(Inner Harbor in Baltimore) 15. Maryland--Average Annual LTC Cost: $60,305 // Adult day care: $2,150 // Licensed home care: $52,281 // Assisted living: $49,800 // Nursing home (private room): $118,990
(Prospect Terrace Park in Providence, RI) 14. Rhode Island--Average Annual LTC Cost: $60,789 // Adult day care: $19,500 // Licensed home care: $57,772 // Assisted living: $61,860 // Nursing home (private room): $104,025
(Hollywood Blvd in Los Angeles) 13. California--Average Annual LTC Cost: $61,239 // Adult day care: $20,020 // Licensed home care: $57,200 // Assisted living: $51,300 // Nursing home (private room): $116,435
(Seattle Seahawk fans cheering. Photo: AP) 12. Washington--Average Annual LTC Cost: $61,704 // Adult day care: $16,900 // Licensed home care: $60,632 // Assisted living: $55,920 // Nursing home (private room): $113,362
(Skier on the slopes at a Killington, Vermont, resort. Photo: AP) 11. Vermont--Average Annual LTC Cost: $63,139 // Adult day care: $34,320 // Licensed home care: $57,200 // Assisted living: $49,527 // Nursing home (private room): $111,508

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(State capitol in Bismarck, ND. Photo: AP) 10. North Dakota--Average Annual LTC Cost: $64,010 // Adult day care: $25,480 // Licensed home care: $63,972 // Assisted living: $36,219 // Nursing home (private room): $130,367
(Lobster boats in Portland) 9. Maine--Average Annual LTC Cost: $64,423 // Adult day care: $28,080 // Licensed home care: $53,768 // Assisted living: $58,680 // Nursing home (private room): $117,165
(Times Square in New York) 8. New York-Average Annual LTC Cost: $65,852 // Adult day care: $20,800 // Licensed home care: $54,340 // Assisted living: $47,850 Nursing home (private room): $140,416
(The Corbin Covered Bridge in Newport, New Hampshire. Photo: AP) 7. New Hampshire--Average Annual LTC Cost: $66,044; Adult day care: $18,720; Licensed home care: $60,357 // Assisted living: $58,260 // Nursing home (private room): $126,838
(Old Capitol Building in Dover.) 6. Delaware--Average Annual LTC Cost: $68,472 // Adult day care: $18,850 // Licensed home care: $50,908 // Assisted living: $72,180 // Nursing home (private room): $131,948

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(Boat on Atlantic City beach) 5. New Jersey--Average Annual LTC Cost: $68,833 // Adult day care: $23,400 // Licensed home care: $52,624 // Assisted living: $69,732 // Nursing home (private room): $129,575
(Waikiki shoreline in Honolulu.) 4. Hawaii--Average Annual LTC Cost: $71,820 // Adult day care: $18,200 // Licensed home care: $59,488; Assisted living: $51,000 // Nursing home (private room): $158,593
(A statue of the Spirit of Victory in Bushnell Park in Hartford. Photo: AP) 3. Connecticut--Average Annual LTC Cost: $72,671 // Adult day care: $20,800 // Licensed home care: $52,624 // Assisted living: $55,200 // Nursing home (private room): $162,060
(Beacon Hill in Boston) 2. Massachusetts--Average Annual LTC Cost: $73,307 // Adult day care: $16,900 // Licensed home care: $59,488 // Assisted living: $67,188 // Nursing home (private room): $149,650
(Crabbers on the fishing grounds in southeast Alaska. Photo: AP) 1. Alaska--Average Annual LTC Cost: $117,800 // Adult day care: $43,709 // Licensed home care: $63,492 // Assisted living: $72,000 // Nursing home (private room): $292,000

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In this year’s version of Genworth Financial’s annual study on the cost of care nationwide—not just in nursing homes, which are less and less on the forefront, but also care provided at home, adult day care and assisted living facilities—the news is not reassuring. Costs have risen steadily, with those for licensed homemakers—those who provide what the study calls “hands-on personal care” for patients still in their homes—rising the fastest, increasing 6.17% just since last year.

And of course since people would prefer to stay in their homes, that’s going to hit a lot of people hard.

(Related: Top 15 Cheapest States for Long-Term Care: 2017)

Less-skilled “homemaker care,” such as cooking, cleaning and running errands (not included in the breakdown that follows) has risen pretty quickly as well, increasing by 4.75% since last year. But both versions of homemaker assistance are at the low end on the price scale, coming in at $21 for homemaker care and $22 for licensed homemaker care. The big bucks are elsewhere.

They may not have risen as quickly percentage-wise as the two already mentioned, but adult day care increased by 2.94% since last year to a national median rate of $70 per day. Assisted living facilities now average a median monthly rate of $3,750, an increase of 3.36% from last year, while nursing homes, at an increase of 5.50% for a private room, now run a median daily rate of $267. No matter how you look at it, that’s a lot of money..

Check out the 15 most expensive states for LTC in the carousel above: