10 Best Small Cities for Nurses With Big Student Loan Debt

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Although nurses shell out less money than doctors to pay for their medical schooling, they’re often just as stressed out about how to pay for it.

About 7 in 10 nurses take out student loans to pay for their graduate program, according to a 2017 report from the American Association of Colleges of Nursing. What’s more, 50% stated their biggest concern after graduation was figuring out how to repay their loans.

But relocating can often help struggling borrowers get a handle on student loan payments, especially if they can combine low costs of living with a healthy salary and job demand.

So if you’re a nurse looking to jump-start your debt payoff journey, check out the following best small cities to live in and work in when paying off student loans.

10 best small cities for nurses paying off student loans


To help nurses figure out whether relocating to a smaller city might be worth it, we first wanted to be able to answer the following questions:

  • What annual salary can a nurse expect to earn?
  • How much demand is there for nurses?
  • How far will a nurse’s salary go when paying for goods and services?

We relied on three data points from the Bureau of Labor Statistics (BLS) to help formulate our answers to the three questions.

  • Average annual wage: The median pay for registered nurses nationally in 2017 was $70,000, according to the BLS.
  • Location quotient: The location quotient compares the employment of nurses in a city to the average for the nation. If a city reports a location quotient greater than 1.0, which is the national average, nurses are more likely to be in demand in that city. Cities with marks below 1.0 are less likely to offer as many employment options.
  • Regional price parity: Price parity refers to varying costs of goods and services in cities, which in turn affects the purchasing power of your wages (or how much you can actually buy with your paycheck). If a city’s regional price parity is less than 100, which is the average, goods and services are less expensive in that city (so a large paycheck will go further). If a city reports a mark greater than 100, goods and services are more expensive there.

Here are the top 10 small cities that received the highest marks in these areas:

1. Bay City, Michigan

The first of two Michigan cities atop our rankings, Bay City comes with the benefit of a lower cost of living. In fact, thanks to the city’s regional price parity, the purchasing power of the average annual wage for a nurse jumps to $78,020, according to the BLS.

  • Average annual wage: $69,360
  • Location quotient: 1.42
  • Regional price parity: 88.9

2. Saginaw, Michigan

Like their neighbors in Bay City, Saginaw nurses can take advantage of the Michigan State Loan Repayment Program. It provides a maximum of $200,000 over eight years to help nurse practitioners repay their loans.

  • Average annual wage: $66,030
  • Location quotient: 1.58
  • Regional price parity: 89.4

3. Greenville, North Carolina

Despite being the most populous small city on our list, Greenville reported a relatively high demand for registered nurses. In fact, it recorded the highest location quotient of any city in our top 10.

  • Average annual wage: $63,130
  • Location quotient: 2.02
  • Regional price parity: 88.4

4. Johnstown, Pennsylvania

Johnstown nurses can look into receiving help repaying their debt via the Pennsylvania Primary Care Loan Repayment Program. It awards up to $60,000 to full-time nurse practitioners in exchange for two years working in an underserved area. Contact the program to stay abreast of application periods.

  • Average annual wage: $62,120
  • Location quotient: 1.69
  • Regional price parity: 87.2

5. Cumberland, Maryland

Aside from being paid well, nurses in Cumberland can take advantage of the Janet L. Hoffman Loan Assistance Repayment Program. In exchange for treating low-income and underserved residents, nurses can receive up to $30,000 in aid over three years if they have debt totaling $75,001 or more.

  • Average annual wage: $65,010
  • Location quotient: 1.36
  • Regional price parity: 88.2

6. Florence, South Carolina

Combine a relatively high demand for nurses with a low cost of living and, boom, you have a city that’s conducive to paying off your student loans.

The cost of goods and services in Florence is so low, in fact, that the average salary of $60,470 has a purchasing power of $70,725, according to the BLS.

  • Average annual wage: $60,470
  • Location quotient: 1.85
  • Regional price parity: 85.5

7. Duluth, Minnesota

Duluth cracked our top 10 because it reported strong marks in each of the three data categories under consideration.

