Optometrist.
St. Louis.
$115,000
median salary, 10% below the national average
$97,000 to $142,000. Updated for 2026.
The numbers.
Everything you need to negotiate with confidence.
St. Louis is 10% cheaper than the national average. For Optometrists, that shakes out to a median of $115,000, with the full range spanning $97,000 to $142,000. Practice ownership versus employment is the largest income differentiator for optometrists. Know the range before you walk in.
Salary range
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How St. Louis compares
St. Louis, MO
$115,000
Cost of living: 10% below average
National Average
$128,000
St. Louis is $13,000 below
What you should know
The Optometrist landscape in St. Louis is not what most salary sites will tell you. St. Louis offers one of the most affordable major metro areas in the country, with a strong base in healthcare, financial services, and manufacturing. The region's anchor employers include Boeing, Centene, and Washington University's medical campus. A growing biotech and plant sciences corridor centered on the Cortex Innovation District is attracting new investment and talent. Practice ownership versus employment is the largest income differentiator for optometrists. States with expanded scope allowing therapeutic procedures and medical management increase earning potential. Optometrists specializing in ocular disease management, specialty contact lenses, or pediatric vision earn above those in routine refraction-only settings.
New associate optometrists start at $105,000 to $120,000 on base plus production models. Experienced ODs with strong patient loyalty earn $130,000 to $155,000 after five to seven years. Practice owners or partners in multi-doctor practices can reach $170,000 to $250,000 depending on revenue and overhead management. In St. Louis, cost of living sits near the national average, so the numbers you see are roughly what you keep.
Base salary is not the full picture. Employed optometrists typically receive production bonuses of 15 to 25% above a base salary guarantee. Benefits include vision and health insurance, CE allowances, malpractice coverage, and optical frame discounts. Practice owners retain higher gross income but manage significant overhead. And on the tax side: missouri's top income tax rate is about 4.8%, and St. Louis City adds a 1% earnings tax. The low base cost of living means your after tax salary still stretches further than in most metros. When someone quotes you $115,000, ask what the total package looks like. The gap between base and total comp is where real money hides.
On negotiation: Emphasize your willingness to work in person at Cortex or the BJC campus. St. Louis employers offer higher packages for candidates who commit to the local innovation hubs. The range for Optometrists in St. Louis runs from $97,000 to $142,000. That is not a narrow window. Where you land inside it depends almost entirely on whether you negotiate and how well you prepare.
Top industries in St. Louis
Negotiating in St. Louis
Emphasize your willingness to work in person at Cortex or the BJC campus. St. Louis employers offer higher packages for candidates who commit to the local innovation hubs.