Let me be completely honest with you—finding registered nurse positions paying $155,000 annually in the USA with visa sponsorship is challenging but absolutely possible. The reality is that most entry-level RN positions with visa sponsorship start at much lower salaries, but there are specific pathways, specializations, and strategic moves that can get you to that six-figure income. I’m going to show you exactly which nursing roles reach $155,000+, what qualifications you need, which visa pathways work for nurses, and how to position yourself for these high-paying opportunities.
The Salary Reality: What Nurses Actually Earn in the USA
First, let’s establish realistic expectations based on current market data. Registered nurses in the USA with visa sponsorship typically earn hourly compensation ranging from $39 to $50 or more, depending on region, market demand, and experience.
Let’s do the math:
- $39/hour × 40 hours/week × 52 weeks = $81,120 annually
- $50/hour × 40 hours/week × 52 weeks = $104,000 annually
So the typical sponsored RN position pays between $81,000 and $104,000. To reach $155,000, you’ll need specialization, experience, location advantages, or a combination of all three. But it’s definitely achievable—let me show you how.
Which Nursing Roles Actually Pay $155,000+ with Sponsorship?
1. Certified Advanced Practice Registered Nurses (APRNs)
Certified Advanced Practice Registered Nurses (APRNs) are generally the first to be accepted for the H-1B petition.
Salary Range: $120,000-$180,000+ annually
APRN Categories That Reach $155,000+:
- Nurse Anesthetists (CRNAs): $180,000-$200,000+ (highest-paid nursing specialty)
- Nurse Practitioners in High-Demand Specialties: $130,000-$170,000+
- Clinical Nurse Specialists in Critical Care: $140,000-$165,000+
- Nurse Midwives in Metropolitan Areas: $120,000-$160,000+
What You Need:
- Bachelor of Science in Nursing (BSN)
- Master’s degree or Doctor of Nursing Practice (DNP) in advanced practice specialty
- National certification in your specialty
- The position requires the nurse to be a certified RN (registered nurse) with a minimum of a Bachelor of Science in Nursing with additional education.
- Several years of RN experience before entering advanced practice
2. Nurse Managers and Administrative Roles
The second level of acceptance applies to nurses who qualify for administrative occupations which require a graduate degree in nursing or healthcare administration. Examples include Nurse Managers and Supervisory Nurses.
Salary Range: $110,000-$170,000+ annually
Roles That Hit $155,000+:
- Director of Nursing at large hospitals
- Nursing Unit Manager in high-acuity units (ICU, OR, Emergency)
- Regional Nursing Director for hospital systems
- Clinical Operations Manager
What You Need:
- BSN minimum (Master’s preferred)
- Graduate degree in nursing administration or healthcare management
- 5-10+ years of nursing leadership experience
- Budget management and staff supervision skills
3. Specialized Critical Care Nurses in High-Cost Areas
Base Salary: $90,000-$130,000 With Differentials, Overtime, and Location: Can reach $150,000-$180,000+
How This Works: Critical care nurses in expensive metropolitan areas (San Francisco, New York City, Los Angeles, Boston) can reach $155,000+ when you factor in:
- Base salary: $100,000-$120,000 in major cities
- Shift differentials: Evening/night shifts add 15-30% premium
- Weekend differentials: Additional 10-15%
- Overtime: Time-and-a-half after 40 hours
- Critical care premium: Specialized units pay higher base rates
High-Paying Specializations:
- ICU/Critical Care in Level 1 Trauma Centers
- Emergency Department nurses in major metropolitan hospitals
- Operating Room nurses with specialized skills
- NICU nurses in major medical centers
- CVOR (Cardiovascular Operating Room) nurses
4. Travel Nurses with Visa Sponsorship
Travel nursing offers some of the highest earning potential, though visa sponsorship is more complex.
Potential Earnings: $130,000-$200,000+ annually
How Travel Nurses Reach $155,000+:
- Higher hourly rates ($60-$80+ per hour)
- Housing stipends (tax-advantaged)
- Meal allowances
- Travel reimbursements
- Crisis pay (during staffing emergencies, rates can double)
The Catch: Employers often offer visa sponsorship with additional support, such as immigration assistance, relocation help, or temporary housing. However, travel nursing with visa sponsorship typically requires you to first establish yourself as a permanent employee, then transition to travel status.