Here’s a fourth reason for its rise up the rankings: the Minnesota Health Care Loan Forgiveness program. It offers repayment assistance of up to $20,000 over four years to nurses who work at least two years in a nursing home.

  • Average annual wage: $66,780
  • Location quotient: 1.38
  • Regional price parity: 91.7

8. Hanford, California

The lone West Coast city among our top 10, Hanford made up for its relatively higher cost of living with an equally impressive salary. In fact, of the 334 small, midsized, and large cities we reviewed, Hanford reported the 13th-highest annual average wage.

Plus, Hanford (and other California) residents can look for assistance via the state’s Bachelor of Science Nursing Loan Repayment Program. Recipients may receive up to $10,000 after agreeing to a one-year obligation practicing direct patient care at a qualifying facility in California.

  • Average annual wage: $91,340
  • Location quotient: 1.56
  • Regional price parity: 95.5

9. Alexandria, Louisiana

You might scoff at Alexandria’s relatively low salary, but the BLS gave this small city in Louisiana a purchasing power of $67,355, thanks to its lower cost of living.

Residents can access the Louisiana State Loan Repayment Program if they work in rural or inner-city communities or for a nonprofit. It awards a maximum of $45,000 over three years.

  • Average annual wage: $59,070
  • Location quotient: 1.89
  • Regional price parity: 87.7

10. Eau Claire, Wisconsin

Although not as mighty as Milwaukee or Madison, Eau Claire represented Wisconsin well by rounding out our top 10. The smaller city reported high marks across the board and also boasts the state’s Health Professions Loan Assistance Program, which offers up to $100,000 in repayment aid.

  • Average annual wage: $66,500
  • Location quotient: 1.42
  • Regional price parity: 92.3

Should you move to a smaller city?


Chances are you don’t already live or work in one of the top 10 best small cities for nurses paying off student loans, but it’s worth considering the benefits of such a move. After all, your location affects the amount of disposable income you can put toward student loan repayment.

Sure, your salary, job prospects, and cost of living vary from city to city. But you’ll also want to compare differences between states. There are many state-based loan forgiveness programs for nurses, for example.

Similarly, you might target smaller cities within states that have no income tax. That way, you can take home more of your paycheck.

Say you moved to Sherman, Texas, which ranked 15th among our top small cities for nurses. You might see a pay increase, more job demand, and a lower cost of living — but you’d also appreciate Texas being one of nine states without an income tax.

Like refinancing or consolidating your loans, moving to a smaller city is a potential repayment tool. It could be the right choice if it helps you pay down debt faster. And, hey, you could always return to the big city once you’re debt-free.

Top 25 small cities for nurses


In case your city fell outside the top 10 but still ranked highly, consider our top 25:

Rank City Annual mean wage Location quotient Regional price parity
1 Bay City, Mich. $69,360 1.42 88.9
2 Saginaw, Mich. $66,030 1.58 89.4
3 Greenville, N.C. $63,130 2.02 88.4
4 Johnstown, Pa. $62,120 1.69 87.2
5 Cumberland, Md. $65,010 1.36 88.2
6 Florence, S.C. $60,470 1.85 85.5
7 Duluth, Minn. $66,780 1.38 91.7
8 Hanford, Calif. $91,340 1.56 95.5
9 Alexandria, La. $59,070 1.89 87.7
10 Eau Claire, Wis. $66,500 1.42 92.3
11 Rome, Ga. $56,250 2.35 82.2
12 St. Cloud, Minn. $79,700 1.17 93
13 Asheville, N.C. $62,030 1.62 92
14 Battle Creek, Mich. $63,460 1.24 90.5
15 Sherman, Texas $60,130 1.74 91.5
16 Redding, Calif. $89,960 1.55 98.6
17 Flint, Mich. $64,920 1.57 93.8
18 Kalamazoo, Mich. $64,200 1.36 92.7
19 Huntington, W.Va. $55,140 2.01 86.7
20 Wenatchee, Wash. $74,290 1.36 96.3
21 Lewiston, Idaho $60,960 1.38 91.7
22 Dothan, Ala. $54,410 1.8 85
23 Cape Girardeau, Mo. $51,990 2.32 82.8
24 Albany, Ga. $60,910 1.09 85.1
25 Danville, Ill. $62,050 1.03 79.4

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1 Important Disclosures for Earnest.

