessee, New Mexico, Alabama, Iowa, Indiana, New Hampshire, Washington, Maine, Wisconsin, Virginia, Colorado, Arkansas, Massachusetts, Maryland, California, West Virginia, Michigan, North Dakota, Wyoming, Alaska, Nebraska, Oregon, Arizona, New Jersey, Nevada, Rhode Island, Mississippi, South Dakota, Idaho, Vermont, Delaware.
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How States Stack Up
Overperformers: Iowa leads the nation at $613,600 (a remarkable figure for a state with 16 total listings and exactly one willing to say so). Washington state follows at $598,000 to $613,600, proving the Pacific Northwest pays physicians well to work in the rain. California averages $565,800 to $619,880 across five listings, which is high but not shocking given the cost of existing there. Missouri quietly overperforms at $530,400 to $542,533 across six listings, a respectable volume that lends credibility. New York checks in at $539,000 to $559,800, which feels almost modest until you remember it’s New York. Texas and Oklahoma both report ranges starting at $520,000, though each has only one data point.
Near-average: Illinois sits at $426,345 to $471,113 across 11 listings, making it the most transparent major market and a reliable benchmark. Vermont averages $439,840 (two listings, both identical, which is either consistency or a copy-paste error). Minnesota lands at $410,000 to $450,000, just south of the national average.
Underperformers: Pennsylvania offers $250,000 to $260,000, a figure so low it suggests either a part-time role, a rural critical access hospital with no trauma, or a profound misunderstanding of market rates. Kansas reports $330,000 to $355,000, which is better than Pennsylvania but still 30% below the national average. An unidentified region coded “GB” shows $337,000. Ohio averages $415,333 to $447,867 across three listings, landing it just under the national mean. Hawaii, despite its cost of living, averages $416,000 to $457,600. South Carolina reports $396,000, well below average despite having 38 total listings.
Volume leaders: Florida (59 listings, no salary data). Texas (58 listings, strong pay). Tennessee (48 listings, no salary data). Ohio (42 listings, below-average pay). South Carolina (38 listings, below-average pay). North Carolina (37 listings, no salary data). High volume does not predict high pay, and high volume does not predict transparency.
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What This Means If You’re a Physician
If your priority is maximum compensation: Target Iowa, Washington, California, or Missouri. The highest disclosed salary in the data set is $717,600, which appears to represent the top end of the national average range rather than a specific listing. Iowa’s $613,600 is the highest state-level figure and represents a real, disclosed offer. California’s top end of $619,880 is similarly credible, backed by five data points.
If your priority is maximum optionality: Florida, Texas, and Tennessee offer the most listings, but only Texas has disclosed competitive pay ($520,000 to $624,000). Florida’s 59 listings come with zero salary transparency, which is either strategic or evasive. Ohio offers 42 listings but pays below the national average.
If your priority is balance: Illinois offers volume (20 listings), reasonable transparency (11 with salary data), and near-average pay ($426,345 to $471,113). Missouri combines above-average pay with decent data volume. Texas offers both scale and strong compensation, though with limited transparency. The compensation gap between Pennsylvania ($250,000) and Iowa ($613,600) is $363,600, which over a 10-year career equals $3,636,000 in forgone earnings—enough to justify a U-Haul and a willingness to learn about corn.
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What This Means If You’re a Recruiter
Salary transparency rate: 5.3% (41 listings with data divided by 774 total listings). This is abysmal. In a market where fewer than one in 20 employers disclose compensation, candidates are flying blind, and recruiters are left selling location, lifestyle, and intangibles.
Pipeline implications: Physicians will gravitate toward the 5.3% of listings that show their cards, especially in a specialty where the salary range spans $467,600. Employers in Florida, Tennessee, North Carolina, Georgia, and Alabama are posting high volumes with zero pay data, which works only if their brands are strong enough to pull inbound interest without it. Most are not.
Volume-pay misalignments: Ohio has 42 listings but pays $415,333 to $447,867, below the national average. Florida has 59 listings and no data. South Carolina has 38 listings and pays $396,000. These are high-supply, low-transparency, low-pay markets. Recruiters will need to lead with schedule flexibility, partnership tracks, sign-on bonuses, or geography. Texas, by contrast, combines high volume (58 listings) with strong pay ($520,000 to $624,000), though only one listing disclosed it. If Texas employers coordinated and published salary ranges, they would dominate the candidate pipeline.
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What’s Driving the Numbers
Salary transparency is the exception, and it is costing employers candidates. Only 5.3% of listings include compensation data, which means 94.7% of employers are asking physicians to apply, interview, and negotiate blind. In a market where the floor is $250,000 and the ceiling is $717,600, that is not a minor gap—it is a career-altering difference. Physicians are rational actors. They will focus on the listings that show numbers, and they will assume the ones that do not are lowballing.
Geography drives compensation far more than volume or demand. Iowa, a state with 16 total listings, pays $613,600. Pennsylvania, a state with 21 listings, pays $250,000. Florida has 59 listings and no salary data. Texas has 58 listings and strong pay. There is no national Emergency Medicine labor market—there are 47 state markets with wildly different pricing structures, and physicians who treat them as interchangeable will leave six figures on the table.
High-volume states are not high-pay states. Florida, Tennessee, and Ohio combine for 149 listings, but none rank in the top tier for compensation. Ohio pays below average. Florida and Tennessee provide no data. Volume signals demand, but it does not signal willingness to pay. In fact, the inverse may be true: states with deep benches of listings may face more competition among employers, which should drive pay up—but the data suggests they are instead competing on non-salary factors or simply not competing at all.
Part-time and hourly roles distort the floor but not the ceiling. The lowest salary of $250,000 in Pennsylvania likely reflects a part-time or limited-scope role (the data does not specify, but the figure is otherwise inexplicable). Hourly rates range from $200 to $310, which annualized at 2,080 hours equals $416,000 to $644,800—a range that mirrors the salaried market. The floor is noisy, but the top end is consistent. Physicians seeking full-time, full-scope Emergency Medicine work can reasonably expect $500,000 to $620,000 in competitive markets.
The Bottom Line
The Emergency Medicine job market is geographically vast, numerically robust, and financially opaque. Physicians have 774 options, but only 41 come with price tags, and the difference between the best and worst offer is equivalent to a modest house in cash every two years. The states with the most jobs do not pay the most. The states that pay the most do not have the most jobs. And 94.7% of employers believe salary is something to discuss later, which is a belief that will cost them candidates in a market where Iowa is offering $613,600 and saying so out loud.
There is a lot of work available for physicians willing to make sure unconscious people stay alive. The pay varies by $467,600 depending on where you do it.
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Salary data based on 41 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.
