TLDR
The average CRNA locum rate in 2026 is $200 per hour, annualizing to roughly $416,000. Top earners clear $400,000 to $500,000. But the rate on your contract tells only part of the story. W-2 versus 1099 tax treatment, benefits gaps, travel costs, and agency rate spreads can swing your actual take-home by $80,000 or more for identical work at the same facility.
CRNA locum rates in 2026 average $200 per hour according to Anesthesia On Call data, with top-performing locum CRNAs earning between $400,000 and $500,000 annually. The gap between the posted rate and actual compensation depends on contract structure, tax status, and whether you know what the facility next door is paying.
A locum CRNA in Jacksonville finishes a 13-week assignment at $195 per hour. Good rate. Steady cases. Reasonable call schedule. On her last Friday, she meets the new locum arriving Monday. Same facility, same case mix, same hours. His rate: $235 per hour. The difference over 13 weeks comes to $31,200. She found the job on one agency's website. He found it on another. Neither knew the other's rate until that conversation in the break room at 6:15 a.m.
That rate gap is not an anomaly. Aya Healthcare lists CRNA locum rates between $195 and $250 per hour for comparable assignments. Industry locum data and Anesthesia On Call report similar ranges. The spread between agencies for the same position at the same facility can exceed $40 per hour. Over a full year of locum work, that spread represents $83,200 in compensation that goes to the agency, not the provider.
What $200 Per Hour Actually Means
The $200 per hour average obscures critical differences in how that money reaches your bank account. A W-2 locum CRNA at $200 per hour receives benefits, malpractice coverage, and employer-paid payroll taxes. A 1099 independent contractor at $200 per hour pays self-employment tax (15.3% on the first $168,600, 2.9% above that), purchases their own malpractice policy ($3,000 to $8,000 per year), and funds their own retirement contributions.
Run the numbers for a CRNA working 2,080 hours annually at $200 per hour. Gross: $416,000. A W-2 provider keeps roughly $280,000 after federal and state taxes, with benefits included. A 1099 provider at the same rate keeps approximately $255,000 after SE tax, malpractice, health insurance, and retirement funding. The gap: $25,000 per year for the same hourly rate, the same facility, the same cases.
That calculation assumes the 1099 provider negotiated the same rate as the W-2 provider. Most do not. The standard practice among experienced locum CRNAs is to add 20% to 30% to a W-2 equivalent rate when negotiating a 1099 contract. A $200 W-2 rate should translate to $240 to $260 on 1099 terms to achieve equivalent take-home pay.
Where CRNA Locum Rates Peak in 2026
Geography drives locum rates more than experience or subspecialty in most cases. Massachusetts pays permanent CRNAs an average of $292,000 per year (BLS), and locum rates in the state reflect that baseline. A weekend locum shift at a Boston-area hospital can pay $250 or more per hour. Vermont ($272,000 average) and Washington state ($276,000 average) show similar locum premiums.
But the highest per-hour locum rates often appear in states with lower permanent salaries. Rural facilities in Montana, Wyoming, and the Dakotas post locum rates above $220 per hour because they cannot attract permanent hires at any salary. A critical access hospital 90 minutes from the nearest city will pay a premium for a CRNA willing to cover a two-week gap. These assignments are short, intense, and lucrative.
Full practice authority states add another layer. CRNAs working in FPA states operate without mandatory physician supervision, which means facilities need fewer total providers to cover the same surgical volume. That efficiency translates into willingness to pay higher individual rates. More than 30 states now grant full practice authority (AANA), and recent expansions in Colorado, Massachusetts, and Wisconsin have opened new locum markets.
The Agency Rate Spread Problem
Healthcare staffing agencies operate on margin, and that margin comes directly from the gap between what the facility pays and what the CRNA receives. A facility contracts with Agency A at $300 per hour for CRNA coverage. Agency A offers the CRNA $200 per hour. The $100 spread covers the agency's overhead, recruiter commissions, insurance, and profit. Agency B, competing for the same facility, might offer the CRNA $235 per hour on a thinner margin.
The CRNA has no visibility into the facility's bill rate. The facility has no visibility into the CRNA's pay rate. Both parties operate with incomplete information, and the agency profits from the asymmetry. The healthcare staffing market generates $36.9 billion annually and is projected to reach $65.9 billion by 2030. A meaningful portion of that growth comes from rate opacity.
Some locum CRNAs negotiate directly with facilities, bypassing agencies entirely. This works best for experienced providers with existing relationships and active credentials in the target state. The facility saves the agency markup. The CRNA earns more. The trade-off: the CRNA handles their own credentialing, travel logistics, and malpractice coverage.
Three Numbers to Know Before Accepting Any Locum Contract
First: the state average for your specialty. BLS publishes annual CRNA compensation data by state. If a locum rate does not exceed the permanent salary equivalent for that state by at least 15%, the assignment does not compensate for the instability, travel, and benefits gap of locum work.
Second: the W-2 equivalent of your 1099 rate. Multiply your target W-2 hourly rate by 1.25 to approximate the 1099 rate needed for equivalent take-home pay. If an agency offers you a 1099 rate below that threshold, you are accepting a pay cut disguised as a higher number.
Third: what other agencies are paying for the same assignment. The rate you see first is not the rate you have to accept. The same facility position appears on multiple agency job boards at different provider rates. Checking two or three sources before committing can mean the difference between $195 and $235 per hour. Over a 13-week contract, that is $31,200.
Related resources: CRNA salaries in Massachusetts, Washington CRNA salary data, Colorado practice authority guide, the 12,500 CRNA shortage problem, CRNA jobs in Texas.
The Takeaway
A locum CRNA rate is not a salary. It is one variable in an equation that includes tax status, benefits, malpractice costs, and agency margins. The CRNAs who earn $400,000 to $500,000 per year do so because they treat rate negotiation as a data problem, not a conversation with a recruiter. They know the state averages. They check multiple sources. They calculate the 1099 equivalent before signing.
See the data on RxRooster. Every rate, every state, every credential verified before the first call.
Frequently Asked Questions
What is the average CRNA locum rate in 2026?
The average CRNA locum rate is $200 per hour according to Anesthesia On Call, annualizing to approximately $416,000 for full-time locum work. Aya Healthcare reports ranges of $195 to $250 per hour depending on location, specialty, and contract terms.
How much do top locum CRNAs earn?
Top-earning locum CRNAs clear $400,000 to $500,000 annually by combining premium assignments in high-demand markets, negotiating above-average rates, and maintaining credentials in multiple states to maximize geographic flexibility.
What is the difference between W-2 and 1099 locum CRNA pay?
A W-2 locum CRNA receives benefits and employer-paid payroll taxes. A 1099 contractor pays self-employment tax (15.3% on the first $168,600), purchases their own malpractice insurance, and funds their own benefits. The same $200 per hour rate yields approximately $25,000 less annually on 1099 terms.
Why do CRNA locum rates vary so much between agencies?
Agencies earn margin on the spread between the facility bill rate and the provider pay rate. Different agencies negotiate different bill rates with facilities and set different pay rates for providers. The spread for the same position at the same facility can exceed $40 per hour between agencies.
Which states pay the highest CRNA locum rates?
Massachusetts, Washington, Vermont, and Alaska consistently show the highest locum rates, reflecting their high permanent salary baselines. Rural facilities in Montana, Wyoming, and the Dakotas also pay premium locum rates due to difficulty attracting permanent hires.