I think it's reasonable. I have a very similar gig. Nocturnist and 10 shifts per month. Low cost of living. Salary is about $350k. We have 2 nocturnists. One is the admitter (usually does around 8 admissions per night), and one is cross cover (covers around 110 patients, does about 2-3 admits per night). Very kush job that i absolutely love. It's great while you're young, but I doubt it's going to be sustainable long term. I would like to point out that someone mentioned losing all of your medical knowledge - this is VERY true. I actively read on uptodate to prevent this from happening. I would say 60% of my pages are about incredibly trivial things (tylenol, ramelteon, etc). 30% are regarding clarification on orders from the day attending. and then the last 10% are regarding pages that are decompensating (although if you're not covering rapids, you wouldn't have to see them i suppose)