Nuclear Medicine Technologist Salary by State (2026): CNMT Pay Compared Across All 50 States

Nuclear medicine technologist salary by state varies meaningfully across the U.S. — the spread reflects state-level cost of living, state NRC and Agreement-State radioactive materials licensure rules, the regional concentration of NCI-designated cancer centers and theranostics programs, hospital union representation, and the supply of CNMT/RT(N) credentialed techs. The national median for Nuclear Medicine Technologists sits at $106,398, but state-by-state pay across the 52 states tracked here ranges widely — from $55,083 in Puerto Rico to $177,272 in California.

This page compares the average nuclear medicine technologist salary by state across 1665+ metropolitan and non-metropolitan areas — drawing on the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey for SOC 29-2033. If you are a working CNMT evaluating relocation, a JRCNMT-accredited program graduate planning your first hospital placement, or a nuclear medicine department director benchmarking pay across states, the state-level comparison below is the central reference point.

How NMT Salary by State Is Measured

The BLS reports state-level NMT salary through three numbers:

• Annual median (50th percentile) — used to rank state-level pay in the table below.
• Annual mean (average) — typically runs 4–7% above median; states with strong PET-CT and theranostics specialty concentration show wider mean-median spreads because senior NMT credentials cluster at upper percentiles.
• Percentile distribution (P10 / P25 / P75 / P90) — P10 reflects entry-level general nuclear medicine technologists at community hospitals; P90 reflects senior NMTs with NMTCB Advanced PET certificate, theranostics-trained technologists running Lu-177 and Y-90 therapy programs, lead/chief NMTs at academic cancer centers, and travel NMTs filling PET-CT and theranostics coverage gaps.

The state-comparison table below applies BEA Regional Price Parity (RPP) adjustment so both nominal pay and real purchasing power are visible.

1. State NRC and Agreement-State Radioactive Materials Licensure

The single largest non-cost-of-living driver of state-level NMT pay structure is state radioactive materials licensure. Nuclear medicine practice requires that the facility hold a radioactive materials license, issued either by the U.S. Nuclear Regulatory Commission (NRC) or by an NRC Agreement State that has assumed regulatory authority. Agreement-State status affects state-level NMT employment structure:

• Agreement States — 39 U.S. states have entered NRC Agreement-State agreements (the NRC delegates radioactive materials regulation to the state). State-specific licensing requirements vary by state and can affect both facility licensing and individual NMT credential requirements.
• State NMT licensure — most states require state-level radiologic technologist or nuclear medicine technologist licensure on top of national NMTCB or ARRT certification. State licensure barriers correlate with higher pay floors.
• State JRCNMT-accredited program density — states with multiple Joint Review Committee on Educational Programs in Nuclear Medicine Technology (JRCNMT) accredited programs (Texas, Florida, Pennsylvania, Ohio, North Carolina, California, Illinois) have larger CNMT/RT(N) candidate pipelines.
• State dosimetry monitoring rules — federal NRC and state-level radiation safety regulations require NMTs to maintain dosimetry monitoring and follow ALARA (As Low As Reasonably Achievable) principles. State implementation of ALARA standards is consistent but state inspections vary.

2. State NCI-Designated Cancer Center Concentration

The single largest demand-side driver of state-level NMT pay is local NCI-designated cancer center density, because PET-CT and theranostics services concentrate at NCI-designated centers:

• High-NCI-density states — Texas (MD Anderson Cancer Center), New York (Memorial Sloan Kettering, Roswell Park), Massachusetts (Dana-Farber), Pennsylvania (Fox Chase, UPMC Hillman), Maryland (Johns Hopkins, NCI Center for Cancer Research), California (Stanford, UCSF, City of Hope, USC Norris, Salk), Minnesota (Mayo), Ohio (Cleveland Clinic, Ohio State James), Tennessee (St. Jude, Vanderbilt-Ingram), Washington (Fred Hutchinson) concentrate NCI-designated and NCI Comprehensive cancer centers. These states drive PET-CT and theranostics technologist demand and support upper-percentile NMT pay.
• Theranostics program states — Lu-177 PSMA-617 (Pluvicto, approved 2022 for prostate cancer) and Lu-177 DOTATATE (Lutathera, approved 2018 for neuroendocrine tumors) treatment programs concentrate at NCI-designated and quaternary cancer center states. Theranostics-trained NMTs are extremely scarce and command premium specialty pay.
• State PET-CT outpatient concentration — beyond academic centers, states with strong outpatient PET-CT chain concentration (RadNet, SimonMed, Akumin) support stronger general PET-CT NMT pay.