Earnest Disclosures

To qualify, you must be a U.S. citizen or possess a 10-year (non-conditional) Permanent Resident Card, reside in a state Earnest lends in, and satisfy our minimum eligibility criteria. You may find more information on loan eligibility here: https://www.earnest.com/eligibility. Not all applicants will be approved for a loan, and not all applicants will qualify for the lowest rate. Approval and interest rate depend on the review of a complete application.

Earnest fixed rate loan rates range from 3.89% APR (with Auto Pay) to 6.97% APR (with Auto Pay). Variable rate loan rates range from 2.47% APR (with Auto Pay) to 6.30% APR (with Auto Pay). For variable rate loans, although the interest rate will vary after you are approved, the interest rate will never exceed 8.95% for loan terms 10 years or less. For loan terms of 10 years to 15 years, the interest rate will never exceed 9.95%. For loan terms over 15 years, the interest rate will never exceed 11.95% (the maximum rates for these loans). Earnest variable interest rate loans are based on a publicly available index, the one month London Interbank Offered Rate (LIBOR). Your rate will be calculated each month by adding a margin between 1.82% and 5.50% to the one month LIBOR. The rate will not increase more than once per month. Earnest rate ranges are current as of Month/Day/Year, and are subject to change based on market conditions and borrower eligibility.

Auto Pay discount: If you make monthly principal and interest payments by an automatic, monthly deduction from a savings or checking account, your rate will be reduced by one quarter of one percent (0.25%) for so long as you continue to make automatic, electronic monthly payments. This benefit is suspended during periods of deferment and forbearance.

The information provided on this page is updated as of 08/21/18. Earnest reserves the right to change, pause, or terminate product offerings at any time without notice. Earnest loans are originated by Earnest Operations LLC. California Finance Lender License 6054788. NMLS # 1204917. Earnest Operations LLC is located at 302 2nd Street, Suite 401N, San Francisco, CA 94107. Terms and Conditions apply. Visit https://www.earnest.com/terms-of-service, email us at hello@earnest.com, or call 888-601-2801 for more information on ourstudent loan refinance product.

© 2018 Earnest LLC. All rights reserved. Earnest LLC and its subsidiaries, including Earnest Operations LLC, are not sponsored by or agencies of the United States of America.


2 Important Disclosures for Laurel Road.

Laurel Road Disclosures

APR stands for “Annual Percentage Rate.” Rates listed include a 0.25% EFT discount, for automatic payments made from a checking or savings account. Interest rates as of 11/8/2018. Rates subject to change.

