Ask “how much does it cost to become a CNA” and you’ll get a different answer depending on which state’s marketing page you land on — and most of those pages don’t say when the number was last checked. We built our CNA requirements hub to fix that: 51 verified records, each fee traced to the state board or exam vendor that actually charges it, dated the day we checked. This post pulls the numbers together and shows what the comparison actually looks like.
How we calculated “cost”
To keep the comparison consistent, we use the same formula our comparison table uses everywhere on the site: application fee, plus license/certification fee, plus every exam fee, added together. We deliberately exclude fees that only apply in specific circumstances — late renewal penalties, duplicate-certificate fees, reciprocity application fees — since those aren’t part of getting certified the first time. A state only gets a total when at least one of those inputs is a documented number; if every input is unknown, we show that honestly instead of guessing.
Texas: $120, and a useful baseline
Texas is a good starting point because its structure is typical: no separate state application or license fee, just two exam components administered by Prometric — a $31 Written Competency Exam and an $89 Clinical Skills Exam, for a documented total of $120. See the full breakdown, including the oral-exam alternative, on our Texas CNA page.
The lowest documented costs — and one true $0 state
Most “cheap” states aren’t actually $0 — they’re states where part of the fee is unpublished, which is a different thing entirely (more on that below). But one state really is documented at $0 from application to exam: Arizona. Federal law (42 CFR §483.152 and §483.154) prohibits states from charging nurse aide candidates for competency testing or registry placement, and Arizona’s baseline CNA tier follows that rule to the letter — the only fee that exists is a $50 charge for Endorsement, which only applies if you’re transferring an existing out-of-state certification rather than testing for the first time. Details and sourcing are on our Arizona CNA page.
A handful of other states come close, with small but real documented totals: Vermont at $25, Idaho at $29, and Rhode Island at $35 — see Vermont, Idaho, and Rhode Island for the itemized fees.
The most expensive documented costs
At the other end, New Hampshire’s documented total is $283 — a $63 application fee (which itself bundles a $28 Professional Health Program fee), a $20 certificate fee, and a $200 combined written-and-skills exam fee charged by Excel Testing, the board’s approved testing agency. That’s before the state’s separate $47 fingerprinting/background-check fee, which isn’t part of our comparable total but is a real out-of-pocket cost every candidate pays. Full sourcing is on our New Hampshire CNA page.
Other states with high, fully documented totals include Alaska ($260, including a $75 nonrefundable fingerprint-processing fee baked into the state’s own charges), Hawaii ($225), and Michigan ($215). Across the 42 states where we could document a complete total, the median is $130 and the mean is $126 — so New Hampshire and Arizona both sit well outside the typical range, in opposite directions.
Why nine states don’t get a total at all
Nine of the 51 records — Delaware, Kansas, Minnesota, North Carolina, Nebraska, Nevada, Oklahoma, Tennessee, and West Virginia — show no combined total on our comparison table, and that’s deliberate rather than an oversight. In each of these, the state board doesn’t publish a consolidated fee schedule that names a dollar amount for the exam itself; the exam is typically administered by a third-party vendor (Prometric, Credentia, Headmaster) under contract, and that vendor sets its own price outside the board’s own published pages. Rather than estimate, we record the fee as unknown and say so, with a note explaining exactly what we could and couldn’t verify.
Maine is a particularly clear example of why this distinction matters. Maine’s Department of Health and Human Services confirms, in writing, that application, license, and renewal are all $0 — federal law again — but the Prometric exam fee itself isn’t published anywhere on an official Maine source, and Prometric’s own candidate bulletin returned a bot-block with no retrievable archive snapshot. So Maine isn’t “free” the way Arizona is; it’s “no state fee, plus an exam fee we can’t currently confirm.” That’s a meaningfully different claim, and conflating the two is exactly the kind of error that shows up on aggregator sites that don’t distinguish “$0” from “not found.”
Same state, different price: the exam-vendor problem
Even within a single state, the price can vary by which vendor or provider you use. Iowa is a clean example: its Direct Care Worker Registry accepts written exam results from two different providers at two different prices — $50 through Headmaster or $70 through Credentia — and skills exam results from a community college ($115) or Health Tech Associates ($135). A candidate who picks the cheaper combination pays $165 total; a candidate who picks the pricier combination pays $205, for the identical credential. See our Iowa CNA page for the full vendor breakdown.
Check your specific state
State-level averages are a starting point, not a substitute for your own state’s current numbers — fee schedules change, and a vendor contract can shift the exam price without much notice. Our CNA comparison table is sortable by cost, training hours, and renewal cycle across all 51 jurisdictions, and every figure links back to its source and the date we checked it. For more on how we source and re-verify these numbers, see our methodology.