10 Best Small Cities for Nurses With Big Student Loan Debt

 September 24, 2018
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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

For media and reporters: Check out our latest surveys and studies by signing up for news updates via our press page.

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Check out the testimonials and our in-depth reviews!
1 Important Disclosures for Splash Financial.

Splash Financial Disclosures

Terms and Conditions apply. Splash reserves the right to modify or discontinue products and benefits at any time without notice. Rates and terms are also subject to change at any time without notice. Offers are subject to credit approval. To qualify, a borrower must be a U.S. citizen or permanent resident in an eligible state and meet applicable underwriting requirements. Not all borrowers receive the lowest rate. Lowest rates are reserved for the highest qualified borrowers. If approved, your actual rate will be within a range of rates and will depend on a variety of factors, including term of loan, a responsible financial history, income and other factors. Refinancing or consolidating private and federal student loans may not be the right decision for everyone. Federal loans carry special benefits not available for loans made through Splash Financial, for example, public service loan forgiveness and economic hardship programs, fee waivers and rebates on the principal, which may not be accessible to you after you refinance. The rates displayed may include a 0.25% autopay discount

The information you provide to us is an inquiry to determine whether we or our lenders can make a loan offer that meets your needs. If we or any of our lending partners has an available loan offer for you, you will be invited to submit a loan application to the lender for its review. We do not guarantee that you will receive any loan offers or that your loan application will be approved. Offers are subject to credit approval and are available only to U.S. citizens or permanent residents who meet applicable underwriting requirements. Not all borrowers will receive the lowest rates, which are available to the most qualified borrowers. Participating lenders, rates and terms are subject to change at any time without notice.

To check the rates and terms you qualify for, Splash Financial conducts a soft credit pull that will not affect your credit score. However, if you choose a product and continue your application, the lender will request your full credit report from one or more consumer reporting agencies, which is considered a hard credit pull and may affect your credit.

Splash Financial and our lending partners reserve the right to modify or discontinue products and benefits at any time without notice. To qualify, a borrower must be a U.S. citizen and meet our lending partner’s underwriting requirements. Lowest rates are reserved for the highest qualified borrowers. This information is current as of May 4, 2022.

2 Rate range above includes optional 0.25% Auto Pay discount. Important Disclosures for Earnest.

Earnest Disclosures

Student Loan Refinance Interest Rate Disclosure Actual rate and available repayment terms will vary based on your income. Fixed rates range from 2.99% APR to 8.24% APR (excludes 0.25% Auto Pay discount). Variable rates range from 1.99% APR to 8.24% APR (excludes 0.25% Auto Pay discount). Earnest variable interest rate student loan refinance loans are based on a publicly available index, the 30-day Average Secured Overnight Financing Rate (SOFR) published by the Federal Reserve Bank of New York. The variable rate is based on the rate published on the 25th day, or the next business day, of the preceding calendar month, rounded to the nearest hundredth of a percent. The rate will not increase more than once per month. The maximum rate for your loan is 8.95% if your loan term is 10 years or less. For loan terms of more than 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%. Please note, we are not able to offer variable rate loans in AK, IL, MN, NH, OH, TN, and TX. Let us know if you have any questions and feel free to reach out directly to our team.

3 Important Disclosures for CommonBond.

CommonBond Disclosures

Offered terms are subject to change and state law restriction. Loans are offered by CommonBond Lending, LLC (NMLS # 1175900), NMLS Consumer Access. 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 0.15% effective Apr 22, 2021 and may increase after consummation.

4 Important Disclosures for SoFi.

SoFi Disclosures

Fixed rates range from 3.49% APR to 7.99% APR with a 0.25% autopay discount. Variable rates from 1.74% APR to 7.99% APR with a 0.25% autopay discount. Unless required to be lower to comply with applicable law, Variable Interest rates on 5-, 7-, and 10-year terms are capped at 8.95% APR; 15- and 20-year terms are capped at 9.95% APR. Your actual rate will be within the range of rates listed above and will depend on the term you select, evaluation of your creditworthiness, income, presence of a co-signer and a variety of other factors. Lowest rates reserved for the most creditworthy borrowers. For the SoFi variable-rate product, the variable interest rate for a given month is derived by adding a margin to the 30-day average SOFR index, published two business days preceding such calendar month, rounded up to the nearest one hundredth of one percent (0.01% or 0.0001). APRs for variable-rate loans may increase after origination if the SOFR 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. This benefit will discontinue and be lost for periods in which you do not pay by automatic deduction from a savings or checking account. The benefit lowers your interest rate but does not change the amount of your monthly payment. This benefit is suspended during periods of deferment and forbearance. Autopay is not required to receive a loan from SoFi.

5 Important Disclosures for Laurel Road.

Laurel Road Disclosures

All credit products are subject to credit approval.

