Pathways / What routes cost
What each route costs
Published fees for 10 of 20 routes, checked 2026-11-10. Steps without a published price are listed, not guessed, so where any are listed the total covers only what is priced.
Informational only. Fees change; confirm the current fee with the body that charges it before you pay. Member prices need a separate membership.
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How the totals work
Each total adds one option per choice: where a step offers FP-C or CFRN, or a member and non-member fee, the first listed option is counted and the others are shown for comparison. Currencies are never added together. Experience and hiring steps are not purchases and are left out, and so is the credential a route starts from. A fee many employers pay after hire, such as offshore survival training, is shown but not counted unless you tick it. On a route's page in Pathways you can tick the steps you already have and pick your options; that plan stays in your browser.
EMT to paramedic
Priced steps: $175; 2 steps have no published price; 1 priced step also has parts with no published price.
| Step | Fee | Amount | Source |
|---|---|---|---|
| 4. Complete certification and state authorization | National Registry paramedic applicationNational Registry of EMTs. Charged for each exam attempt. | $175 | National Registry of EMTs — Paramedic certification process“The Paramedic application fee is $175. The fee is charged for each examination attempt” Checked 2026-11-10. |
Also no published price: Your state paramedic license fee.
Steps with no published price: 2. Choose a qualifying paramedic program · 3. Complete classroom and clinical education
Not counted: 1. Check your EMT foundation (your starting credential: a state EMT license or NREMT certification already meets this step)
Flight paramedic or flight nurse
Priced steps: $741; 1 priced step also has parts with no published price.
| Step | Fee | Amount | Source |
|---|---|---|---|
| 2. Earn the flight certificationChoose one; the first is counted. | FP-C exam, non-memberIBSC. Paramedic flight exam, computer-based or onsite. | $385 | IBSC — Exam fees (FP-C, CCP-C, CP-C)“Computer-Based (CBT) $285 (Affiliate Membership) $385 (non-members)” Checked 2026-11-10. |
| FP-C exam, IBSC affiliate memberIBSC. Affiliate membership price; membership is separate. | $285 | IBSC — Exam fees (FP-C, CCP-C, CP-C)“Computer-Based (CBT) $285 (Affiliate Membership) $385 (non-members)” Checked 2026-11-10. | |
| CFRN exam, non-memberBCEN. Flight nurse exam. | $380 | BCEN — CFRN frequently asked questions“Yes, the fee is $285 for professional association members and $380 for non-members.” Checked 2026-11-10. | |
| CFRN exam, professional association memberBCEN. Member price; association membership is separate. | $285 | BCEN — CFRN frequently asked questions“Yes, the fee is $285 for professional association members and $380 for non-members.” Checked 2026-11-10. | |
| 3. Keep resuscitation and trauma cards current | HeartCode ACLS online portionAmerican Heart Association. Online part only; the hands-on skills session is sold separately by a Training Center. | $178 | American Heart Association — HeartCode ACLS (online portion)“for more details or to schedule a hands-on session. × $178.00 Instock” Checked 2026-11-10. |
| HeartCode PALS online portionAmerican Heart Association. Online part only; the hands-on skills session is sold separately by a Training Center. | $178 | American Heart Association — HeartCode PALS (online portion)“for more details or to schedule a hands-on session. × $178.00 Instock” Checked 2026-11-10. |
Also no published price: ACLS and PALS hands-on skills sessions; A trauma course; NRP for neonatal programs.
