Complete 2026 guide with all 50 states and DC
If you're researching assisted living options for a parent or loved one, one of the first questions you'll have is: how much does it actually cost? The answer depends heavily on where they live. The national median for assisted living in 2026 is approximately $4,500 per month, but that number masks enormous variation. In Missouri, the median monthly cost is just $3,000. In Washington, DC, it's $6,978 -- more than double.
This guide breaks down assisted living costs for every state in the country, ranks them from least to most expensive, and explains what drives those differences. Whether you're comparing states because you have flexibility in where your loved one lives, or you simply want to understand what to expect in your home state, you'll find the numbers you need here.
The table below shows the median monthly cost of assisted living in all 50 states plus Washington, DC. The annual cost column multiplies the monthly figure by 12. States are ranked from cheapest (#1) to most expensive (#51).
| State | Monthly Cost | Annual Cost | Rank |
|---|---|---|---|
| Alabama | $3,503 | $42,036 | 7 |
| Alaska | $6,830 | $81,960 | 50 |
| Arizona | $4,000 | $48,000 | 16 |
| Arkansas | $3,760 | $45,120 | 12 |
| California | $5,250 | $63,000 | 39 |
| Colorado | $4,750 | $57,000 | 35 |
| Connecticut | $5,129 | $61,548 | 38 |
| Delaware | $5,995 | $71,940 | 44 |
| Florida | $4,000 | $48,000 | 17 |
| Georgia | $3,535 | $42,420 | 8 |
| Hawaii | $5,375 | $64,500 | 42 |
| Idaho | $3,838 | $46,056 | 13 |
| Illinois | $4,488 | $53,856 | 28 |
| Indiana | $4,283 | $51,396 | 25 |
| Iowa | $4,367 | $52,404 | 26 |
| Kansas | $4,580 | $54,960 | 31 |
| Kentucky | $3,448 | $41,376 | 4 |
| Louisiana | $3,748 | $44,976 | 10 |
| Maine | $5,865 | $70,380 | 43 |
| Maryland | $4,900 | $58,800 | 36 |
| Massachusetts | $6,500 | $78,000 | 48 |
| Michigan | $4,250 | $51,000 | 24 |
| Minnesota | $4,508 | $54,096 | 30 |
| Mississippi | $3,500 | $42,000 | 5 |
| Missouri | $3,000 | $36,000 | 1 |
| Montana | $4,450 | $53,400 | 27 |
| Nebraska | $4,076 | $48,912 | 19 |
| Nevada | $3,750 | $45,000 | 11 |
| New Hampshire | $6,053 | $72,636 | 46 |
| New Jersey | $6,495 | $77,940 | 47 |
| New Mexico | $4,498 | $53,976 | 29 |
| New York | $4,580 | $54,960 | 32 |
| North Carolina | $4,010 | $48,120 | 18 |
| North Dakota | $3,391 | $40,692 | 3 |
| Ohio | $4,635 | $55,620 | 34 |
| Oklahoma | $3,855 | $46,260 | 14 |
| Oregon | $5,045 | $60,540 | 37 |
| Pennsylvania | $4,100 | $49,200 | 20 |
| Rhode Island | $6,826 | $81,912 | 49 |
| South Carolina | $3,612 | $43,344 | 9 |
| South Dakota | $3,350 | $40,200 | 2 |
| Tennessee | $4,105 | $49,260 | 21 |
| Texas | $3,998 | $47,976 | 15 |
| Utah | $3,500 | $42,000 | 6 |
| Vermont | $5,250 | $63,000 | 40 |
| Virginia | $5,250 | $63,000 | 41 |
| Washington | $6,000 | $72,000 | 45 |
| West Virginia | $4,160 | $49,920 | 22 |
| Wisconsin | $4,600 | $55,200 | 33 |
| Wyoming | $4,169 | $50,028 | 23 |
| Washington, DC | $6,978 | $83,736 | 51 |
Data from World Population Review 2026, CareScout/Genworth Cost of Care Survey. Figures represent median costs and may vary by facility and level of care.
A few things jump out immediately. The gap between the cheapest state (Missouri at $3,000/month) and the most expensive (DC at $6,978/month) is nearly $48,000 per year. That's not a rounding error -- it's a life-changing difference in what families need to budget.
See assisted living, memory care, and nursing home costs for your state.
