South Dakota includes three key cities, namely Rapid City, Sioux City and Sioux Falls. These three cities offer a different rate in terms of medical assistant salary in South Dakota. The location is one of the factors affecting the pay. Results showed that the salary based on the national average median in these key cities are as follows: Rapid City (25,630 dollars), Sioux City (27,280 dollars), and Sioux Falls (26,980 dollars). The national average is pegged at 26,840 dollars. The state is very small; that is why the medical assistant profession is not as lucrative compared with others. The US Bureau of Statistics said that due to the competition in the place, medical assistants must be well prepared to compete for the job.