5. Nurses in Underserved Rural Areas with Incentive Packages
Some rural hospitals offer comprehensive compensation packages that effectively reach $130,000-$160,000 when including all benefits and incentives.
Package Components:
- Base salary: $85,000-$100,000
- Sign-on bonus: $15,000-$25,000 (amortized annually)
- Housing assistance: Worth $15,000-$25,000 annually
- Student loan repayment: $10,000-$25,000 annually
- Relocation assistance: $5,000-$15,000
- Retention bonuses
UPMC is offering sign-on bonuses up to $15,000 for RNs with at least one year of experience, plus housing assistance for you and eligible family members, and support with sponsorship and payment for the permanent residency process.
Understanding Visa Options for Nurses
The most commonly used visa options for foreign nurses include H-1B, EB-3, and TN visas. Let me break down each option and which is best for reaching that $155,000 salary goal.
H-1B Visa: The Specialty Occupation Route
Registered nurses with just a two-year associate’s degree will need to pursue further education to increase their chances of getting an H-1B visa.
Who Qualifies:
- Advanced Practice Registered Nurses (APRNs)
- Nurse managers with graduate degrees
- Specialized nurses with BSN + advanced certifications
- Nurses in administrative roles requiring bachelor’s degree minimum
Process: Once all employees have been registered, United States Citizenship and Immigration Services (USCIS) randomly selects a predetermined number of petitions to meet the visa cap of 85,000 available visas.
Duration: 3 years initially, renewable for another 3 years (6 years total)
The Reality: The annual visa quota for new admissions is 85,000 positions, and there is limited competition to win these visas. This lottery system means you’re not guaranteed approval even with employer sponsorship.
Salary Potential: H-1B roles typically require bachelor’s degree minimum and pay $80,000-$180,000+, making this a viable pathway to $155,000+ salaries.
EB-3 Visa: The Green Card Pathway
The EB-3 visa functions as an immigrant classification because it results in the attainment of permanent US residency, known as the Green Card.
Categories for Nurses:
- Skilled Workers: Minimum 2 years nursing experience
- Professionals: BSN or equivalent required
- Unskilled Workers: Less common for nurses
The Process: Immigration Petition (Form I-140 for EB-3) filed by employer.
Advantages:
- Direct pathway to permanent residency (Green Card)
- No annual cap (though country-specific backlogs exist)
- Can work toward higher salaries over time as permanent resident
Timeline: 2-4 years typically, depending on your country of origin
Salary Potential: Entry-level EB-3 sponsored positions start at $70,000-$90,000, but with permanent residency, you can pursue advanced degrees and specializations to reach $155,000+ within 5-10 years.
TN Visa: For Canadian and Mexican Nurses Only
TN Visa (for Canadians & Mexicans): Available under USMCA (special provisions for nurses).
This is the easiest pathway but only available to Canadian and Mexican citizens. No lottery, no complex sponsorship process—just employer offer and qualification proof.
The Essential Requirements: What You Must Have
To qualify for a Registered Nurse (RN) job in the USA with visa sponsorship, candidates must meet the following requirements:
1. Educational Qualifications
The US requires a Bachelor’s Degree in Nursing (BSN) as the minimum academic qualification for most nursing roles.
For higher-paying positions ($155,000+), you’ll typically need:
- BSN minimum (for basic RN roles)
- Master’s degree or DNP (for APRN and administrative roles)
- Specialized post-graduate certificates
2. NCLEX-RN Certification
To become a licensed nurse in the United States, candidates must pass the National Council Licensure Examination for Registered Nurses, or NCLEX-RN.
The nurse needs to pass the NCLEX-RN test in addition to satisfying the state professional licensing requirements for her work location.
The Process:
- Register with Pearson VUE
- Pay examination fee ($200)
- Schedule and pass the exam
- Apply for state licensure
3. VisaScreen Certificate
Visa Screen Certificate from CGFNS (Commission on Graduates of Foreign Nursing Schools), confirming nursing license and education equivalency.
This certificate verifies:
- Your nursing education is equivalent to U.S. standards
- Your English proficiency (usually IELTS or TOEFL)
- Your nursing license is valid
Cost: Approximately $500-$800 Timeline: 3-6 months typically
4. English Proficiency
Foreign nurses must complete the IELTS exam and achieve at least 6.5 on the overall grade and 7 for the speaking portion.
