Somewhere in Webster, South Dakota, a Family Medicine physician is being offered $315,000 a year to practice in a town most Americans cannot locate on a map. Somewhere in Kankakee, Illinois, another is being offered $185,000 to do roughly the same job. This is the Family Medicine market in 2026: 2,636 active listings, 50 states plus Guam and D.C., and a pay spread wide enough to drive a rural ambulance through. The data shows a specialty in extraordinary demand, priced unevenly, and quietly rewarding the physicians willing to read a map.
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The Family Medicine Job Market at a Glance

Total listings: 2,636
Listings with salary data: 753
Full salary range: $110,000 to $800,000
National average range: $257,667 to $289,094

The $800,000 ceiling is almost certainly a data-entry artifact (or a very generous concierge practice we would love to meet). Strip the outliers and most Family Medicine roles live tidily between $200,000 and $300,000. The lower bound of $110,000 likely reflects part-time or hourly arrangements rather than a full-time insult.

States represented: California, New York, Florida, Texas, North Carolina, Georgia, Massachusetts, Pennsylvania, Illinois, Indiana, Connecticut, South Carolina, New Jersey, Virginia, Minnesota, Oregon, Vermont, Maryland, Alabama, Washington, Missouri, Wisconsin, Arizona, Ohio, South Dakota, Tennessee, Montana, New Mexico, New Hampshire, Maryland, Colorado, Maine, Kentucky, Iowa, Arkansas, Hawaii, Louisiana, Oklahoma, Kansas, Idaho, Mississippi, Vermont, Alaska, North Dakota, Nevada, Nebraska, Rhode Island, Delaware, Utah, West Virginia, Wyoming, D.C., and Guam.
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How States Stack Up

Overperformers

• Arkansas: $397,800 to $428,300 (two listings, so treat as a rumor with footnotes).
• Louisiana: $250,000 to $436,111, with a spread suggesting either rural incentives or chaos.
• North Carolina: $354,167 to $371,667 across 12 listings, the most credible high-pay signal in the country.
• South Dakota: $329,750 to $334,125, quietly out-earning the coasts.
• Kentucky: $315,232 to $320,224, Appalachia paying a premium.
• Iowa: $318,333, flat and generous.
• Minnesota: $309,913 to $324,913, the Upper Midwest doing Upper Midwest things.
• Montana: $305,600 to $313,600, big sky, bigger checks.
• North Dakota: $302,500, small sample, large number.
• Maine: $300,000 to $325,000, lobster optional.
• Guam: $315,000 to $330,000 (one listing, but it counts).

Near-average

• California: $257,297 to $293,662, fine for the market but humbling for the rent.
• Texas: $291,538 to $303,538, the rare high-volume state paying above average.
• Illinois: $249,184 to $270,947, textbook midpoint.
• Connecticut: $251,683 to $280,541.
• South Carolina: $252,632 to $270,526.
• Massachusetts: $243,045 to $272,227.
• New Hampshire: $260,000 to $280,000.
• Georgia: $249,753 to $290,118.
• Washington: $270,234 to $322,077.
• Arizona: $270,800 to $320,600.
• Missouri: $281,364 to $292,273.
• Florida: $271,900 to $279,100, near average despite massive volume.
• Ohio: $246,889 to $271,722.
• Pennsylvania: $237,143 to $270,571.
• Alabama: $264,375 flat.
• Nevada: $284,167 to $298,667.

Underperformers

• Virginia: $221,159 to $255,100, surprisingly soft for a state this populous.
• Vermont: $221,667 to $253,333.
• Kansas: $220,000 to $291,000, with a low end that stings.
• Rhode Island: $230,000 to $250,000.
• Maryland: $234,000 to $254,714.
• Colorado: $232,250 to $274,000, mountain views priced in.
• New York: $236,767 to $273,124, paying like Pennsylvania despite 172 listings.
• Indiana: $235,385 to $250,385.
• Hawaii: $235,000 to $279,167 (sunshine tax confirmed).
• New Jersey: $236,133 to $264,800.
• Michigan: $238,000 to $268,000.

Volume leaders: California (405), New York (172), Florida (164), Texas (138), North Carolina (120). New York and Florida both pay below the national midpoint despite enormous listing counts — high demand, soft wallets.
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What This Means If You’re a Physician

If your priority is maximum compensation: Look at North Carolina, South Dakota, Kentucky, Iowa, Minnesota, and Montana. The highest credible listings landed in Webster, South Dakota and Canby, Minnesota, both at $315,000. North Carolina is the only top-payer with real volume behind it (120 listings, 12 with disclosed salary).

If your priority is maximum optionality: California (405 listings) is the obvious answer, followed by New York, Florida, and Texas. Just know that California pay does not stretch to California rent, and New York is paying like Pittsburgh.

If your priority is balance: Texas is the rare unicorn — 138 listings averaging $291,538 to $303,538. Hourly/locum seekers should note Sanford, Florida at $125–$130/hour ($260,000–$270,400 annualized) and Monroe, Georgia at $135–$150/hour ($280,800–$312,000 annualized).
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What This Means If You’re a Recruiter

Salary transparency rate: 753 ÷ 2,636 = 28.6%. Roughly seven in ten Family Medicine listings still hide the number, which is a remarkable choice in a candidate-driven market.

That opacity has a cost. Family Medicine physicians have 2,636 options. They will not click on the one that makes them guess. Pipelines are leaking at the top of the funnel, and the leak is your own job description.

Volume-pay misalignment is loudest in New York and Florida — enormous listing counts, sub-average pay. Recruiters in those markets cannot lead with money. They will need to lead with schedule, scope, patient panel size, loan repayment, or a genuinely livable call structure. Texas recruiters, conversely, can lead with the number and win.
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What’s Driving the Numbers

Rural and underserved markets are pricing in scarcity. South Dakota, Iowa, Montana, Kentucky, and North Dakota are all paying north of $300,000 because they have to. The premium is not a reward for rural life; it is the price of convincing someone to move there. Arkansas and Louisiana show even wilder numbers on tiny samples, which is what scarcity looks like before the market settles.

The volume-pay relationship is broken at the coasts. California, New York, and Florida account for 741 listings combined — 28% of the entire national market — and none of them pay above the national midpoint with conviction. Demand is high, but so is supply of willing physicians. The coasts do not need to pay up. They know it.

Part-time and hourly roles are distorting the floor. The $110,000 national low is almost certainly a part-time figure, and the hourly listings in Florida and Georgia annualize into respectable six-figure territory. The true full-time floor for Family Medicine sits closer to $185,000 (see: Kankakee).

North Carolina is the outlier that makes sense. It has volume (120 listings), it has disclosed pay (12 salary listings), and it pays $354,167 to $371,667. That is not a small-sample mirage. That is a state actively bidding for primary care physicians, and winning.

The Bottom Line

Family Medicine in 2026 is a specialty with more demand than supply, more listings than transparency, and more geographic variance than most physicians realize before they start looking. The money is real, the spread is wider than the specialty’s reputation suggests, and the best-paying jobs are not where the most jobs are. California has the openings. The Dakotas have the checks. North Carolina has both, which is why it is the most interesting market on the board.

Family Medicine pays best in the places Family Medicine is needed most — and that is not a coincidence, it is the entire business model.
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Salary data based on 753 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.