Calculate Your Costs →If you have flexibility in where your loved one receives care, these states offer the lowest median assisted living costs in the country:
The pattern is clear: the South and Midwest dominate the affordable end of the spectrum. Missouri stands apart as the least expensive state for assisted living in the country, with a median cost that's roughly $1,500 per month below the national median. The Dakotas, Kentucky, and Mississippi are also well below $3,500 per month.
These lower costs are driven by a combination of factors: lower cost of living, lower wages (which means lower staffing costs for facilities), less stringent staffing ratio requirements, and in some cases, lower real estate costs for the facilities themselves. Utah is a notable exception to the Southern/Midwestern pattern -- it benefits from lower operating costs relative to its Western neighbors like California and Colorado.
One important caveat: lower median cost doesn't necessarily mean lower quality. Many facilities in these states provide excellent care. However, families should always evaluate individual facilities on their own merits, regardless of state-level pricing.
On the other end of the spectrum, these states and DC carry the highest price tags:
The Northeast dominates the expensive list, claiming six of the top ten spots. Washington, DC leads the nation at nearly $7,000 per month -- a figure that reflects the district's extremely high cost of living, competitive labor market, and premium real estate costs. Alaska's high costs are driven by its remote location, limited supply of facilities, and the high cost of everything from food to construction materials.
Rhode Island and Massachusetts both exceed $6,500 per month, making New England one of the most expensive regions in the country for senior care. These states have some of the strictest staffing requirements and highest minimum wages in the nation, both of which push facility costs higher.
For families in these states, the annual cost of assisted living can exceed $70,000 to $80,000 -- a figure that requires significant financial planning. Many families in high-cost states explore options like Medicaid waivers, veterans benefits, or long-term care insurance to help offset these expenses.
Assisted living costs in the United States follow clear regional patterns. Understanding these patterns can help you set realistic expectations and plan more effectively.
The South consistently offers the most affordable assisted living in the country. States like Missouri, Mississippi, Alabama, Georgia, South Carolina, and Kentucky all fall well below the national median. Even states with growing metropolitan areas like Texas ($3,998) and Florida ($4,000) remain at or below the national average. The primary drivers are lower labor costs, lower cost of living, and generally less restrictive regulatory environments.
The Midwest is a mixed bag but generally affordable. The Dakotas are among the cheapest states in the country, and Indiana ($4,283), Iowa ($4,367), and Nebraska ($4,076) all come in below the national median. However, states like Ohio ($4,635), Wisconsin ($4,600), and Minnesota ($4,508) creep closer to or slightly above the national median, particularly in their larger metro areas.
The West shows the widest range of any region. Utah ($3,500) and Nevada ($3,750) are among the cheapest states nationally, while Washington ($6,000) and California ($5,250) are among the most expensive. Alaska ($6,830) and Hawaii ($5,375) are outliers driven by geographic isolation. If you're in the West, your state matters enormously -- the difference between Utah and Washington is over $2,500 per month.
The Northeast is consistently the most expensive region for assisted living. Only Pennsylvania ($4,100) comes in near the national average. Every other Northeastern state exceeds $5,000 per month, and several (Massachusetts, New Jersey, New Hampshire, Rhode Island) exceed $6,000. High wages, strict regulations, expensive real estate, and a high cost of living all contribute. Families in this region should budget significantly above the national median.
A $4,000 per month difference between the cheapest and most expensive states doesn't happen by accident. Several interconnected factors drive these variations.
This is the single biggest factor. States with high costs of living -- housing, food, utilities, transportation -- inevitably have higher assisted living costs. Facilities need to charge enough to cover their operating expenses, and those expenses mirror the local economy. A facility in Boston pays dramatically more for real estate, food service, and supplies than one in rural Missouri.
Each state sets its own rules for assisted living facilities, and these regulations vary widely. Some states mandate specific staff-to-resident ratios, require certain levels of nursing oversight, or impose training hour requirements for caregivers. States with stricter requirements (like Massachusetts, New Jersey, and Washington) tend to have higher costs because facilities need more staff and more qualified staff.
Staff wages typically represent 50-70% of an assisted living facility's operating budget. States with higher minimum wages, tighter labor markets, or stronger healthcare unions will have higher staffing costs. In 2026, states like Washington and Massachusetts have minimum wages above $15/hour, while states like Missouri and Mississippi have lower wage floors. This alone accounts for a significant portion of the state-to-state cost variation.