Variable rate options consist of a range from 3.27% per year to 6.09% per year for a 5-year term, 4.64% per year to 6.14% per year for a 7-year term, 4.69% per year to 6.19% per year for a 10-year term, 4.94% per year to 6.44% per year for a 15-year term, or 5.19% per year to 6.69% per year for a 20-year term, with no origination fees. APR is subject to increase after consummation. The variable interest rate will change on the first day of every month (“Change Date”) if the Current Index changes. The variable interest rates are based on a Current Index, which is the 1-month London Interbank Offered Rate (LIBOR) (currency in US dollars), as published on The Wall Street Journal’s website. The variable interest rates and Annual Percentage Rate (APR) will increase or decrease when the 1-month LIBOR index changes. The variable interest rates are calculated by adding a margin ranging from 0.98% to 3.80% for the 5-year term loan, 2.35% to 3.85% for the 7-year term loan, 2.40% to 3.90% for the 10-year term loan, 2.65% to 4.15% for the 15-year term loan, and 2.90% to 4.40% for the 20-year term loan, respectively, to the 1-month LIBOR index published on the 25th day of each month immediately preceding each “Change Date,” as defined above, rounded to two decimal places, with no origination fees. If the 25th day of the month is not a business day or is a US federal holiday, the reference date will be the most recent date preceding the 25th day of the month that is a business day. The monthly payment for a sample $10,000 loan at a range of 3.27% per year to 6.09% per year for a 5-year term would be from $180.89 to $193.75. The monthly payment for a sample $10,000 loan at a range of 4.64% per year to 6.14% per year for a 7-year term would be from $139.65 to $146.76. The monthly payment for a sample $10,000 loan at a range of 4.69% per year to 6.19% per year for a 10-year term would be from $104.56 to $111.98. The monthly payment for a sample $10,000 loan at a range of 4.94% per year to 6.44% per year for a 15-year term would be from $78.77 to $86.78. The monthly payment for a sample $10,000 loan at a range of 5.19% per year to 6.69% per year for a 20-year term would be from $67.05 to $75.68.

However, if the borrower chooses to make monthly payments automatically by electronic funds transfer (EFT) from a bank account, the variable rate will decrease by 0.25%, and will increase back up to the regular variable interest rate described in the preceding paragraph if the borrower stops making (or we stop accepting) monthly payments automatically by EFT from the designated borrower’s bank account.


3 Important Disclosures for SoFi.

SoFi Disclosures

  1. Student loan Refinance: Fixed rates from 3.899% APR to 7.979% APR (with AutoPay). Variable rates from 2.470% APR to 6.990% APR (with AutoPay). Interest rates on variable rate loans are capped at either 8.95% or 9.95% depending on term of loan. See APR examples and terms. Lowest variable rate of 2.470% APR assumes current 1 month LIBOR rate of 2.30% plus 0.91% margin minus 0.25% ACH discount. Not all borrowers receive the lowest rate. If approved for a loan, the fixed or variable interest rate offered will depend on your creditworthiness, and the term of the loan and other factors, and will be within the ranges of rates listed above. For the SoFi variable rate loan, the 1-month LIBOR index will adjust monthly and the loan payment will be re-amortized and may change monthly. APRs for variable rate loans may increase after origination if the LIBOR index increases. The SoFi 0.25% AutoPay interest rate reduction requires you to agree to make monthly principal and interest payments by an automatic monthly deduction from a savings or checking account. The benefit will discontinue and be lost for periods in which you do not pay by automatic deduction from a savings or checking account. *To check the rates and terms you qualify for, SoFi conducts a soft credit inquiry. Unlike hard credit inquiries, soft credit inquiries (or soft credit pulls) do not impact your credit score. Soft credit inquiries allow SoFi to show you what rates and terms SoFi can offer you up front. After seeing your rates, if you choose a product and continue your application, we will request your full credit report from one or more consumer reporting agencies, which is considered a hard credit inquiry. Hard credit inquiries (or hard credit pulls) are required for SoFi to be able to issue you a loan. In addition to requiring your explicit permission, these credit pulls may impact your credit score.
  2. Terms and Conditions Apply. SOFI RESERVES THE RIGHT TO MODIFY OR DISCONTINUE PRODUCTS AND BENEFITS AT ANY TIME WITHOUT NOTICE. To qualify, a borrower must be a U.S. citizen or permanent resident in an eligible state and meet SoFi’s underwriting requirements. Not all borrowers receive the lowest rate. To qualify for the lowest rate, you must have a responsible financial history and meet other conditions. If approved, your actual rate will be within the range of rates listed above and will depend on a variety of factors, including term of loan, a responsible financial history, years of experience, income and other factors. Rates and Terms are subject to change at anytime without notice and are subject to state restrictions. SoFi refinance loans are private loans and do not have the same repayment options that the federal loan program offers such as Income Based Repayment or Income Contingent Repayment or PAYE. Licensed by the Department of Business Oversight under the California Financing Law License No. 6054612. SoFi loans are originated by SoFi Lending Corp., NMLS # 1121636. (www.nmlsconsumeraccess.org)