Not counted: 1. Build high-acuity experience (experience, not a purchase) · 4. Apply to air-medical programs (hiring, not a purchase)
Ground critical-care transport
Priced steps: $385; 1 priced step also has parts with no published price.
| Step | Fee | Amount | Source |
|---|---|---|---|
| 2. Earn the transport certificationChoose one; the first is counted. | CCP-C exam, non-memberIBSC. Paramedic critical-care exam, computer-based or onsite. | $385 | IBSC — Exam fees (FP-C, CCP-C, CP-C)“Computer-Based (CBT) $285 (Affiliate Membership) $385 (non-members)” Checked 2026-11-10. |
| CCP-C exam, IBSC affiliate memberIBSC. Affiliate membership price; membership is separate. | $285 | IBSC — Exam fees (FP-C, CCP-C, CP-C)“Computer-Based (CBT) $285 (Affiliate Membership) $385 (non-members)” Checked 2026-11-10. | |
| CTRN exam, non-memberBCEN. Transport nurse exam. | $380 | BCEN — CTRN frequently asked questions“Yes, the fee is $285 for professional association members and $380 for non-members.” Checked 2026-11-10. | |
| CTRN exam, professional association memberBCEN. Member price; association membership is separate. | $285 | BCEN — CTRN frequently asked questions“Yes, the fee is $285 for professional association members and $380 for non-members.” Checked 2026-11-10. |
Also no published price: A critical-care preparation course.
Not counted: 1. Build critical-care experience (experience, not a purchase) · 3. Apply to critical-care transport teams (hiring, not a purchase)
Travel nurse
The one fee step on this route has no published price we could confirm.
Steps with no published price: 2. Set up your licenses
Not counted: 1. Get specialty experience (experience, not a purchase) · 3. Keep a real tax home (A tax-home rule, not a purchase.) · 4. Compare offers on what you keep (hiring, not a purchase)
Paramedic to registered nurse
Priced steps: $350; 3 steps have no published price; 1 priced step also has parts with no published price.
| Step | Fee | Amount | Source |
|---|---|---|---|
| 4. Check RN examination and authorityChoose one; the first is counted. | NCLEX registration, U.S. licensure, from Feb 1, 2027NCSBN (paid through Pearson VUE). No refunds. Applies to registrations from February 1, 2027; the fee is $200 until then. | $350 | NCSBN NCLEX — Fees and payment (scheduled change)“Effective Feb. 1, 2027, the NCLEX registration fee will be $350 in the United States and Australia.” Checked 2026-11-10. |
| NCLEX registration, U.S. licensure, before Feb 1, 2027NCSBN (paid through Pearson VUE). No refunds. Only if you register before February 1, 2027. | $200 | NCSBN NCLEX — Fees and payment“Registration Fee Candidates Seeking U.S. Licensure $200 USD” Checked 2026-11-10. |
Also no published price: Your state board of nursing application fee.
Steps with no published price: 1. Find a paramedic-to-RN bridge · 2. Complete the school's prerequisites · 3. Complete the nursing transition
LPN to registered nurse
Priced steps: $350; 3 steps have no published price; 1 priced step also has parts with no published price.
| Step | Fee | Amount | Source |
|---|---|---|---|
| 4. Plan the RN licensing stepChoose one; the first is counted. | NCLEX registration, U.S. licensure, from Feb 1, 2027NCSBN (paid through Pearson VUE). No refunds. Applies to registrations from February 1, 2027; the fee is $200 until then. | $350 | NCSBN NCLEX — Fees and payment (scheduled change)“Effective Feb. 1, 2027, the NCLEX registration fee will be $350 in the United States and Australia.” Checked 2026-11-10. |
| NCLEX registration, U.S. licensure, before Feb 1, 2027NCSBN (paid through Pearson VUE). No refunds. Only if you register before February 1, 2027. | $200 | NCSBN NCLEX — Fees and payment“Registration Fee Candidates Seeking U.S. Licensure $200 USD” Checked 2026-11-10. |
Also no published price: Your state board of nursing application fee.