Laurel Road began originating student loans in 2013 and has since helped thousands of professionals with undergraduate and postgraduate degrees consolidate and refinance more than $4 billion in federal and private school loans. Laurel Road also offers a suite of online graduate school loan products and personal loans that help simplify lending through customized technology and personalized service. In April 2019, Laurel Road was acquired by KeyBank, one of the nation’s largest bank-based financial services companies. Laurel Road is a brand of KeyBank National Association offering online lending products in all 50 U.S. states, Washington, D.C., and Puerto Rico. All loans are provided by KeyBank National Association, a nationally chartered bank. Member FDIC. For more information, visit www.laurelroad.com.

As used throughout these Terms & Conditions, the term “Lender” refers to KeyBank National Association and its affiliates, agents, guaranty insurers, investors, assigns, and successors in interest.

  1. Checking your rate with Laurel Road only requires a soft credit pull, which will not affect your credit score. To proceed with an application, a hard credit pull will be required, which may affect your credit score.
  2. Savings vary based on rate and term of your existing and refinanced loan(s). Refinancing to a longer term may lower your monthly payments, but may also increase the total interest paid over the life of the loan. Refinancing to a shorter term may increase your monthly payments, but may lower the total interest paid over the life of the loan. Review your loan documentation for total cost of your refinanced loan.
  3. After loan disbursement, if a borrower documents a qualifying economic hardship, we may agree in our discretion to allow for full or partial forbearance of payments for one or more 3-month time periods (not to exceed 12 months in the aggregate during the term of your loan), provided that we receive acceptable documentation (including updating documentation) of the nature and expected duration of the borrower’s economic hardship. During any period of forbearance interest will continue to accrue. At the end of the forbearance period, any unpaid accrued interest will be capitalized and be added to the remaining principle amount of the loan.
  4. Automatic Payment (“AutoPay”) Discount: if the borrower chooses to make monthly payments automatically from a bank account, the interest rate will decrease by 0.25% and will increase back if the borrower stops making (or we stop accepting) monthly payments automatically from the borrower’s bank account. The 0.25% AutoPay discount will not reduce the monthly payment; instead, the discount is applied to the principal to help pay the loan down faster.

Assumptions: Repayment examples above assume a loan amount of $10,000 with repayment beginning immediately following disbursement. Repayment examples do not include the 0.25% AutoPay Discount.

Annual Percentage Rate (“APR”): This term represents the actual cost of financing to the borrower over the life of the loan expressed as a yearly rate.

Interest Rate: A simple annual rate that is applied to an unpaid balance.

Variable Rates: The current index for variable rate loans is derived from the one-month London Interbank Offered Rate (“LIBOR”) and changes in the LIBOR index may cause your monthly payment to increase. Borrowers who take out a term of 5, 7, or 10 years will have a maximum interest rate of 9%, those who take out a 15 or 20-year variable loan will have a maximum interest rate of 10%.


This information is current as of April 29, 2021. Information and rates are subject to change without notice.

6 Important Disclosures for Navient.

Navient Disclosures

You can choose between fixed and variable rates. Fixed interest rates are 2.99% – 8.24% APR (2.74% – 7.99% APR with Auto Pay discount). Starting variable interest rates are 1.99% APR to 8.24% APR (1.74% – 7.99% APR with Auto Pay discount). Variable rates are based on an index, the 30-day Average Secured Overnight Financing Rate (SOFR) plus a margin. Variable rates are reset monthly based on the fluctuation of the index. We do not currently offer variable rate loans in AK, CO, CT, HI, IL, KY, MA, MN, MS, NH, OH, OK, SC, TN, TX, and VA.

7 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.

Subject to floor rate and may require the automatic payments be made from a checking or savings account with the lender. The rate reduction will be removed and the rate will be increased by 0.25% upon any cancellation or failed collection attempt of the automatic payment and will be suspended during any period of deferment or forbearance. As a result, during the forbearance or suspension period, and/or if the automatic payment is canceled, any increase will take the form of higher payments. The lowest advertised variable APR is only available for loan terms of  5 years and is reserved for applicants with FICO scores of at least 810.

As of 11/15/2021 student loan refinancing rates range from 1.90% APR – 5.25% Variable APR with AutoPay and 2.49% APR – 7.75% Fixed APR with AutoPay.

8 Important Disclosures for PenFed.

PenFed Disclosures

Fixed Rate Loan Terms: 5 years/60 monthly payments, 8 years/96 monthly payments, 12 years/144 monthly payments or 15 years/180 monthly payments. Annual Percentage Rate is the cost of credit calculating the interest rate, loan amount, repayment term and the timing of payments. Fixed rates range from 3.29% to 5.43% APR. Rates are subject to change without notice. Fixed APR: Fixed rates will not change during the term. This rate is expressed as an APR. Since there are no fees associated with this loan offer, the APR is the same percentage as the actual interest rate of the loan. These rates are 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.