3. State Cost of Living and Hospital Union Representation

Cost of living and union representation drive state-level NMT pay above general healthcare-tech baselines:

• High-cost states with union representation — California (SEIU-UHW, NUHW), New York (1199SEIU, NYSNA), Massachusetts (1199SEIU, MNA), Hawaii lead state-level NMT pay rankings.
• State income tax variation — NMTs in Texas, Florida, Tennessee, Nevada, Washington, Wyoming, South Dakota, Alaska, and New Hampshire keep more of every dollar.

4. State Demand-Supply Dynamics for NMTs

State-level NMT pay reflects the demand-supply balance:

• State cardiac nuclear medicine density — states with strong outpatient cardiology and stress-imaging concentration (Florida, Texas, Pennsylvania, Arizona) support NMTCB Nuclear Cardiology Technologist (NCT) credential demand and pay.
• State academic medical center concentration — Massachusetts, Maryland, Pennsylvania, Texas, North Carolina, California concentrate academic medical centers with complex case mix (PET-CT, theranostics, complex nuclear cardiology).
• State HPSA concentration — rural and underserved states routinely offer $10,000–$30,000 sign-on bonuses plus relocation packages for CNMTs willing to anchor critical-access hospital nuclear medicine coverage.
• State PET-CT outpatient chain expansion — RadNet, SimonMed, Akumin have rapidly expanding PET-CT operations in major-metro markets. State expansion rate correlates with NMT hiring competition.
• State theranostics program expansion — the post-2022 explosion in Lu-177 PSMA therapy programs has concentrated at quaternary cancer center states. New theranostics program launches in Texas, California, Massachusetts, Pennsylvania, New York, Maryland, Ohio drive specialty NMT pay above general NMT baseline.

5. NMTCB Advanced PET and NCT Credential Distribution by State

NMTCB issues advanced credentials beyond entry CNMT. Distribution by state shapes upper-percentile state NMT pay:

• NMTCB Advanced PET (PET) certificate — concentrate at outpatient PET-CT center markets (California, Texas, Florida, New York, Arizona, Massachusetts, Pennsylvania).
• NMTCB Nuclear Cardiology Technologist (NCT) — concentrate at outpatient cardiology and hospital cardiac program markets.
• SNMMI-TS theranostics training and certification frameworks — emerging credential pathways for radiopharmaceutical therapy specialty. Cluster at NCI-designated cancer center states.
• RT(N) vs CNMT — most U.S. NMTs hold CNMT (NMTCB) credential; a subset hold RT(N) (ARRT post-primary) instead. Both are recognized at hospital employers nationally.

How to Compare Nuclear Medicine Tech Salary by State Effectively

When comparing the average nuclear medicine technologist salary by state, work through this checklist:

• Verify state radiologic/nuclear medicine licensure requirements — most states require state license plus national CNMT or RT(N).
• Compare nominal and real (cost-adjusted) pay together — a state with the highest nominal median can have lower real purchasing power if its cost of living is higher.
• Check state income tax — NMTs in Texas, Florida, Tennessee, Nevada, Washington, Wyoming, South Dakota, Alaska, and New Hampshire keep more of every dollar.
• Factor in NCI-designated cancer center density — Texas, New York, Massachusetts, Pennsylvania, Maryland, California, Minnesota, Ohio, Tennessee concentrate PET-CT and theranostics demand.
• Compare percentile distribution, not just median — states with strong PET-CT and theranostics program density show wider P75–P90 spreads.
• Consider theranostics specialty trajectory — Lu-177 PSMA and Lu-177 DOTATATE program expansion is concentrating at quaternary cancer center states. Theranostics-trained NMTs reach top of the SOC distribution.

2026 State-Level NMT Salary Outlook

Nuclear medicine technologist pay has grown at a compound annual rate of 4.96% nationally over the past five years — driven by chronic CNMT supply shortages, rapid PET-CT outpatient expansion, the post-2022 explosion in Lu-177 PSMA and Lu-177 DOTATATE theranostics programs at NCI-designated cancer centers, and ongoing demand from cardiac SPECT and bone-scan imaging. States with rapid theranostics program expansion (Texas, California, Massachusetts, New York, Pennsylvania, Maryland, Ohio, Tennessee), states with high PET-CT outpatient density, and rural shortage states using sign-on bonuses to recruit are seeing the fastest state-level pay growth through 2026. The BLS projects Nuclear Medicine Technologists employment growth approximately 1% through 2033 for the general SOC, but the subspecialty mix is shifting sharply toward PET-CT and theranostics — driving strong wage premiums for technologists trained in those modalities.

Browse the state-by-state comparison table below to see the $106,398-baseline state ranking, top 10 and bottom 10 states by projected median, regional groupings (Northeast / Midwest / South / West), and direct links to per-state pages for deeper city-level breakdown.