Many U.S. states also accept:
- TOEFL scores
- OET (Occupational English Test) – specifically designed for healthcare
5. Clinical Experience
A minimum of one to two years of nursing experience may be required by certain workplaces.
For $155,000+ positions, you’ll typically need:
- 3-5+ years for specialized clinical roles
- 5-10+ years for management positions
- 2-3+ years for APRN roles (after becoming RN)
Where to Find $155,000+ Nursing Jobs with Visa Sponsorship
Opportunity for advancement interested in becoming a United States Registered Nurse in multiple acute care specialties. Benefits include visa sponsorship and full-time employment.
Major Hospital Systems Offering Sponsorship
UPMC (University of Pittsburgh Medical Center) UPMC is seeking registered nurses (RNs) to work directly in our hospitals with sign-on bonuses up to $15,000, housing assistance, and support with sponsorship and payment for the permanent residency process.
Other Major Systems Actively Sponsoring:
- Mayo Clinic (Minnesota, Arizona, Florida)
- Cleveland Clinic (Ohio, Florida)
- Johns Hopkins (Maryland)
- Massachusetts General Hospital (Boston)
- NewYork-Presbyterian Hospital
- UCLA Medical Center (California)
- UCSF Medical Center (California)
Healthcare Staffing Agencies
Many employers partner with healthcare staffing agencies that handle recruitment, sponsorship, and workforce distribution.
Agencies Specializing in International Nurse Recruitment:
- Conexus MedStaff
- O’Grady Peyton International
- TNAA (The Nurse Advocate)
- AMN Healthcare
- HealthTrust Workforce Solutions
High-Paying States for Nurses
States where RN salaries most commonly reach or exceed $155,000 (especially for specialized roles):
California: Highest-paying state for nurses
- Average RN: $120,000-$140,000
- Specialized/Experienced: $150,000-$180,000+
New York: Major metropolitan premium
- NYC hospitals: $110,000-$160,000
- Specialized roles: $140,000-$170,000+
Massachusetts: Academic medical centers
- Boston hospitals: $100,000-$150,000
- Specialized/management: $140,000-$165,000+
Washington: Seattle market
- Average RN: $100,000-$130,000
- Specialized: $130,000-$160,000+
Hawaii: Cost of living adjustments
- Average RN: $95,000-$120,000
- Experienced: $120,000-$150,000+
The Application Process: Step by Step to $155,000
Step 1: Get Your Foundation Right (Months 1-6)
Actions:
- Take and pass NCLEX-RN
- Apply for VisaScreen Certificate
- Take IELTS/TOEFL if needed
- Gather all educational documents
- Get documents translated and certified
Timeline: 3-6 months Cost: $1,500-$3,000
Step 2: Gain Targeted Experience (Years 1-3)
If you’re not yet qualified for $155,000 roles:
- Work as RN in your home country in specialty areas (ICU, ER, OR)
- Pursue advanced certifications (CCRN, CEN, CNOR)
- Consider online MSN or DNP programs
- Build 2-5 years of specialized experience
Step 3: Target High-Paying Opportunities (Months 7-12)
Research Employers:
- Focus on states with highest RN pay
- Target large hospital systems known for sponsorship
- Consider rural areas with comprehensive incentive packages
- Look at academic medical centers
Apply Strategically:
- Use nursing-specific job boards (Indeed, Monster, Nurse.com)
- Work with international healthcare recruiters
- Network with nurses who’ve successfully moved to USA
- Attend virtual job fairs for international nurses
Step 4: Secure Sponsorship (Months 12-18)
What Happens:
- Interview process (often virtual initially)
- Job offer contingent on visa approval
- Employer sponsorship: To begin the H-1B visa process, a U.S. employer must sponsor you as a nurse.
- Employer files petition with USCIS
- Wait for lottery results (if H-1B) or processing (if EB-3)
Timeline: 6-18 months depending on visa type
Step 5: Final Steps and Arrival (Months 18-24)
- Visa approval
- State nursing license application
- Travel arrangements
- Relocation and orientation
- Begin work!