4 Important Disclosures for LendKey.

LendKey Disclosures

Refinancing via LendKey.com is only available for applicants with qualified private education loans from an eligible institution. Loans that were used for exam preparation classes, including, but not limited to, loans for LSAT, MCAT, GMAT, and GRE preparation, are not eligible for refinancing with a lender via LendKey.com. If you currently have any of these exam preparation loans, you should not include them in an application to refinance your student loans on this website. Applicants must be either U.S. citizens or Permanent Residents in an eligible state to qualify for a loan. Certain membership requirements (including the opening of a share account and any applicable association fees in connection with membership) may apply in the event that an applicant wishes to accept a loan offer from a credit union lender. Lenders participating on LendKey.com reserve the right to modify or discontinue the products, terms, and benefits offered on this website at any time without notice. LendKey Technologies, Inc. is not affiliated with, nor does it endorse, any educational institution.


5 Important Disclosures for CommonBond.

CommonBond Disclosures

Offered terms are subject to change. Loans are offered by CommonBond Lending, LLC (NMLS # 1175900). If you are approved for a loan, the interest rate offered will depend on your credit profile, your application, the loan term selected and will be within the ranges of rates shown.

All Annual Percentage Rates (APRs) displayed assume borrowers enroll in auto pay and account for the 0.25% reduction in interest rate. All variable rates are based on a 1-month LIBOR assumption of 2.28% effective October 10, 2018.


