BLS figures put the median pay for nurse practitioners in Fresno, CA, at $166,570 a year. It runs 29% above the national median of $129,030 for this occupation — pay here is notably stronger than the U.S. average. The middle 50% land between $138,900 and $191,270 — a 52,370 range that reflects differences in seniority, employer type, and specialization. The average (mean) of $167,690 comes in higher than the median, which usually means a share of high earners is pulling the average up. The catch: Fresno is roughly in line with the national cost of living (cost index 100 against a 100 baseline), so that headline number buys less than it would elsewhere. On an hourly basis that is about $80.08, useful for comparing contract or part-time offers.

For context, the national median for nurse practitioners across all U.S. metros in our data is $129,030.