Nurse Practitioner Pay

San Francisco vs Fresno: Nurse Practitioner Salary (2026)

Compare nurse practitioner salaries between San Francisco, CA and Fresno, CA. All figures are 2026 estimates projected from BLS 2025 data.

San Francisco, CA
$226,638
$108.96/hr
Fresno, CA
$172,317
$82.84/hr

Side-by-Side Comparison

MetricSan Francisco, CAFresno, CA
Median Salary$226,638$172,317
Hourly Rate$108.96$82.84
Entry Level (P10)$158,568$133,761
25th Percentile$182,579$143,692
75th Percentile$250,256$197,869
Top Earner (P90)$283,412$219,645
Total Employed3,110570
Side-by-side bar chart comparing San Francisco ($226,638) and Fresno ($172,317) nurse practitioner salaries.San FranciscoFresnoMedian Salary$226,638$172,317Entry Level (P10)$158,568$133,761Top Earner (P90)$283,412$219,645US Median $136,864

Verdict

San Francisco, CA offers better overall compensation for nurse practitioners, winning 4 out of 4 metrics compared to Fresno.

The salary gap between San Francisco and Fresno is $54,321 (31.52%). San Francisco's median is +65.59% compared to the US national median of $136,864.

Salary Range Comparison

The full salary range (10th to 90th percentile) in San Francisco spans $124,844,Fresno spans $85,884. San Francisco has a wider pay range, meaning more potential for high earners but also more variation.

San Francisco
P10 (Entry)$158,568
P25$182,579
Median$226,638
P75$250,256
P90 (Top)$283,412
Fresno
P10 (Entry)$133,761
P25$143,692
Median$172,317
P75$197,869
P90 (Top)$219,645

Cost-of-Living Adjusted Comparison

After cost-of-living adjustment, San Francisco ($196,032 effective) pays 16.22% more than Fresno ($168,677 effective).

San Francisco
Nominal: $226,638
CoL Index: 115.613
Adjusted: $196,032
Fresno
Nominal: $172,317
CoL Index: 102.158
Adjusted: $168,677

Cost-of-living adjustment: salary × (100 / CoL index). Index of 100 = national average.

Which City Is Right for You?

Choose San Francisco if…

  • Higher median salary ($226,638/year)
  • Better top-earner potential ($283,412)
  • Larger job market (3,110 employed)
  • Better purchasing power (CoL-adjusted: $196,032)
  • You prefer the California area and lifestyle

Choose Fresno if…

  • You prefer the California area and lifestyle

Historical Salary Growth Comparison

Based on BLS OEWS metropolitan area data, nurse practitioner salaries in San Francisco grew 58.6% from 2019 to 2025, compared to 26.7% growth in Fresno over the same period.

San Francisco, CA

+58.6%

$138,100 (2019) → $219,080 (2025)

Fresno, CA

+26.7%

$131,450 (2019) → $166,570 (2025)

View Full Salary Data

Frequently Asked Questions

Which city pays nurse practitioners more: San Francisco or Fresno?

San Francisco has a higher median nurse practitioner salary at $226,638/year, compared to Fresno at $172,317/year — a difference of $54,321 (31.52%).

What is the hourly rate difference between San Francisco and Fresno?

San Francisco nurse practitioners earn $108.96/hr while Fresno hygienists earn $82.84/hr (2026 est.).

Should I relocate from San Francisco to Fresno as a nurse practitioner?

Consider more than just salary when comparing San Francisco and Fresno. Factor in cost of living (CoL-adjusted: San Francisco = $196,032, Fresno = $168,677), job availability (3,110 vs 570 employed), commute, and career growth potential.

What do entry-level nurse practitioners earn in San Francisco vs Fresno?

Entry-level (10th percentile) nurse practitioners earn $158,568 in San Francisco and $133,761 in Fresno. The San Francisco area offers higher starting salaries.

Related Comparisons

MG

Written by Maria Gonzalez, MSN, NP-C

Career Analyst

Maria has 10 years of experience in adult healthcare. She works in a community health clinic. Her specialty is chronic disease management.

Clinically reviewed by James Patel, DNP, APRNData verified by Aisha Khan, MSN, FNP-BC

Methodology & Data Source

All salary figures are 2026 projections based on BLS OEWS May 2025 data. A 3.45% CAGR (derived from 6-year national BLS trends) was applied to estimate current compensation. Cost-of-living adjustments use BEA Regional Price Parity data. Actual salaries vary by employer, certifications, and experience.

Data Sources & Methodology

Source: BLS, OEWS , released .

Compiled and verified by Maria Gonzalez, MSN, NP-C, a licensed nurse practitioner with 10+ years of clinical experience. · View source data at BLS.gov