The Complete Cost Breakdown
Your Costs:
- NCLEX-RN exam: $200
- VisaScreen Certificate: $500-$800
- IELTS/TOEFL: $200-$250
- Document translation/certification: $300-$500
- Visa application fee: $190
- Medical examination: $200-$400
- Travel to U.S. embassy: $100-$500
- Your Total: $1,690-$2,840
Employer Covers:
- Visa petition filing: $460-$1,500
- Legal fees: $3,000-$7,000
- Labor certification (if required): $1,000-$3,000
- Employer Total: $4,460-$11,500
Benefits Beyond Salary
Registered nurses in the USA with visa sponsorship enjoy numerous benefits including 401(k) retirement savings plan with company matching, medical/dental/vision insurance, paid leave and holidays, short-term and long-term disability coverage, and life insurance policies.
For a $155,000 Salary Position, Additional Benefits Typically Include:
- 401(k) match: Worth $7,750-$15,500 (5-10% of salary)
- Health insurance: Worth $15,000-$20,000 annually
- Paid time off: 4-6 weeks (worth $11,923-$17,885)
- Continuing education: $2,000-$5,000 annually
- Retirement pension: Additional to 401(k) at some systems
Total Compensation Package: $190,000-$215,000 in value
Common Mistakes to Avoid
Mistake 1: Applying with Only an Associate Degree Registered nurses with just a two-year associate’s degree will need to pursue further education to increase their chances of getting an H-1B visa.
Solution: Get your BSN before applying, or enroll in an RN-to-BSN bridge program.
Mistake 2: Expecting $155,000 in Entry-Level Positions Solution: Build a strategic career plan—start at $80,000-$100,000, specialize, advance, and reach $155,000+ within 5-8 years.
Mistake 3: Ignoring State-Specific Requirements Solution: Research requirements for your target state early. California and New York have additional requirements beyond NCLEX.
Mistake 4: Missing Application Deadlines For the 2025 H-1B lottery, applications must be submitted, and typically all petitions need to be filed by the end of June.
Solution: Work with your employer 6-12 months before the lottery to ensure timely filing.
Mistake 5: Falling for Scams Solution: Only work with established healthcare systems, verified recruiters, or accredited staffing agencies. Never pay for a “guaranteed” visa.
The Realistic Timeline to $155,000
Scenario 1: Direct Path (Faster but Requires Advanced Qualifications)
- Years 0-4: Complete BSN + work as RN in home country
- Years 5-7: Complete MSN/DNP while working
- Year 8: Apply for APRN positions in USA with H-1B sponsorship
- Starting salary: $130,000-$160,000+
Scenario 2: Build-Up Path (More Common)
- Year 1-2: Complete NCLEX, VisaScreen, secure EB-3 sponsorship
- Year 3-4: Work in USA at $80,000-$100,000, get U.S. experience
- Year 5-6: Pursue specialty certification or advance practice degree
- Year 7-10: Move to specialized role or management
- Salary progression: $155,000-$180,000+
Scenario 3: Location Strategy (Fastest to Six Figures)
- Year 1-2: Secure sponsorship with high-paying state (CA, NY, MA)
- Year 3: Start at $100,000-$120,000 in high-cost metro area
- Year 4-5: Add specialty certification, overtime, differentials
- Effective compensation: $130,000-$160,000+ with all pay components
The Bottom Line
Can you earn $155,000 as a registered nurse in the USA with visa sponsorship? Yes, absolutely—but not usually in entry-level positions. The realistic pathways are:
Immediate $155,000+ Options:
- Become a Certified Nurse Anesthetist (CRNA)
- Get Nurse Practitioner specialization in high-demand area
- Pursue nursing management with graduate degree
- Work in California or New York in specialized critical care
Build to $155,000 Options:
- Start with EB-3 sponsorship at $80,000-$100,000
- Gain U.S. experience and certifications
- Advance to specialized roles
- Reach $155,000+ within 5-10 years
The opportunities are real, as nurse relocation to USA 2026 is expected to be more structured and supportive due to global competition for healthcare talent. With proper planning, qualifications, strategic positioning, and patience, that $155,000 nursing salary isn’t just a dream—it’s an achievable goal for qualified international nurses willing to invest in specialization and career development.
Start with NCLEX-RN, get your VisaScreen Certificate, target employers in high-paying states, consider advanced practice roles, and build strategically toward that six-figure nursing career in America. Your $155,000 salary is waiting—you just need the roadmap to get there.