Steps with no published price: 1. Find an LPN-to-RN transition track · 2. Meet the selected campus's admission gates · 3. Complete the transition curriculum
CNA to LPN or RN
Priced steps: $350; 2 steps have no published price; 1 priced step also has parts with no published price.
| Step | Fee | Amount | Source |
|---|---|---|---|
| 4. Complete the selected license routeChoose one; the first is counted. | NCLEX registration, U.S. licensure, from Feb 1, 2027NCSBN (paid through Pearson VUE). Same fee for NCLEX-PN and NCLEX-RN. No refunds. Applies to registrations from February 1, 2027; the fee is $200 until then. | $350 | NCSBN NCLEX — Fees and payment (scheduled change)“Effective Feb. 1, 2027, the NCLEX registration fee will be $350 in the United States and Australia.” Checked 2026-11-10. |
| NCLEX registration, U.S. licensure, before Feb 1, 2027NCSBN (paid through Pearson VUE). Same fee for NCLEX-PN and NCLEX-RN. No refunds. Only if you register before February 1, 2027. | $200 | NCSBN NCLEX — Fees and payment“Registration Fee Candidates Seeking U.S. Licensure $200 USD” Checked 2026-11-10. |
Also no published price: Your state board of nursing application fee.
Steps with no published price: 1. Choose LPN or RN · 3. Complete the selected education program
Not counted: 2. Check how your CNA record counts (experience, not a purchase)
Registered nurse to CRNA
None of the 4 fee steps has a published price we could confirm.
Steps with no published price: 1. Check the degree and RN license · 3. Enter an accredited doctoral program · 4. Complete doctoral education and the NCE · 5. Plan the practice-authority review
Not counted: 2. Build qualifying critical-care RN experience (experience, not a purchase)
Community paramedic
Priced steps: $385; 1 step has no published price; 1 priced step also has parts with no published price.
| Step | Fee | Amount | Source |
|---|---|---|---|
| 3. Get certifiedChoose one; the first is counted. | CP-C exam, non-memberIBSC. Computer-based or onsite. | $385 | IBSC — Exam fees (FP-C, CCP-C, CP-C)“Computer-Based (CBT) $285 (Affiliate Membership) $385 (non-members)” Checked 2026-11-10. |
| CP-C exam, IBSC affiliate memberIBSC. Affiliate membership price; membership is separate. | $285 | IBSC — Exam fees (FP-C, CCP-C, CP-C)“Computer-Based (CBT) $285 (Affiliate Membership) $385 (non-members)” Checked 2026-11-10. |
Also no published price: Minnesota community paramedic certification, if you work there.
Steps with no published price: 2. Complete a community paramedic course
Not counted: 1. Build paramedic experience (experience, not a purchase) · 4. Find a funded program (hiring, not a purchase)
Disaster medical response
No step on this route charges a fee you pay up front.
Not counted: 1. Match your skills to a team (experience, not a purchase) · 2. Compare deployment commitments (hiring, not a purchase) · 3. Apply to a specific USAJOBS announcement (hiring, not a purchase) · 4. Complete screening and team preparation (hiring, not a purchase)
Mine-site medic
None of the 3 fee steps has a published price we could confirm.
Steps with no published price: 1. Hold the right clinical license for the state · 2. Complete MSHA miner training · 3. Add site-hazard training
Not counted: 4. Apply to mine operators and site-medical contractors (hiring, not a purchase)
Occupational health medic or nurse
None of the 3 fee steps has a published price we could confirm.
Steps with no published price: 1. Hold a clinical license · 2. Add the testing certifications · 3. Learn the respirator and surveillance programs
Not counted: 4. Apply to clinics, employers and site-medical contractors (hiring, not a purchase)
Construction and plant turnaround medic
Priced steps: $127; 2 steps have no published price.
| Step | Fee | Amount | Source |
|---|---|---|---|
| 3. Get your TWIC | TWIC, new applicantTSA. Non-refundable; the card is valid five years. | $127 | TSA — Transportation Worker Identification Credential (TWIC)“New applicant: $127.00” Checked 2026-11-10. |
Steps with no published price: 1. Hold a license and occupational health skills · 2. Add site safety and rescue training
Not counted: 4. Get on contractor call lists (hiring, not a purchase)
Wind and solar site medic
None of the 3 fee steps has a published price we could confirm.