States with a large aging population and limited supply of facilities tend to have higher prices. Conversely, states where new facilities are being built at a pace that keeps up with demand tend to have more competitive pricing. The baby boomer generation is creating increased demand nationwide, but the impact is felt most acutely in states where development has not kept pace.
Many assisted living facilities accept Medicaid, and the reimbursement rate set by each state influences overall pricing. States with lower Medicaid reimbursement rates may see facilities charge private-pay residents more to make up the difference. States with more generous Medicaid rates may see somewhat lower private-pay costs, though the relationship is not always straightforward.
State medians are useful benchmarks, but your family's actual cost will depend on several individual factors. It's not unusual for costs within a single state to vary by $2,000 or more per month.
Most assisted living facilities use a tiered pricing model based on how much help a resident needs with activities of daily living (ADLs) -- bathing, dressing, eating, mobility, and medication management. A relatively independent resident who just needs help with medications might pay the base rate, while someone who needs assistance with multiple ADLs throughout the day could pay $1,000 to $2,000 more per month. Memory care for residents with Alzheimer's or dementia typically adds an additional $1,000 to $3,000 per month on top of standard assisted living rates.
A private room or apartment generally costs 20-40% more than a shared or semi-private arrangement. Studio apartments are the most common and most affordable private option. One-bedroom apartments cost more, and two-bedroom units (available at some facilities) carry a premium. Couples sharing a room can sometimes negotiate a rate that's less than double the single-occupancy price.
Urban facilities almost always cost more than rural ones. A facility in downtown Denver will charge significantly more than one in a small Colorado town, even though the state median is a single number. If your loved one doesn't need to be in a major metro area, looking at suburban or rural facilities can yield meaningful savings. In large states like California and Texas, the cost difference between metro and rural areas can be $1,500 or more per month.
Assisted living facilities range from basic residential care homes to resort-style communities with fine dining, fitness centers, pools, and on-site salons. The amenities and overall quality of the facility directly impact pricing. A no-frills facility focused on care basics will be significantly cheaper than a luxury community, even in the same city.
See assisted living, memory care, and nursing home costs for your state.
Calculate Your Costs →Assisted living costs have been rising steadily, and families should plan for continued increases.
Over the past several years, assisted living costs have increased by approximately 3-5% annually nationwide. Some states have seen even sharper increases, particularly those facing acute labor shortages in healthcare. The primary drivers of these increases are:
What this means practically: if assisted living costs $4,500 per month today, it could cost $4,635 to $4,725 next year and $5,250 to $5,850 in five years. Families planning for a multi-year stay should build in annual cost increases of at least 4% when budgeting. Starting the research and financial planning process early -- even a year or two before care is needed -- gives families more time to explore options and arrange financing.
Given these costs, most families need to explore multiple funding sources. Here are the most common ways families pay for assisted living:
Many families use a combination of these sources. A common approach is to use Social Security and pension income to cover a portion of the monthly cost, then bridge the gap with savings, long-term care insurance, or Medicaid. Speaking with an elder care financial planner can help you map out the best strategy for your family's situation.
What is the average cost of assisted living in the US in 2026?
The national median cost of assisted living in 2026 is approximately $4,500 per month, or about $54,000 per year. However, costs range from $3,000 per month in Missouri to $6,978 per month in Washington, DC. Your actual cost will depend on your state, the specific facility, and the level of care your loved one needs.
Does Medicare pay for assisted living?
No. Medicare does not cover assisted living costs. Medicare covers hospital stays, doctor visits, and short-term skilled nursing care, but it does not pay for long-term custodial care in an assisted living facility. Medicaid, which is a separate program, may help cover assisted living costs in many states through Home and Community-Based Services (HCBS) waivers, but eligibility is based on income and assets, and wait lists can be long.
Is it cheaper to have in-home care or move to assisted living?
It depends on how many hours of care are needed. For someone who only needs a few hours of help per day, in-home care is typically cheaper. The national median for a home health aide is about $30 per hour. At 4 hours per day, that's roughly $3,600 per month -- comparable to or less than assisted living in many states. However, if your loved one needs 8 or more hours of daily assistance, in-home care quickly becomes more expensive than assisted living, which provides 24/7 staffing as part of the monthly cost. Assisted living also includes housing, meals, and social activities, which have their own value.
Data from World Population Review 2026, CareScout/Genworth Cost of Care Survey. All costs represent median values and are subject to change. Individual facility costs may vary significantly from state medians.
See assisted living, memory care, and nursing home costs for your state.
Calculate Your Costs →