Boomers weighing long term care costs will have to factor in their location, as a new study commissioned by Northwestern Mutual reveals some Americans are spending almost seven times more for certain LTC services than others.

A survey of nearly 7,000 home health care providers, assisted living facilities and nursing homes shows the biggest difference was the hourly wage of Home Health Aides (HHAs). Furthermore, the cost of nursing home care also varied across the country. Those living in Lafayette, La., for example, are at a better cost advantage, spending an average $118 a day for a private nursing home room as compared to residents in New York City, which averages $590 a day.

Those living in the Northeast will have to fork over at least twice as much as residents in North Dakota, where the average cost for care in an assisted living facility, the least expensive in the nation, is $1,901 a month (Maryland alone averages $4,289); Hawaii is the most expensive with an average of $4,406.

“These differences in cost for long-term care services illustrate the choices Americans have and the questions they should ask themselves,” says Northwestern Mutual’s Terence Holahan. “Americans should prioritize. Is it important to live in close proximity to family, or in a moderate climate? Do you want to remain in your own home, or would you prefer a retirement community? All of these considerations will impact your budget for long-term care.”

View Northwestern Mutual’s entire survey here.