Steps with no published price: 1. Hold a license and remote-care experience · 2. Take GWO Basic Safety Training for wind work · 3. Learn the electrical and height hazards
Not counted: 4. Apply to site-medical contractors (hiring, not a purchase)
US offshore medic (Gulf of Mexico)
Priced steps: $302; 1 step has no published price; 1 priced step also has parts with no published price.
| Step | Fee | Amount | Source |
|---|---|---|---|
| 1. Get licensed and Registry-certified | National Registry paramedic applicationNational Registry of EMTs. Charged for each exam attempt. Skip this if you already hold NREMT paramedic. | $175 | National Registry of EMTs — Paramedic certification process“The Paramedic application fee is $175. The fee is charged for each examination attempt” Checked 2026-11-10. |
| 2. Get your TWIC | TWIC, new applicantTSA. Non-refundable; the card is valid five years. | $127 | TSA — Transportation Worker Identification Credential (TWIC)“New applicant: $127.00” Checked 2026-11-10. |
Also no published price: Your state paramedic license and the adjacent state's license (Louisiana for most Gulf work).
Steps with no published price: 3. Complete offshore safety training
Not counted: 4. Apply to offshore medical contractors (hiring, not a purchase)
Wildland fire medic
None of the 3 fee steps has a published price we could confirm.
Steps with no published price: 1. Keep your state license current · 2. Take the basic wildland fire courses · 3. Pass the Pack Test
Not counted: 4. Get hired for the season (hiring, not a purchase)
Wilderness and expedition medic
None of the 2 fee steps has a published price we could confirm.
Steps with no published price: 1. Hold a clinical license · 2. Add wilderness medicine training
Not counted: 3. Build field skills and references (hiring, not a purchase)
Motorsports and event medic
None of the 2 fee steps has a published price we could confirm.
Steps with no published price: 1. Hold an EMT or paramedic license · 2. Build trauma and off-road skills
Not counted: 3. Get on event company rosters (hiring, not a purchase)
UK offshore medic (North Sea)
Priced steps: £2,200; 1 step has no published price; 1 step has a published fee left unticked.
| Step | Fee | Amount | Source |
|---|---|---|---|
| 2. Complete an HSE-approved offshore medic course | HSE Offshore Medic, initial courseDDRC Healthcare, Plymouth. Provider's published price including VAT. A listed date is not a confirmed seat. | £2,200 | DDRC Healthcare — HSE Offshore Medic course (Plymouth)“Plymouth John Dillingham £2,200.00 incl. VAT” Checked 2026-11-10. |
| 3. Apply to offshore medical contractors | OPITO BOSIET with CA-EBS3t Global, Newcastle or Aberdeen. Provider's published price per person including VAT. Not counted unless you tick it: many contractors pay for this after hire, so ask first. | £986.40 | 3t Global — OPITO BOSIET with CA-EBS“Duration 3 Days Cost £986.40pp (inc VAT)” Checked 2026-11-10. |
Also no published price: OEUK offshore medical.
Shown but not counted unless you tick it on the route: OPITO BOSIET with CA-EBS
Steps with no published price: 1. Get UK registration
Ship, cruise and yacht medic
The one fee step on this route has no published price we could confirm.
Steps with no published price: 2. Get STCW basic safety training
Not counted: 1. Build acute experience (experience, not a purchase) · 3. Apply to cruise lines, yacht crew agencies and ship operators (hiring, not a purchase)
Sources for this page
- National Registry of EMTs — Paramedic certification process Checked November 10, 2026.
- IBSC — Exam fees (FP-C, CCP-C, CP-C) Checked November 10, 2026.
- BCEN — CFRN frequently asked questions Checked November 10, 2026.
- BCEN — CTRN frequently asked questions Checked November 10, 2026.
- American Heart Association — HeartCode ACLS (online portion) Checked November 10, 2026.
- American Heart Association — HeartCode PALS (online portion) Checked November 10, 2026.
- NCSBN NCLEX — Fees and payment Checked November 10, 2026.
- TSA — Transportation Worker Identification Credential (TWIC) Checked November 10, 2026.
- DDRC Healthcare — HSE Offshore Medic course (Plymouth) Checked November 10, 2026.
- 3t Global — OPITO BOSIET with CA-EBS Checked November 10, 2026.