6 Important Disclosures for Citizens Bank.

Citizens Bank Disclosures

  1. Education Refinance Loan Rate Disclosure: Variable rate, based on the one-month London Interbank Offered Rate (“LIBOR”) published in The Wall Street Journal on the twenty-fifth day, or the next business day, of the preceding calendar month. As of November 1, 2018, the one-month LIBOR rate is 2.29%. Variable interest rates range from 2.79%-8.39% (2.79%-8.39% APR) and will fluctuate over the term of the borrower’s loan with changes in the LIBOR rate, and will vary based on applicable terms, level of degree earned and presence of a cosigner. Fixed interest rates range from 3.75%-8.69% (3.75%-8.69% APR) based on applicable terms, level of degree earned and presence of a cosigner. Lowest rates shown require application with a cosigner, are for eligible, creditworthy applicants with a graduate level degree, require a 5-year repayment term and include our Loyalty discount and Automatic Payment discounts of 0.25 percentage points each, as outlined in the Loyalty and Automatic Payment Discount disclosures. The maximum variable rate on the Education Refinance Loan is the greater of 21.00% or Prime Rate plus 9.00%. Subject to additional terms and conditions, and rates are subject to change at any time without notice. Such changes will only apply to applications taken after the effective date of change. Please note: Due to federal regulations, Citizens Bank is required to provide every potential borrower with disclosure information before they apply for a private student loan. The borrower will be presented with an Application Disclosure and an Approval Disclosure within the application process before they accept the terms and conditions of their loan.
  2. Federal Loan vs. Private Loan Benefits: Some federal student loans include unique benefits that the borrower may not receive with a private student loan, some of which we do not offer with the Education Refinance Loan. Borrowers should carefully review their current benefits, especially if they work in public service, are in the military, are currently on or considering income based repayment options or are concerned about a steady source of future income and would want to lower their payments at some time in the future. When the borrower refinances, they waive any current and potential future benefits of their federal loans and replace those with the benefits of the Education Refinance Loan. For more information about federal student loan benefits and federal loan consolidation, visit http://studentaid.ed.gov/. We also have several resources available to help the borrower make a decision at http://www.citizensbank.com/EdRefinance, including Should I Refinance My Student Loans? and our FAQs. Should I Refinance My Student Loans? includes a comparison of federal and private student loan benefits that we encourage the borrower to review.
  3. Citizens Bank Education Refinance Loan Eligibility: Eligible applicants may not be currently enrolled. Applicants with an Associate’s degree or with no degree must have made at least 12 qualifying payments after leaving school. Qualifying payments are the most recent on time and consecutive payments of principal and interest on the loans being refinanced. Primary borrowers must be a U.S. citizen, permanent resident or resident alien with a valid U.S. Social Security Number residing in the United States. Resident aliens must apply with a cosigner who is a U.S. citizen or permanent resident. The cosigner (if applicable) must be a U.S. citizen or permanent resident with a valid U.S. Social Security Number residing in the United States. For applicants who have not attained the age of majority in their state of residence, a cosigner will be required. Citizens Bank reserves the right to modify eligibility criteria at anytime. Interest rate ranges subject to change. Education Refinance Loans are subject to credit qualification, completion of a loan application/consumer credit agreement, verification of application information, certification of borrower’s student loan amount(s) and highest degree earned.
  4. Loyalty Discount Disclosure: The borrower will be eligible for a 0.25 percentage point interest rate reduction on their loan if the borrower or their co-signer (if applicable) has a qualifying account in existence with us at the time the borrower and their co-signer (if applicable) have submitted a completed application authorizing us to review their credit request for the loan. The following are qualifying accounts: any checking account, savings account, money market account, certificate of deposit, automobile loan, home equity loan, home equity line of credit, mortgage, credit card account, or other student loans owned by Citizens Bank, N.A. Please note, our checking and savings account options are only available in the following states: CT, DE, MA, MI, NH, NJ, NY, OH, PA, RI, and VT and some products may have an associated cost. This discount will be reflected in the interest rate disclosed in the Loan Approval Disclosure that will be provided to the borrower once the loan is approved. Limit of one Loyalty Discount per loan and discount will not be applied to prior loans. The Loyalty Discount will remain in effect for the life of the loan.
  5. Automatic Payment Discount Disclosure: Borrowers will be eligible to receive a 0.25 percentage point interest rate reduction on their student loans owned by Citizens Bank, N.A. during such time as payments are required to be made and our loan servicer is authorized to automatically deduct payments each month from any bank account the borrower designates. Discount is not available when payments are not due, such as during forbearance. If our loan servicer is unable to successfully withdraw the automatic deductions from the designated account three or more times within any 12-month period, the borrower will no longer be eligible for this discount.
  6. Co-signer Release: Borrowers may apply for co-signer release after making 36 consecutive on-time payments of principal and interest. For the purpose of the application for co-signer release, on-time payments are defined as payments received within 15 days of the due date. Interest only payments do not qualify. The borrower must meet certain credit and eligibility guidelines when applying for the co-signer release. Borrowers must complete an application for release and provide income verification documents as part of the review. Borrowers who use deferment or forbearance will need to make 36 consecutive on-time payments after reentering repayment to qualify for release. The borrower applying for co-signer release must be a U.S. citizen or permanent resident. If an application for co-signer release is denied, the borrower may not reapply for co-signer release until at least one year from the date the application for co-signer release was received. Terms and conditions apply.

2.47% – 6.99%3Undergrad
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2.47% – 6.30%1Undergrad
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2.51% – 8.09%4Undergrad
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3.02% – 6.44%2Undergrad
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2.69% – 7.21%5Undergrad
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2.79% – 8.39%6Undergrad
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Our team at Student Loan Hero works hard to find and recommend products and services that we believe are of high quality and will make a positive impact in your life. We sometimes earn a sales commission or advertising fee when recommending various products and services to you. Similar to when you are being sold any product or service, be sure to read the fine print understand what you are buying, and consult a licensed professional if you have any concerns. Student Loan Hero is not a lender or investment advisor. We are not involved in the loan approval or investment process, nor do we make credit or investment related decisions. The rates and terms listed on our website are estimates and are subject to change at any time. Please do your homework and let us know if you have any questions or concerns.