Based on recent data, the states that pay registered nurses the lowest average salaries are South Dakota, Arkansas, and Alabama. Specifically, South Dakota offers an average annual wage of approximately $64,500, Arkansas around $66,530, and Alabama about $66,910. However, when evaluating these figures, it is essential to consider the cost of living in each state, as lower wages may be offset by a lower cost of living, making the overall quality of life comparable or even better than in higher-paying states. Factors such as housing costs, taxes, and healthcare expenses can significantly influence the real value of these wages for RNs living and working in these regions.