Somewhere in Idaho, a single Gastroenterology job is offering $1,000,000 a year. That is not the ceiling of a range. That is the number. One million dollars, flat, to perform colonoscopies in a state better known for potatoes than portal hypertension. The national data set contains 559 active Gastroenterology listings across nearly every state in the union, from Vermont to Hawaii, with 82 disclosing actual compensation. What that disclosed slice reveals is a specialty where the floor is comfortable, the ceiling is absurd, and geography is doing most of the heavy lifting.
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The Gastroenterology Job Market at a Glance

Total listings: 559
Listings with salary data: 82
Full salary range: $200,000 to $1,000,000
National average range: $526,383 to $582,376

The spread here is the story. A $200,000 gap between the average low and a top-end listing that clears seven figures suggests a market where individual roles — scope-heavy, leadership-flavored, or geographically inconvenient — are pulling the top end skyward while a handful of pathology-adjacent and part-time roles anchor the floor.

States represented: FL, NY, TX, IL, CA, IN, TN, MA, VA, PA, NC, WA, KY, WI, AL, MO, GA, MN, OH, MI, NH, NM, AR, CO, NH, CO, MD, SC, OK, ND, MD, NJ, MS, ID, UT, AZ, SD, CT, OR, LA, IA, KS, MT, WY, NV, ME, HI, WV, NE, VT, DC.

Translation: Gastroenterology is genuinely national. The paycheck, less so.
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How States Stack Up

Overperformers:

• Idaho — $1,000,000 flat, on the strength of exactly one listing (a very persuasive listing).
• Louisiana — $624,000 to $832,000; scarcity pricing in a five-listing market.
• Illinois — $675,000 across six salary-disclosed listings, which is the rare case of volume and pay agreeing.
• Florida — $675,000 on two listings, which we will believe when the other 43 postings show their math.
• Missouri — $660,000 to $660,200, a suspiciously tight band that suggests a dominant employer.
• Nevada — $587,775 to $650,000, buoyed by a GI Medical Director role.
• Utah — $600,000 flat across two listings.
• Washington — $536,070 to $662,534, quietly excellent.

Near-average:

• Maryland — $500,000 to $534,286, the platonic ideal of a benchmark market.
• New York — $474,108 to $547,529 across 24 salary listings, which is a lot of data pointing to “fine.”
• California — $516,900 to $626,200, decent on paper before rent enters the chat.
• Massachusetts — $475,000 to $667,500, a range wide enough to drive a hospital through.
• Indiana — $550,000 flat.

Underperformers:

• Colorado — $400,000 to $425,000, the lowest reported average in the country.
• Connecticut — $409,000 to $428,333, and no, the Metro-North does not subsidize this.
• New Jersey — $450,000 to $461,500 across six listings, home to the $200,000 pathology-adjacent role in Berlin.
• Ohio — $448,333 to $488,333, below the national floor.

Volume leaders: Florida (45), New York (42), Texas (30), Illinois (22), Indiana (22), Tennessee (21), Massachusetts (20), Virginia (20), California (19), Pennsylvania (19). Texas and Tennessee, despite a combined 51 listings, disclosed nothing. Make of that what you will.
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What This Means If You’re a Physician

If your priority is maximum compensation: Idaho, at $1,000,000, is the highest-paying Gastroenterology listing in the country. Louisiana ($624,000 to $832,000) and the Gardnerville, Nevada GI Medical Director role ($680,000 to $800,000 via CompHealth) are the credible runners-up. These are not markets with depth. They are markets with one very good door.

If your priority is maximum optionality: Florida (45), New York (42), and Texas (30) offer the deepest benches. Just accept that New York pays average and Texas pays whatever it decides not to disclose.

If your priority is balance: Illinois is the answer. Twenty-two listings, $675,000 average, and cost of living that does not require a second income. Missouri and Washington are close behind. Meanwhile, California’s $516,900 to $626,200 looks generous until you price a house in French Camp — where, incidentally, CompHealth is dangling a $435,000 to $955,000 range that is either the deal of the decade or a productivity trap in disguise.
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What This Means If You’re a Recruiter

Salary transparency rate: 82 of 559 listings, or 14.7%. That is not a rate. That is a rounding error with ambitions.

Candidates in Gastroenterology are shopping a market where 85% of postings refuse to name a number, which means the ones that do disclose become the anchor for every negotiation nationwide — and those anchors currently sit at $675,000 in Illinois and $1,000,000 in Idaho. Good luck posting a blind listing next to that.

Texas (30 listings, zero salaries), Tennessee (21, zero), Virginia (20, zero), Pennsylvania (19, zero), and North Carolina (18, zero) are the biggest volume-pay misalignments in the data. Recruiters in these states will need to lead with scope, autonomy, call structure, partnership track, and lifestyle — because the moment a candidate opens a second tab, Illinois is right there.
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What’s Driving the Numbers

Leadership and scope command a real premium. The Gardnerville GI Medical Director role at $680,000 to $800,000 and the French Camp range topping out at $955,000 are not accidents. Directorships, endoscopy volume, and ASC ownership stakes are what push Gastroenterology into seven-figure territory. Standard employed roles cluster around the $475,000 to $575,000 band. The million-dollar listings are compensating for something — usually administrative burden or geographic remoteness.

Part-time and specialized roles are absolutely distorting the floor. The $200,000 Berlin, New Jersey pathology-adjacent role via Tandym Health is not a full-time clinical Gastroenterology job in the traditional sense, and it drags the national low into territory no board-certified gastroenterologist would actually accept for a full clinical panel. Strip out the outliers and the real floor is closer to $400,000.

Underserved markets are pricing in scarcity, loudly. Idaho ($1,000,000), Louisiana ($624,000 to $832,000), and Missouri ($660,000+) are all sub-15-listing markets punching well above the national average. Rural systems have figured out that the only way to recruit a gastroenterologist to a town without a direct flight is to write a bigger check.

The volume-pay relationship is officially broken. New York, the second-largest market by volume, pays right at the national average. Florida, the largest, disclosed only two salaries. Illinois is the sole state where high volume and high pay coexist honestly. Everywhere else, depth and dollars are inversely correlated — or, more accurately, the deep markets simply refuse to say.

The Bottom Line

Gastroenterology in 2026 is a market where the average is comfortable, the ceiling is theatrical, and the disclosure rate is a national embarrassment. The best combined play is Illinois. The best pure-pay play is Idaho, if you can find the listing and tolerate the commute. The worst-kept secret is that Texas, Tennessee, and Virginia are almost certainly paying well — they just refuse to admit it in writing.

There is a lot of money in looking inside people, and the states willing to say so out loud are the ones worth answering the phone for.
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Salary data based on 82 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.