Iowa is paying urologists $900,000. Iowa. The state has three job listings and one of them offers nearly a million dollars to handle kidney stones and prostate procedures in the Midwest. The national Urology market includes 270 active listings spanning 47 states, with salary data disclosed on just 36 of them. What the data shows: Urology remains a highly compensated specialty with dramatic geographic variance, where low-volume rural markets are pricing in scarcity and high-volume coastal markets are pricing in supply.
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The Urology Job Market at a Glance
Total listings: 270. Listings with salary data: 36. Full salary range: $300,000 to $900,000. National average range: $481,165 to $518,983.
The $600,000 spread between floor and ceiling is one of the widest in physician compensation, and it tells two stories. The first: Urology is universally well-paid. The second: geography and market dynamics matter more than the specialty itself. Most disclosed salaries cluster between $400,000 and $650,000, but the outliers are where the market gets interesting. A $900,000 offer in Iowa suggests desperation or dominance. A $300,000 offer in Tennessee suggests something structural—supply, institutional pay caps, or part-time scope.
States represented: New York, California, Florida, Texas, Georgia, Pennsylvania, Washington, Indiana, North Carolina, Minnesota, Arizona, Ohio, Illinois, Missouri, Colorado, West Virginia, Idaho, Iowa, Tennessee, Vermont, Massachusetts, Connecticut, New Jersey, Nevada, Wisconsin, New Hampshire, North Dakota, Oregon, Kentucky, New Mexico, Oklahoma, Michigan, Hawaii, South Carolina, Alabama, Wyoming, Nebraska, Maryland, Maine, Virginia, Rhode Island, Alaska, Arkansas, Louisiana, South Dakota.
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How States Stack Up
Overperformers: Iowa leads the nation at $900,000 (one listing, three total jobs, and apparently infinite urgency). Idaho offers $637,000 and makes no apologies. Washington averages $600,000 to $650,000 across one disclosed listing and 12 total jobs—a rare combination of volume and premium pay. West Virginia hits $600,000 flat (11 total listings, one disclosed). Colorado ranges $550,000 to $610,000. Missouri averages $550,000 to $566,667 across three salary listings. Ohio posts $560,000 on one disclosed listing.
Near-average: Illinois ranges $500,000 to $525,000. New York averages $456,656 to $522,231 across six salary listings and 17 total jobs. California averages $453,750 to $514,750 across eight disclosed salaries—the most transparency in the dataset—and 13 total listings. Hawaii offers $480,000 to $500,000. Indiana reports $475,000 (16 total jobs, one disclosed).
Underperformers: Tennessee bottoms out at $300,000. Florida, Nevada, New Jersey, Vermont, Massachusetts, and Connecticut all average $400,000 on the low end, which is competitive in absolute terms but below the national average of $481,165.
Volume leaders: Florida (19 listings), New York (17), Indiana and Pennsylvania (16 each), Georgia and Texas (15 each), California (13), Washington (12), West Virginia and Minnesota (11 each), Arizona (11). Florida leads the nation in job count and trails it in pay. Pennsylvania and Georgia each posted 15+ listings with zero salary transparency.
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What This Means If You’re a Physician
If your priority is maximum compensation: Iowa, Idaho, Washington, West Virginia, Colorado, and Missouri are your targets. The highest individual listing identified is in Springfield, MO at $700,000. Iowa’s $900,000 figure reflects an average (likely one very high listing), but even if it’s an outlier, it’s worth the phone call.
If your priority is maximum optionality: Focus on Florida (19 listings), New York (17), Indiana (16), Pennsylvania (16), Georgia (15), Texas (15), and California (13). Expect pay in the $400,000 to $520,000 range in these states. Florida’s volume comes with a compensation trade-off.
If your priority is balance: Washington offers 12 jobs and $600,000+ pay. Missouri has four listings, three with disclosed salaries, and a $550,000+ floor. West Virginia has 11 listings and $600,000 disclosed pay. These are the rare markets where volume, pay, and cost of living align. The coasts offer stability but not premium compensation. The heartland offers premium compensation but not volume. Choose accordingly.
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What This Means If You’re a Recruiter
Salary transparency rate: 13.3% (36 listings with data divided by 270 total listings). This is a problem. In a specialty this competitive, opacity is a candidate repellent. Physicians know what Urology pays. If you’re not disclosing, they assume you’re low.
Candidate pipeline implications: High-volume states with below-average pay (Florida, Georgia, Pennsylvania, Texas) will struggle to convert without leading with lifestyle, partnership track, or ancillary income potential. Low-volume states with premium pay (Iowa, Idaho, West Virginia) have pricing power but limited awareness. Your job is to close the visibility gap.
Volume-pay misalignments: Florida has 19 listings and $400,000 average pay. Iowa has three listings and $900,000 average pay. Pennsylvania has 16 listings and zero disclosed salaries. If you’re recruiting in a high-volume, low-transparency state, you will lose candidates to markets that post numbers. If you’re recruiting in a low-volume, high-pay state, your competitive advantage is the number—use it.
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What’s Driving the Numbers
Scarcity pricing in underserved markets is real. Iowa, Idaho, West Virginia, and Missouri are not traditional physician magnets, yet they dominate the top of the pay scale. This is not coincidence. It is compensation as recruitment strategy. Rural and semi-rural markets are pricing in isolation, call burden, and the cost of losing a candidate to a coastal offer. It works—if the number is visible.
Volume does not correlate with pay. Florida leads the nation in listings and ranks near the bottom in salary. Washington has half the volume and pays 50% more. This breaks the traditional supply-demand model and suggests that high-volume states are either saturated with supply or anchored to institutional pay bands that suppress market rates. Candidates should not assume volume equals value.
Salary transparency is a competitive weapon. California disclosed eight salaries across 13 listings (61.5% transparency). New York disclosed six across 17 (35.3%). Pennsylvania disclosed zero across 16. Missouri disclosed three across four (75%). The states winning the transparency game are either paying well (Missouri, Washington) or have enough volume to absorb variability (California, New York). The states hiding compensation are either paying poorly or don’t yet realize the market has moved.
The floor is soft. Tennessee and Florida both reported $300,000 salaries. These may reflect part-time roles, academic positions, or early-career offers, but they drag the average down and create confusion. A $300,000 Urology job is either a lifestyle play or a red flag. Without scope and hour details, it is impossible to know which.
The Bottom Line
The Urology job market is robust, well-compensated, and geographically polarized. The highest pay is in the lowest-volume markets. The highest volume is in the lowest-transparency markets. Physicians who prioritize income over location will find exceptional opportunities in the Midwest and Mountain West. Physicians who prioritize optionality and brand-name institutions will find volume on the coasts and accept a $100,000 to $200,000 haircut. There is no wrong choice, only trade-offs.
Urology pays well everywhere. It pays exceptionally well in Iowa.
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Salary data based on 36 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.
