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The highest paid EKG technicians in the United States tend to work in major metropolitan areas such as Los Angeles, California, where the average hourly wage is approximately $28.93, and New York City, New York, with an average of about $28.44 per hour. These cities offer higher compensation due to factors like increased demand for healthcare services, higher living costs, and the presence of larger healthcare facilities that require specialized technicians. Salaries can vary based on experience, certifications, and the specific healthcare setting, but generally, urban centers with more advanced medical infrastructure tend to provide the highest wages for EKG technicians.